Table of ContentsView AllTable of ContentsLocation of MetastasesBreast Cancer StagingTreatmentSurvival RatesMonitoringCopingFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Location of Metastases
Breast Cancer Staging
Treatment
Survival Rates
Monitoring
Coping
Frequently Asked Questions
Stage 4breast cancer(called metastatic cancer) is often diagnosed whencancer recurs, although it may sometimes be discovered at the initial diagnosis.Metastatic breast canceris not curable, but treatment can help control the spread of the disease and provide quality of life.
Some people are able to thrive with this chronic disease, including writer Katherine Russell Rich, author ofThe Red Devil.She found a breast lump and was diagnosed with stage 4 breast cancer, which has a five-year survival rate of 29%.However, she survived 25 years after her diagnosis.
This article will give an overview of stage 4 breast cancer, what it means for most people, how it’s treated, and its outlook.
Verywell / JR Bee
Stage 4 breast cancer is diagnosed when cells from aprimary tumorin the breast spread to other parts of the body and establish one or moresecondary tumors.
Breast cancer can spread to nearly any organ of the body. The location ofmetastasescan vary but tends to follow a similar pattern based on the type of breast cancer.
For example:
Cancers metastasize at differenttimes and speeds. For example, estrogen receptor-positive tumors tend to be around 3 centimeters (1.2 inches) in diameter before they metastasize. By contrast, HER2-positive (human epidermal growth factor receptor 2-positive) tumors may be less than 1 centimeter (0.4 inches) before they spread tolymph nodesand beyond.
For the purpose of classification and treatment, breast cancer that has spread to other parts of the body is still considered breast cancer regardless of its location.
Breast cancer that spreads to the lungs, for example, would not be referred to as lung cancer. Rather, it would be deemed “breast cancer metastatic to the lungs.” If you look at these cells under a microscope, they would be breast cancer cells, rather than lung cancer cells.
Different Types of Metastatic Breast Cancer
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Cancer stagingis performed to direct treatment and predict the likely outcome, orprognosis. The staging system most commonly used for breast cancer—and most other cancers—is called theTNM Classification of Malignant Tumors. In the TNM staging system:
Regarding the “M” classification, you can either be M0 (no metastasis) or M1 (metastasis). There is no in-between. Therefore, you can be any T or N classification and still be considered stage 4 if metastasis is confirmed.
Metastatic breast cancers are not all treated the same. The diagnosis would also include an assessment of the tumor location,tumor grade, tumor size, hormone receptor status, HER2 status, and many other factors, each of which directs the ultimate course of treatment.
How Is Stage 4 Breast Cancer Treated?
The aim of treatment is to improve the quality and length of life of people with stage 4 breast cancer. Each person will be treated differently based on the disease characteristics and the intended goals of treatment.
Most treatments aim at decreasing the tumor burden (number of cancer cells, size of the tumor, or amount of cancer) and stabilizing the disease. In general, stage 4 cancer treatments—although they may extend life in a significant number of people—are consideredpalliative(meant to relieve disease burden). This is because only a handful of people treated at this stage are cured of their disease.
Systemic Therapy
For those who decide to pursue treatment, systemic therapies (those that provide treatment throughout the body) are commonly used. These include:
A combination of therapies may be used, either together or in stages.
Treatment staging involves using a drug until the side effects become intolerable or the cancer starts to grow again. If this happens, the first-line drug will be switched with a second-line drug, and so on.
Drug Selection
The choice of systemic therapy is largely based on one’shormone receptor status(an indication of whether the hormonesestrogenorprogesteroneaffect the growth of a tumor) and/orHER2 status(whether a particular gene influences tumor growth).
Based on these evaluations, the oncologist will typically recommend the following treatments:
Radiation and Surgery
Among the examples of how these treatments are used:
Radiation can also shrink tumors that have penetrated the skin and caused an open wound on the breast or chest.
Because current treatments are unlikely to cure metastatic breast cancer, you may want to take part in aclinical trialto try newer treatments if you are in good health.
Treatment Options for Metastatic Breast Cancer
How Long Can You Live With Stage 4 Breast Cancer?
Thefive-year survival ratefor stage 4 breast cancer is 29%, which means that 29 out of 100 women will live forat leastfive years.Some will live far longer, while others will live less long. The median life expectancy is three years.
As distressing as this may seem, the figures do not differentiate between the number of women who decide to be treated vs. those who don’t. As such, you should not assume that having stage 4 breast cancer means that you have three to five years to live. Some women will live more than 10 years.
A number of factors are known to influence survival, including:
It is important to remember that these survival statistics are derived from a large population of women, all with differing circumstances. Moreover, as newer and more effective treatments are being developed, the survival rate five years from now may be much greater than today.
Can Stage 4 Breast Cancer Be Cured?Stage 4 breast cancer is considered to be incurable. However, treatments can often keep the cancer from growing, spreading, or progressing for months or even years.
Can Stage 4 Breast Cancer Be Cured?
Stage 4 breast cancer is considered to be incurable. However, treatments can often keep the cancer from growing, spreading, or progressing for months or even years.
Stage 4 Breast Cancer Survival Rates
Monitoring Stage 4 Breast Cancer
While the goal of early-stage cancer treatment is to eliminate the malignancy and put the cancer intoremission, the goals associated with stage 4 cancer are different. The primary aim is to keep the cancer from spreading, which requires ongoing monitoring.
The tool most commonly used for this is an imaging technique known as a positron-emission tomography/computed tomography (PET/CT) scan. It involvesPET technology, which looks at cell activity, andCT technology, which uses X-rays to create 3D images of tissue to measure tumor size and disease progression.
Other techniques, likemagnetic resonance imaging (MRI)anddual-energy X-ray absorptiometry (DEXA), may be used to monitor certain soft tissue or bone malignancies, respectively.
Serial blood tumor markers are also used to monitor disease status. These are blood tests that detect substances, referred to as tumor markers, that increase as cancer either spreads or advances. Examples include the tumor markers CA 15-3 and CA 27-29, which are elevated in more than 70% of people with metastatic breast cancer.
Disease Progression
While systemic treatment may keep the cancer stable for months or years, there may be times when it becomes unstable and starts to progress. When this happens, a change of treatment can often stabilize the malignancy.
Generally speaking, doctors will start with hormonal therapy (if hormone receptor-positive) or targeted therapy (if HER2-positive), changing individual agents if one starts to fail.
If these no longer work, chemotherapy will be used. However, each time that cancer progresses during chemo, the chances of the new drug working get lower. It is at this stage that palliative care may be considered.
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Coping With Stage 4 Breast Cancer
It is natural to feel depressed, anxious, or even angry when you have been diagnosed with stage 4 breast cancer. It can leave you feeling as if you have no control over your health or future. Moreover, you may find that certain people will withdraw from you or suggest that you have metastatic cancer because you “left it too long.”
It is important to shield yourself from these negative emotions and embrace people who can provide you with genuine support. These include loved ones,support groups, and your oncology team. If you are unable to cope, ask for a referral to a therapist who can provide you counseling or a psychiatrist able to dispense treatment.
With that being said, there are women who experience positive emotional growth after being diagnosed with stage 4 breast cancer. It is not uncommon to hear someone say that cancer helped them prioritize their life, allowing them to pursue what is truly important and connect with people on a deeper, more profound level.
Whatever your experience, don’t go it alone. Seek support and work with your medical team as a full partner in your care.
Summary
Stage 4 breast cancer is also known as metastatic breast cancer, meaning the cancer has spread to other organs. While stage 4 breast cancer is not considered curable, treatments can control the spread and improve quality of life in many cases. The median survival is three years, but some people live 10 years or more after diagnosis. Treatments can include chemotherapy, radiation, surgery, hormone therapy, and targeted therapy.
The five-year-survival rate for stage 4 breast cancer is 29%. However, some people live with this chronic illness for many years.
How to Find a Metastatic Breast Cancer Support Group
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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