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Metastatic Breast Cancer

Learning that your breast cancer has spread to another part of your body can understandably cause tremendous fear and uncertainty. But there are effective treatment options for metastatic breast cancer, and many women find that these treatments effectively control their cancer with relatively few side effects, and providing a good quality of life as well.

Metastatic breast cancer is also called late stage, which is considered to be stage IV. Metastatic breast cancer describes a cancer that has spread from the original tumor site in the breast, past the breast and axillary (underarm) lymph nodes to other areas of the body where they continue to grow and multiply. Breast cancer has the potential to spread to almost any region of the body. The original tumor that cells break away from is called the primary tumor The new tumor that the traveling cells create is called the secondary tumor. The most common region breast cancer spreads to is the bone, followed by the lung, liver and brain. Treatment of metastatic breast cancer generally focuses on relieving symptoms and extending a woman’s lifetime.

In 10% of breast cancer diagnoses, the cancer has already spread to distant organs in the body. A primary diagnosis of Stage IV breast cancer may indicate a rapid progression of the disease or that the cancer was present but not detected in the breast for some time.

Metastatic breast cancer may also occur from a recurrence (return) of breast cancer after initial treatment. There are three types of breast cancer recurrences: local, regional, and distant. Local and regional recurrences are usually less serious than distant recurrences and may be detected by mammogram or seen as abnormalities with breast imaging exams (such as ultrasound or T-scan). Once a local or regional recurrence is detected, physicians will order a variety of other tests to determine whether the cancer has metastasized (spread) to distant organs. These tests include:

  • Bone scan
  • Chest X-ray
  • CAT scan
  • MRI scan
  • Blood Tests

Symptoms depend upon the areas in which the cancer has spread to. When symptoms do manifest, they commonly include:

  • Bone pain (possible indication of bone metastases)
  • Shortness of breath (possible indication of lung metastases)
  • Lack of appetite (possible indication of liver metastases)
  • Weight loss (possible indication of liver metastases)
  • Neurological pain or weakness, headaches (possible indications of neurological metastases)

These symptoms are sometimes but not always associated with metastatic breast cancer, and having one or more of these symptoms does not necessarily mean a woman has metastatic breast cancer. Most women whose breast cancer has metastasized do not show symptoms until the disease is extensive.

  • 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, ovaries, and spinal cord.


The majority of treatments for metastatic breast cancer focus on alleviating symptoms. Therapies will differ depending on the patient’s history of treatment and how well she responds to specific therapies.

Surgery is rarely an option because the cancer is not usually confined to one specific spot on the organ. Radiation therapy may be used, depending on the extent to which the cancer has spread throughout an organ. The purpose of radiation therapy in cases of metastatic breast cancer is usually to shrink the cancer and provide pain relief. If cancer is only on one or more spots of the bone, for example, radiation may be done.

Systemic therapies such as chemotherapy or other drug therapies are usually given to advanced breast cancer patients because they affect the entire body (as opposed to localized treatments that only affect one area). Chemotherapy is treatment with anti-cancer drugs. Most courses are three to six months long and may be given daily, weekly, or monthly, depending on the body’s response to the drugs. Chemotherapy sessions are not usually continuous; they include rest cycles because chemotherapy targets both healthy and cancerous cells.

Last Updated on Thursday, 21 January 2010 10:14