Breast Cancer and Metastasis: What to Expect

Metastatic cancer is cancer that’s spread to a different part of the body than where it originated. For example, a person who has been cured of breast cancer may be later diagnosed with distant recurrent cancer in the lungs. Metastatic cancer is a form of recurrent cancer. Recurrent cancer is cancer that comes back after your initial treatment.

Metastasis and recurrence can occur with almost every type of cancer.

The most common metastasis locations for breast cancer are the:

• bones
• liver
• lungs
• brain

Metastatic breast cancer is considered advanced-stage cancer. This cancer may occur months to years after initial breast cancer treatment.

Breast cancer may recur locally, regionally, or distantly:

• Local recurring breast cancer occurs when a new tumor develops in the breast originally affected. If the breast has been removed, the tumor may grow in the chest wall or nearby skin.
• Regional recurring breast cancer happens in the same region as the original cancer. In the case of breast cancer, this may be the collarbone or armpit lymph nodes.
• Distant recurring breast cancer happens when cancer cells travel to a different part of the body. This new location is far away from the point of origin. When cancer recurs distantly, it’s referred to as metastatic.

Not everyone with metastatic breast cancer experiences symptoms. When symptoms do occur, they can vary. Symptoms depend on where the metastasis appears and its severity.

The symptoms of metastatic breast cancer may include:

• persistent bone, back, or joint pain
• difficulty urinating
• numbness
• weakness
• persistent dry cough
• weight loss
• shortness of breath
• difficulty breathing
• a loss of appetite
• abdominal pain and bloating
• nausea
• vomiting
• jaundice, or yellowing of the skin and the whites of the eyes
• severe headaches
• seizures
• a loss of balance
• confusion

Initial breast cancer treatments are intended to eliminate any cancer cells that may remain after surgery. Potential treatments include radiation, hormone therapy, and chemotherapy.

In some cases, some cancer cells survive these treatments or break away from the original tumor. These cells then make their way to other parts of the body via the circulatory or lymphatic systems. Once the cells settle somewhere in the body, they may remain dormant for years. The cells may be eliminated by the body’s immune system or eventually form a new tumor.

Several tests are used to confirm a diagnosis of metastatic breast cancer. These include:

• an MRI
• a CT scan
• X-rays
• a positron emission tomography (PET) scan
• a tissue biopsy

There isn’t a cure for metastatic breast cancer. Instead, there are treatments aimed at preventing further progression, reducing symptoms, and improving the quality and length of life. Treatments are individualized. They depend on the type and extent of recurrence, previous treatment received, and your overall health.

Treatment options may include:

• hormone therapy for ER-positive breast cancer, which is the most common type of breast cancer
• chemotherapy for ER-negative breast cancer or for breast cancer when hormone treatment isn’t effective
• medications that target specific types of cancer cells, or targeted therapy, for HER2-positive breast cancer
• bone-building drugs to reduce bone pain and increase bone strength
• radiation therapy
• surgery

The drug Ibrance was approved in 2015 by the U.S. Food and Drug Administration (FDA) for use in conjunction with hormone therapy. This combination can treat ER-positive, HER2-negative metastatic breast cancer that hasn’t previously been treated with hormone therapy in postmenopausal women.

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The drug combination that includes the following is another recent option for women.

• pertuzumab
• trastuzumab
• chemotherapy

This treatment is meant for women with HER2-positive metastatic breast cancer.

Deciding which treatment option is best is a personal decision. While you should work with your doctor to understand your options, ultimately the choice is up to you. As you consider the possibilities, keep these tips in mind:

• Don’t rush into anything. Take time to consider your choices, and get a second opinion if necessary.
• To make sure you don’t forget anything that’s discussed, bring someone with you to your doctor appointments. Take notes or ask your doctor if you can record your visit.
• Ask your doctor to explain all potential benefits, risks, and side effects associated with each treatment.
• Find out if there are any clinical trials for which you may be eligible.

Although receiving a metastatic breast cancer diagnosis can be overwhelming, there’s reason to have hope. Research on how to stop cancer cell growth, boost the immune system, and disrupt cancer metastasis is ongoing. Thanks to treatment breakthroughs, women are living longer than ever before with the condition.

There isn’t a definitive way to guarantee that you won’t get metastatic breast cancer, but there are steps you can take to reduce your risk. These steps include:

• maintaining a healthy weight
• quitting smoking
• staying active
• eating more fresh fruits and vegetables (at least 2 ½ cups daily), legumes, whole grains, poultry, and fish
• reducing your intake of red meat and only eating lean red meat in smaller portions
• avoiding processed and sugar-laden foods
• cutting back on alcohol to one drink per day for women