Table of ContentsView AllTable of ContentsSurvival RatesSurvival FactorsNon-FactorsSurvivorsCopingPalliative Care
Table of ContentsView All
View All
Table of Contents
Survival Rates
Survival Factors
Non-Factors
Survivors
Coping
Palliative Care
Life expectancy for stage 4 breast cancer (metastaticbreast cancer) varies widely. Each person is different, and factors like your age, overall health, the type of breast cancer you have, and the organs where the cancer has spread (metastasized) can inform yourprognosis(likely outcome).
Stage 4 cancer isn’t curable, but it’s important to remember that there isn’t one set path for the disease. By learning about cancer survival rates—and the variables that influence them—you can get a better handle on what to expect and a stronger sense of control over the choices you make.
This article explains what cancer survival rates mean, how they apply to stage 4 breast cancer, and the different variables that do and do not have any impact on them.
Verywell / Jo Zixuan Zhou
Five-Year Survival Rates
Relative survival rates describe the percentage of people who live to or beyond a specific period of time. Most cancer specialists use a five-year survival rate as the standard measure.
So, if the type of cancer you have has a relative five-year survival rate of 50%, it means that 50% of people will live forat leastfive years. Many may go on to live for many years more.
Even so, the rate may not reflectyourlikely outcome given that the statistics are based on every personof every age and health status with breast cancer. This includes people who may be older or younger than you, healthier or less healthy than you are, or have a different subtype orgradeof breast cancer than you.
As such, five-year survival rates provide you and your oncologist with a general snapshot of expectations that you can build on.
As of April 2023, based on data from the NCI’s ongoing Surveillance, Epidemiology, and End Results (SEER) program, therelative five-year survival for female breast cancer is 31%.
As of February 2023, the American Society of Clinical Oncology (ASCO), drawing from SEER data, reports that arelative five-year survival rate formale breast canceris 22%.
Limitation of Survival RatesIt is important to remember that the SEER data are historical and do not immediately reflect newer treatments that are extending survival time (includingHER2 targeted therapies,bisphosphonates, and the ever-expanding list ofimmunotherapies). As such, the survival rate you receive today may be very different in the next couple of years.
Limitation of Survival Rates
It is important to remember that the SEER data are historical and do not immediately reflect newer treatments that are extending survival time (includingHER2 targeted therapies,bisphosphonates, and the ever-expanding list ofimmunotherapies). As such, the survival rate you receive today may be very different in the next couple of years.
Immunotherapy for Cancer
Oligometastases and Treatment
Another area of treatment that is changing is the treatment ofoligometastases,which are defined as one or only a few metastases to a particular organ. In the past, people with metastatic disease (whether to a single site or many) were treated the same way, via general treatments for metastatic cancer such aschemotherapyorhormonal therapy.
Research has begun to look at the benefit of treating oligometastases. These isolated metastases may be treated with:
With some cancer and metastases in some regions (such aslung cancerwith brain metastases), treatment has extended life and sometimes results in long-term survival. Future advances may lead to similar improvements in life expectancy.
Stereotactic Body Radiotherapy (SBRT) Side Effects and More
Variables and Breast Cancer Survival
There are certain variables that can positively or negatively influence survival rates if you have breast cancer. Many of these variables are fixed and cannot be changed, but there are some over which you have control.
By understanding which variables you have control over (and which you don’t), you can make informed choices.
Age plays a significant role in breast cancer survival but not as you might expect. According to a 2020 study inFrontiers of Oncology,which drew upon SEER data, females under 40 and those over 79 have poorer outcomes than those diagnosed between these age groups.
By and large, younger females tend to get moreaggressive types of breast cancer, while females over 79 are generally less healthy and are diagnosed when the spread of cancer is extensive.
Between 15% and 20% of breast cancers have higher levels of a protein known asHER2. While HER2 helps tumors grow quickly, they are more responsive to targeted therapies for metastatic breast cancer.
This is especially true if the tumor tests positive forHER2 receptorsand tests positive forhormone receptors (HR)for estrogen and progesterone.
For people with stage 4 breast cancer, the presence or lack of these receptors can influence five-year survival rates, according to 2023 SEER data:
Cancer staging is estimated on several factors, including the size of theprimary (original) tumor. With stage 4 breast cancer, the size of the primary tumor in the breast also influences the survival time even if the cancer has already spread.
The treatments used for metastatic breast cancer can influence survival rates. Although you may not have complete control over which treatments are available to you, knowing how they affect survival can help you better understand why youroncologistmay recommend a certain treatment and not others.
A good illustration of this is the five-year survival rate for people with metastatic breast cancer who are treated withbreast cancer surgeryversus those who are treated withchemotherapyorhormone therapy:
Performance status (PS)is a measurement used in cancer to assess a person’s level of function and ability to take care of themselves. It is more than an assessment of a person’s general health but takes into account their ability to remain active, do office or housework, and perform tasks without restriction.
PS scores typically range from 0 to 100, with 100 being optimal function and 0 being dead. (Other methods calculate PS on a scale of 0 to 5, with 0 being optimal and 5 being dead.)
Ultimately, people with a higher PS score—meaning that they are stronger and better able to take of themselves—are more likely to fare better on cancer treatment than those with a lower PS score.
Your PS also factors into what treatments your oncologist will prescribe as they consider whether you can tolerate them or not. As a result, your PS can have a direct impact on your relative survival.
Complications of Metastatic (Stage 4) Breast Cancer
Variables That Don’t Affect Survival
People tend to not understand these factors as well. They include:
Treatment goals for metastatic breast cancer are often different than that of early-stage disease. With early-stage breast cancer, the goal is usually to be aggressive in order to reduce the risk that the cancer will come back.
In contrast, with stage 4 disease, the goal is usually to use the minimum amount of treatment possible to control the disease (at least at the current time). Studies have found that more aggressive treatment does not improve survival rates but does reduce quality of life.
While having a good attitude may improve your sense of well-being, it has not been shown to affect survival rates. On the other hand, nearly 42% of people diagnosed with breast cancer experienceanxiety.Trying to appear positive rather than expressing your concerns may be harmful to your health in general.
Who Are Long-Term Survivors?
Being a long-term survivor is usually defined as living five or more years beyond a diagnosis of stage 4 breast cancer.
Living 10 or more years isn’t unheard of, and the10-year survival ratefor primary orde novometastatic breast cancer is around 13%. (This rate is based on de novo cases, or cases in which stage 4 was the initial diagnosis.)
Characteristics
While there is a significant degree of variability, long-term survivors are:
Long-term survivors are also more often diagnosed with metastatic breast cancer at the onset (de novo breast cancer), rather than having had previous early-stage breast cancer that recurred at distant sites.
In different studies, the length of response after the first treatment for metastatic breast cancer was linked to survival.That said, it can be difficult to predict who may survive for a lengthy period of time based on measurements currently available.
Recently, research has begun to focus on people who survive longer than expected, or “outliers,” to gain insight into genetics and other factors that may be making the difference.
Coping With Stage 4 Breast Cancer
Coping with stage 4 breast cancer is challenging, and it is different from coping with early-stage disease. For those who originally faced early-stage breast cancer, not only do they need to face cancer again but this time they aren’t dealing with a disease that can potentially be cured.
Metastatic breast cancer often comes with more symptoms as well, such as bone pain due to bone metastases anditchingwith liver metastases. On top of all of this (and despite all of the “awareness” that has taken place), people with stage 4 disease may feel left out within the breast cancer community.
What Causes Bone Pain in the Legs?
Support
Support is very important, and some studies suggest that social support even improves the length of survival.Family and friends are key but becoming involved in a support group or breast cancer community is extremely helpful as well.
Through these communities, you have the opportunity to connect with others who are facing some of the same challenges.
Many people with stage 4 breast cancer prefer a social community dedicated to metastatic breast cancer. If you’re living with metastatic cancer, it may be hard to listen to others talk about concerns common with early-stage, such as hair loss or the chance of pregnancy. You may have drastically different concerns, such as how long you will live.
Cancer and CaregiversCaring for a loved one with stage 4 breast cancer has special challenges as well. Some support groups are designed for loved ones and can help you to learn more about self-care as well as your loved one’s needs. Most people with metastatic breast cancer will require some type of treatment for the rest of their lives, and support can help you to become better equipped.
Cancer and Caregivers
Caring for a loved one with stage 4 breast cancer has special challenges as well. Some support groups are designed for loved ones and can help you to learn more about self-care as well as your loved one’s needs. Most people with metastatic breast cancer will require some type of treatment for the rest of their lives, and support can help you to become better equipped.
How Breast Cancer Can Be Misdiagnosed
Being Your Own Advocate
The relationship betweenself-advocacyand survival is unclear, but being your own advocate can’t hurt in maximizing your survival. For example, some studies show that informed decision-making may improve among people attuned to their breast cancer symptoms.
Oncology is changing rapidly and it’s difficult for any oncologist—even those who specialize in breast cancer—to stay aware of all of the latest research and clinical trials taking place.
It can be helpful to research your cancer yourself. Becoming involved via social media such as Twitter is also an excellent way to learn about the latest research, using the hashtag #bcsm, which stands for breast cancer social media.
Getting a second opinion can be helpful as well, especially from one of the larger cancer centers such as a National Cancer Institute-designated cancer center.
Some opportunities don’t require traveling for opinions. There are now clinical trial matching services in which a nurse navigator can help to match your particular tumor and characteristics with clinical trials in progress all over the world.
Larger cancer centers may offer remote second opinions, in which an oncology team can review your medical information and talk to you on the phone about treatment options that may not be available elsewhere.
Best Hospitals for Cancer in the United States
Palliative Care and Coping
Coping with the many symptoms that can occur with stage 4 breast cancer can be frustrating and discouraging, and people sometimes wonder if they will feel poorly for the rest of their lives. Anxiety and depression are also severe for some people with advanced disease.
Fortunately,palliative careteam consults are now offered at many cancer centers. While hospice is a form of palliative care, palliative care can be helpful even with early, curable tumors.
Some research suggests that people who receive palliative care consults not only have a better quality of life with advanced cancer, but they may actually live longer too.
Summary
With stage 4 breast cancer, the spread (metastasis) of the disease changes the priorities people have at an earlier stage of diagnosis. Treatment options are different, and so is your outlook on how your cancer will progress.
Five-year survival rates are a common and reliable measure of prognosis, but they never tell the whole story. Each person is different and the variables affecting your cancer diagnosis, including its receptor status and related therapies, affect the outcome.
Life expectancy for people living with stage 4 breast cancer also continues to evolve on the basis of new research discoveries. Your healthcare team can help you to understand your disease, make informed choices, and connect you and your loved ones with support resources.
Metastatic Breast Cancer Support Communities
23 SourcesVerywell 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.National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program.Cancer stat facts: female breast cancer.American Cancer Society.Key statistics for breast cancer.Gion M, Saavedra C, Perez-Garcia J, Cortes J.Oligometastatic disease: when stage IV breast cancer could be “cured".Cancers. 2022;14(21):5229. doi:10.3390/cancers14215229Cai S, Zuo W, Lu X, et al.The prognostic impact of age at diagnosis upon breast cancer of different immunohistochemical subtypes: a Surveillance, Epidemiology, and End Results (SEER) population-based analysis.Front Oncol.2020 Sep 23;10:1729. doi:10.3389/fonc.2020.01729Wang R, Zhu Y, Liu X, Liao X, He J, Niu L.The clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer.BMC Cancer.2019;19:1091. doi:10.1186/s12885-019-6311-zAmerican Cancer Society.Breast cancer HER2 status.National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program.Cancer stat facts: female breast cancer subtypes.Ganggayah MD, Taib NA, Har YC, Lio P, Dhillon SK.Predicting factors for survival of breast cancer patients using machine learning techniques.BMC Med Inform Decis Mak.2019;19:48. doi:10.1186/s12911-019-0801-4West HJ, Jin JO.Performance status in patients with cancer.JAMA Oncol. 2015;1(7):998. doi:10.1001/jamaoncol.2015.3113Kelly CM, Shahrokni A.Moving beyond Karnofsky and ECOG Performance Status assessments with new technologies.J Oncol. 2016;2016:6186543. doi:10.1155/2016/6186543Jang RW, Caraiscos VB, Swami N, Banerjee S, Mak E, Kaya E, et al.Simple prognostic model for patients with advanced cancer based on performance status.J Oncol Pract. 2014 Sep;10(5):e335-41. doi:10.1200/JOP.2014.001457.Fred Hutchinson Cancer Institute.Living with stage 4: the breast cancer no one understands.Falchook AD, Dusetzina SB, Tian F, Basak R, Selvam N, Chen RC.Aggressive end-of-life care for metastatic cancer patients younger than age 65 years.J Natl Cancer Inst. 2017;109(9). doi:10.1093/jnci/djx028Hashemi SM, Rafiemanesh H, Aghamohammadi T, et al.Prevalence of anxiety among breast cancer patients: a systematic review and meta-analysis.Breast Cancer. 2020;27(2):166-178. doi:10.1007/s12282-019-01031-9Kontani K, Hashimoto S ichiro, Murazawa C, et al.Factors responsible for long-term survival in metastatic breast cancer.World J Surg Onc. 2014;12(1):344. doi:10.1186/1477-7819-12-344Coughlin SS.Social determinants of breast cancer risk, stage, and survival.Breast Cancer Res Treat. 2019;177(3):537-548. doi:10.1007/s10549-019-05340-7Caswell-Jin JL, Plevritis SK, Tian L, et al.Change in survival in metastatic breast cancer with treatment advances: meta-analysis and systematic review.JNCI Cancer Spectrum. 2018;2(4):pky062. doi:10.1093/jncics/pky062Adams S, Diamond JR, Hamilton E, et al.Atezolizumab plus nab-paclitaxel in the treatment of metastatic triple-negative breast cancer with 2-year survival follow-up: a phase 1b clinical trial.JAMA Oncol. 2019;5(3):334. doi:10.1001/jamaoncol.2018.5152Segaert P, Lopes MB, Casimiro S, Vinga S, Rousseeuw PJ.Robust identification of target genes and outliers in triple-negative breast cancer data.Stat Methods Med Res. 2019;28(10-11):3042-3056. doi:10.1177/0962280218794722Kroenke CH.A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival.Transl Behav Med. 2018;8(4):629-642. doi:10.1093/tbm/ibx061Hagan TL, Gilbertson-White S, Cohen SM, Temel JS, Greer JA, Donovan HS.Symptom burden and self-advocacy: exploring the relationship among female cancer survivors.Clin J Oncol Nurs. 2018;22(1):E23-E30. doi:10.1188/18.CJON.E23-E30Tsaras K, Papathanasiou IV, Mitsi D, et al.Assessment of depression and anxiety in breast cancer patients: prevalence and associated factors.Asian Pac J Cancer Prev. 2018;19(6). doi:10.22034/APJCP.2018.19.6.1661Hoerger M, Wayser GR, Schwing G, Suzuki A, Perry LM.Impact of interdisciplinary outpatient specialty palliative care on survival and quality of life in adults with advanced cancer: a meta-analysis of randomized controlled trials.Ann Behav Med. 2019;53(7):674-685. doi:10.1093/abm/kaAdditional ReadingEng LG, Dawood S, Sopik V, Haaland B, Tan PS, Bhoo-Pathy N, Warner E, Iqbal J, Narod SA, Dent R.Ten-year survival in women with primary stage IV breast cancer.Breast Cancer Res Treat. 2016;160(1):145-152. doi:10.1007/s10549-016-3974-xFranceschini D, De Rose F, Franzese C, Comito T, Di Brina L, Radicioni G, Evangelista A, D’Agostino GR, Navarria P, Scorsetti M.Predictive factors for response and survival in a cohort of oligometastatic patients treated with Stereotactic Body Radiation Therapy.International Journal of Radiation Oncology-Biology-Physics.2019;104(1):111-121. doi:10.1016/j.ijrobp.2018.12.049Klar N, et al.Features associated with long-term survival in metastatic breast cancer.Journal of Clinical Oncology.2018. 36(15_Suppl):e13074-e13074. doi:10.1200/JCO.2018.36.15_suppl.e13074
23 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.National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program.Cancer stat facts: female breast cancer.American Cancer Society.Key statistics for breast cancer.Gion M, Saavedra C, Perez-Garcia J, Cortes J.Oligometastatic disease: when stage IV breast cancer could be “cured".Cancers. 2022;14(21):5229. doi:10.3390/cancers14215229Cai S, Zuo W, Lu X, et al.The prognostic impact of age at diagnosis upon breast cancer of different immunohistochemical subtypes: a Surveillance, Epidemiology, and End Results (SEER) population-based analysis.Front Oncol.2020 Sep 23;10:1729. doi:10.3389/fonc.2020.01729Wang R, Zhu Y, Liu X, Liao X, He J, Niu L.The clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer.BMC Cancer.2019;19:1091. doi:10.1186/s12885-019-6311-zAmerican Cancer Society.Breast cancer HER2 status.National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program.Cancer stat facts: female breast cancer subtypes.Ganggayah MD, Taib NA, Har YC, Lio P, Dhillon SK.Predicting factors for survival of breast cancer patients using machine learning techniques.BMC Med Inform Decis Mak.2019;19:48. doi:10.1186/s12911-019-0801-4West HJ, Jin JO.Performance status in patients with cancer.JAMA Oncol. 2015;1(7):998. doi:10.1001/jamaoncol.2015.3113Kelly CM, Shahrokni A.Moving beyond Karnofsky and ECOG Performance Status assessments with new technologies.J Oncol. 2016;2016:6186543. doi:10.1155/2016/6186543Jang RW, Caraiscos VB, Swami N, Banerjee S, Mak E, Kaya E, et al.Simple prognostic model for patients with advanced cancer based on performance status.J Oncol Pract. 2014 Sep;10(5):e335-41. doi:10.1200/JOP.2014.001457.Fred Hutchinson Cancer Institute.Living with stage 4: the breast cancer no one understands.Falchook AD, Dusetzina SB, Tian F, Basak R, Selvam N, Chen RC.Aggressive end-of-life care for metastatic cancer patients younger than age 65 years.J Natl Cancer Inst. 2017;109(9). doi:10.1093/jnci/djx028Hashemi SM, Rafiemanesh H, Aghamohammadi T, et al.Prevalence of anxiety among breast cancer patients: a systematic review and meta-analysis.Breast Cancer. 2020;27(2):166-178. doi:10.1007/s12282-019-01031-9Kontani K, Hashimoto S ichiro, Murazawa C, et al.Factors responsible for long-term survival in metastatic breast cancer.World J Surg Onc. 2014;12(1):344. doi:10.1186/1477-7819-12-344Coughlin SS.Social determinants of breast cancer risk, stage, and survival.Breast Cancer Res Treat. 2019;177(3):537-548. doi:10.1007/s10549-019-05340-7Caswell-Jin JL, Plevritis SK, Tian L, et al.Change in survival in metastatic breast cancer with treatment advances: meta-analysis and systematic review.JNCI Cancer Spectrum. 2018;2(4):pky062. doi:10.1093/jncics/pky062Adams S, Diamond JR, Hamilton E, et al.Atezolizumab plus nab-paclitaxel in the treatment of metastatic triple-negative breast cancer with 2-year survival follow-up: a phase 1b clinical trial.JAMA Oncol. 2019;5(3):334. doi:10.1001/jamaoncol.2018.5152Segaert P, Lopes MB, Casimiro S, Vinga S, Rousseeuw PJ.Robust identification of target genes and outliers in triple-negative breast cancer data.Stat Methods Med Res. 2019;28(10-11):3042-3056. doi:10.1177/0962280218794722Kroenke CH.A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival.Transl Behav Med. 2018;8(4):629-642. doi:10.1093/tbm/ibx061Hagan TL, Gilbertson-White S, Cohen SM, Temel JS, Greer JA, Donovan HS.Symptom burden and self-advocacy: exploring the relationship among female cancer survivors.Clin J Oncol Nurs. 2018;22(1):E23-E30. doi:10.1188/18.CJON.E23-E30Tsaras K, Papathanasiou IV, Mitsi D, et al.Assessment of depression and anxiety in breast cancer patients: prevalence and associated factors.Asian Pac J Cancer Prev. 2018;19(6). doi:10.22034/APJCP.2018.19.6.1661Hoerger M, Wayser GR, Schwing G, Suzuki A, Perry LM.Impact of interdisciplinary outpatient specialty palliative care on survival and quality of life in adults with advanced cancer: a meta-analysis of randomized controlled trials.Ann Behav Med. 2019;53(7):674-685. doi:10.1093/abm/kaAdditional ReadingEng LG, Dawood S, Sopik V, Haaland B, Tan PS, Bhoo-Pathy N, Warner E, Iqbal J, Narod SA, Dent R.Ten-year survival in women with primary stage IV breast cancer.Breast Cancer Res Treat. 2016;160(1):145-152. doi:10.1007/s10549-016-3974-xFranceschini D, De Rose F, Franzese C, Comito T, Di Brina L, Radicioni G, Evangelista A, D’Agostino GR, Navarria P, Scorsetti M.Predictive factors for response and survival in a cohort of oligometastatic patients treated with Stereotactic Body Radiation Therapy.International Journal of Radiation Oncology-Biology-Physics.2019;104(1):111-121. doi:10.1016/j.ijrobp.2018.12.049Klar N, et al.Features associated with long-term survival in metastatic breast cancer.Journal of Clinical Oncology.2018. 36(15_Suppl):e13074-e13074. doi:10.1200/JCO.2018.36.15_suppl.e13074
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.
National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program.Cancer stat facts: female breast cancer.American Cancer Society.Key statistics for breast cancer.Gion M, Saavedra C, Perez-Garcia J, Cortes J.Oligometastatic disease: when stage IV breast cancer could be “cured".Cancers. 2022;14(21):5229. doi:10.3390/cancers14215229Cai S, Zuo W, Lu X, et al.The prognostic impact of age at diagnosis upon breast cancer of different immunohistochemical subtypes: a Surveillance, Epidemiology, and End Results (SEER) population-based analysis.Front Oncol.2020 Sep 23;10:1729. doi:10.3389/fonc.2020.01729Wang R, Zhu Y, Liu X, Liao X, He J, Niu L.The clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer.BMC Cancer.2019;19:1091. doi:10.1186/s12885-019-6311-zAmerican Cancer Society.Breast cancer HER2 status.National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program.Cancer stat facts: female breast cancer subtypes.Ganggayah MD, Taib NA, Har YC, Lio P, Dhillon SK.Predicting factors for survival of breast cancer patients using machine learning techniques.BMC Med Inform Decis Mak.2019;19:48. doi:10.1186/s12911-019-0801-4West HJ, Jin JO.Performance status in patients with cancer.JAMA Oncol. 2015;1(7):998. doi:10.1001/jamaoncol.2015.3113Kelly CM, Shahrokni A.Moving beyond Karnofsky and ECOG Performance Status assessments with new technologies.J Oncol. 2016;2016:6186543. doi:10.1155/2016/6186543Jang RW, Caraiscos VB, Swami N, Banerjee S, Mak E, Kaya E, et al.Simple prognostic model for patients with advanced cancer based on performance status.J Oncol Pract. 2014 Sep;10(5):e335-41. doi:10.1200/JOP.2014.001457.Fred Hutchinson Cancer Institute.Living with stage 4: the breast cancer no one understands.Falchook AD, Dusetzina SB, Tian F, Basak R, Selvam N, Chen RC.Aggressive end-of-life care for metastatic cancer patients younger than age 65 years.J Natl Cancer Inst. 2017;109(9). doi:10.1093/jnci/djx028Hashemi SM, Rafiemanesh H, Aghamohammadi T, et al.Prevalence of anxiety among breast cancer patients: a systematic review and meta-analysis.Breast Cancer. 2020;27(2):166-178. doi:10.1007/s12282-019-01031-9Kontani K, Hashimoto S ichiro, Murazawa C, et al.Factors responsible for long-term survival in metastatic breast cancer.World J Surg Onc. 2014;12(1):344. doi:10.1186/1477-7819-12-344Coughlin SS.Social determinants of breast cancer risk, stage, and survival.Breast Cancer Res Treat. 2019;177(3):537-548. doi:10.1007/s10549-019-05340-7Caswell-Jin JL, Plevritis SK, Tian L, et al.Change in survival in metastatic breast cancer with treatment advances: meta-analysis and systematic review.JNCI Cancer Spectrum. 2018;2(4):pky062. doi:10.1093/jncics/pky062Adams S, Diamond JR, Hamilton E, et al.Atezolizumab plus nab-paclitaxel in the treatment of metastatic triple-negative breast cancer with 2-year survival follow-up: a phase 1b clinical trial.JAMA Oncol. 2019;5(3):334. doi:10.1001/jamaoncol.2018.5152Segaert P, Lopes MB, Casimiro S, Vinga S, Rousseeuw PJ.Robust identification of target genes and outliers in triple-negative breast cancer data.Stat Methods Med Res. 2019;28(10-11):3042-3056. doi:10.1177/0962280218794722Kroenke CH.A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival.Transl Behav Med. 2018;8(4):629-642. doi:10.1093/tbm/ibx061Hagan TL, Gilbertson-White S, Cohen SM, Temel JS, Greer JA, Donovan HS.Symptom burden and self-advocacy: exploring the relationship among female cancer survivors.Clin J Oncol Nurs. 2018;22(1):E23-E30. doi:10.1188/18.CJON.E23-E30Tsaras K, Papathanasiou IV, Mitsi D, et al.Assessment of depression and anxiety in breast cancer patients: prevalence and associated factors.Asian Pac J Cancer Prev. 2018;19(6). doi:10.22034/APJCP.2018.19.6.1661Hoerger M, Wayser GR, Schwing G, Suzuki A, Perry LM.Impact of interdisciplinary outpatient specialty palliative care on survival and quality of life in adults with advanced cancer: a meta-analysis of randomized controlled trials.Ann Behav Med. 2019;53(7):674-685. doi:10.1093/abm/ka
National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program.Cancer stat facts: female breast cancer.
American Cancer Society.Key statistics for breast cancer.
Gion M, Saavedra C, Perez-Garcia J, Cortes J.Oligometastatic disease: when stage IV breast cancer could be “cured".Cancers. 2022;14(21):5229. doi:10.3390/cancers14215229
Cai S, Zuo W, Lu X, et al.The prognostic impact of age at diagnosis upon breast cancer of different immunohistochemical subtypes: a Surveillance, Epidemiology, and End Results (SEER) population-based analysis.Front Oncol.2020 Sep 23;10:1729. doi:10.3389/fonc.2020.01729
Wang R, Zhu Y, Liu X, Liao X, He J, Niu L.The clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer.BMC Cancer.2019;19:1091. doi:10.1186/s12885-019-6311-z
American Cancer Society.Breast cancer HER2 status.
National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program.Cancer stat facts: female breast cancer subtypes.
Ganggayah MD, Taib NA, Har YC, Lio P, Dhillon SK.Predicting factors for survival of breast cancer patients using machine learning techniques.BMC Med Inform Decis Mak.2019;19:48. doi:10.1186/s12911-019-0801-4
West HJ, Jin JO.Performance status in patients with cancer.JAMA Oncol. 2015;1(7):998. doi:10.1001/jamaoncol.2015.3113
Kelly CM, Shahrokni A.Moving beyond Karnofsky and ECOG Performance Status assessments with new technologies.J Oncol. 2016;2016:6186543. doi:10.1155/2016/6186543
Jang RW, Caraiscos VB, Swami N, Banerjee S, Mak E, Kaya E, et al.Simple prognostic model for patients with advanced cancer based on performance status.J Oncol Pract. 2014 Sep;10(5):e335-41. doi:10.1200/JOP.2014.001457.
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