Metastatic Breast Cancer

A diagnosis of breast cancer is always frightening. Even if you and your health care provider have caught the disease in its early stages, breast cancer can still be a very scary thing to have to deal with. For the most part, breast cancer is diagnosed early on, thanks to the help of mammograms and breast self examination. Unfortunately though, breast cancer can sometimes be too far advanced to treat effectively. Metastatic breast cancer is the most advanced stage of breast cancer. Though this type of cancer cannot be gotten rid of completely, there are some effective treatments available to help reduce your symptoms, increase your comfort, and extend your life expectancy.

What is Metastatic Breast Cancer?
Metastatic breast cancer is the name given to the most advanced type of breast cancer. Also known as Stage IV breast cancer, this type of cancer occurs when cancer cells have spread from the original tumor site to different areas of your body. Cancer cells can travel through your lymphatic system and blood vessels, taking root in almost any area of your body. Here, the cancer cells multiply and grow, attacking bodily function and compromising overall health. 10% of all cases of metastatic breast cancer are found upon initial diagnosis. Metastic breast cancer can also occur during breast cancer recurrence.

Where Can Breast Cancer Spread?
Unfortunately, breast cancer can spread to almost any organ inside your body. Regional metastases spread to the areas surrounding the breast while distant metastases can spread to faraway organs. The most common sites for metastases include the bones, the lungs, and the liver.

 

• Bone Metastases: Bone metastases account for 25% of all metastatic breast cancers. There are two main types of bone cancer: osteolytic and osteoblastic. Osteolytic cancer eats away at your bones, causing holes to form. This leaves bones open to breaks and fractures. Osteoblastic cancer increases the density of your bones, but also makes them prone to fracture. Both forms of bone cancer cause pain.
• Lung Metastases: Lung metastases account for 60% to 70% of the deaths associated with metastatic breast cancer. It occurs when cancer begins to form inside of your lungs. It is often symptomless.
• Liver Metastases: Liver metastases occur in two-thirds of metastatic breast cancers. It occurs when cancer cells begin to multiply inside your liver�s tissues. It is often associated with intense symptoms.

 

Though less common, breast cancer can also spread to the eyes, brain, ovaries, and spinal cord.

Symptoms of Metastatic Breast Cancer
Unfortunately, symptoms of metastatic breast cancer generally don�t occur until the very advanced stages. Symptoms also depend upon the areas in which the cancer has spread to. When symptoms do manifest, they commonly include:

 

• regional pain
• weight loss
• gastrointestinal problems
• bone fractures and bone pain
• headaches
• weakness
• fever and chills

 

Diagnosing Metastatic Breast Cancer
Metastatic breast cancer can be diagnosed in a number of different ways. Because breast cancer cells first travel to the axillary (armpit) lymph nodes, these nodes are generally removed during breast surgery and analyzed for the presence of cancer. If these nodes test positive for cancer cells, further diagnostic procedures can be performed including:

 

• bone scans
• x-rays
• MRI (magnetic resonance imaging)
• CAT scans (computed axial tomography)

 

Sometimes however, breast cancer cells do not travel through the lymph system. In this case, a blood test known as the tumor marker test is administered. This blood test tracks changes in the levels of certain markers in the blood (specifically CA-153 and CEA). Metastatic breast cancers are often associated with high levels of these markers.

Treating Metastatic Breast Cancer
Treatment for advanced breast cancer focuses on providing symptom relief and extending your life expectancy. With stage 4 breast cancer, it is typically impossible to kill all of the existing cancer cells. However, breast cancer treatments can shrink existing tumors or slow the growth of cancer cells. Treatments can target the entire body or local regions to which cancer has metastasized.

Whole Body Treatments
Whole body treatments include:

 

• Hormonal Therapy: Hormone therapy targets female hormones in the body, specifically estrogen. Estrogen can cause cancer cells to develop rapidly.
• Chemotherapy: Chemotherapy is a treatment that uses anti-cancer drugs to kill and slow the growth of all cancer cells.

 

Local (Regional) Treatments
Local treatments can include:

 

• Surgery: Small tumors can be removed from specific areas, including the lungs and liver. Surgery can also be performed to replace broken bones and joints.
• Radiation: Radiation can be helpful in stopping the growth of small sections of cancer, particularly bone cancer.

 

Symptom Relief:
As your cancer progresses, you will begin to notice that your symptoms become worse. Pain management is an important part of treating metastatic breast cancer. Common pain treatments include:

 

• opioids
• NSAIDS (non-steroidal anti-inflammatory drugs)
• aspirin

 

Alternative therapies, including acupuncture and massage, also prove helpful when it comes to dealing with cancer pain.