Metastatic breast cancer (MBC), or stage 4 breast cancer, is a late-stage breast cancer that has spread beyond the breast to other parts of the body. Many women who are diagnosed are often only given several years to live because of its severity.
According to the American Cancer Society, the five-year relative survival rate for metastatic breast cancer is 31%, meaning that roughly 1 in 3 women diagnosed with metastatic breast cancer are still alive at the end of five years.
While the statistics are jarring, advancements in technology and treatments have come a long way, and some women can survive up to 15 years after their diagnosis, living relatively pain-free.
To better understand just how much metastatic breast cancer affects the entire body, and what women who are suffering from the disease should know, Flow Space spoke with Pennsylvania-based surgical oncologist and Lehigh Valley Topper Cancer Institute‘s deputy physician in chief Dr. Lori Alfonse.
Flow Space: What exactly is metastatic breast cancer and how does it affect the body?
Dr. Lori Alfonse: Metastatic breast cancer is cancer that began in the breast and then progressed to other parts of the body. Common sites for metastatic breast cancer include bone, liver, lung and, in some cases, brain.
Symptoms of metastatic breast cancer depend on the site of distant disease. For example, unrelenting back pain that wakes a patient from sleep and is not relieved by traditional methods of NSAIDs (nonsteroidal anti-inflammatory drugs) or rest can represent metastatic breast cancer to the bone.
Metastasis to the lung may cause a dry, unrelenting cough. Metastatic disease to the liver may cause gastrointestinal symptoms of nausea and vomiting and may also cause jaundice, which is the yellowing of the eyes and skin.
Does metastatic breast cancer affect certain people more than others and what treatments are currently available?
Any tumor biology of breast cancer can produce metastatic disease, but the more aggressive types—or “triple negative” breast cancer, meaning breast cancer that lacks estrogen, progesterone and human epidermal growth factor receptor 2 (HER2) receptors—tend to produce more metastatic disease than the other tumor types.
There are many different types of systemic therapies that can be used to treat metastatic breast cancer, depending on the tumor biology. Radiation can also be used to palliate painful bone metastases, as well as chemotherapy.
Does breast density increase your risk of breast cancer?
Breast density affects the risk of breast cancer detection.
For example, dense breast tissue may hide small, early cancers and should be supplemented with other imaging studies such as ABUS (automated breast ultrasound) or breast MRI. Truthfully, we do not know the exact reason why dense breasts are at an increased risk of developing cancer, but some theories suggest the increase in number of cells and active tissue in dense breasts may be the cause.
What hope or advice can you offer patients who have metastatic breast cancer?
Many patients with metastatic breast cancer may live many years by undergoing treatments that keep the disease from progressing.
A great friend and patient once described living with metastatic breast cancer as riding on a train—you are undergoing a treatment that is controlling disease progression, and you ride that train until that treatment stops working. Then, you get “off that train” and get on a different train with a different treatment and ride that out as long as it is effective.
In some cases, metastatic breast cancer can be compared to other chronic medical conditions, such as heart disease or COPD (chronic obstructive pulmonary disease); a patient with these disease processes is going to be diligent about taking their medications and getting the appropriate lab work and imaging studies. This is also the case with metastatic breast cancer patients.
What can women do who are worried about being diagnosed with metastatic breast cancer?
I encourage everyone to mitigate their risk for metastatic breast cancer through early detection efforts. That means regular annual screenings for women 40 and older but also should include self-examinations, especially for younger women who have not yet begun annual screenings.
You know your own body better than anyone, and the sooner you can understand what your body’s “normal” is, the better equipped you’ll be for identifying an abnormality and seeking testing and treatment if necessary.