Metastatic, or stage 4, breast cancer is when the cancer has spread to another part of the body. It most commonly affects the bones, brain, liver, or lungs.
Metastatic cancer refers to cancer that has spread from the original tumor and nearby lymph nodes to other parts of the body. It is also referred to as stage 4 cancer, which is the most severe type of cancer.
Approximately 30% of people with early-stage breast cancer will eventually receive a diagnosis of metastatic breast cancer. This diagnosis can occur months or even
Metastatic breast cancer is also referred to as advanced secondary breast cancer because when breast cancer spreads to other areas of the body, the cancer cells are still breast cancer cells.
For example, even if the cancer metastasizes in the bones, the tumor will consist of breast cancer cells, not bone cancer cells.
Both terms are used, however, advanced is more commonly discussed than secondary.
According to the
- The cancer cells grow into or invade nearby healthy tissue.
- They penetrate the walls of nearby lymph nodes or blood vessels.
- They travel through the lymphatic system and bloodstream to other areas in the body.
- They invade blood vessel walls and move into surrounding healthy tissue at the new location.
- They grow in the new tissue until a small tumor forms.
- They develop new blood vessels to establish a blood supply for the tumor so that it continues to grow.
Some people may have metastatic breast cancer and not experience any symptoms. If symptoms do occur, they may vary based on the size of the tumors and where in the body they have spread.
Common signs and symptoms of metastatic cancer include:
| Bones | • bone pain and fractures commonly in the spine, pelvis, ribs, or the long bones in the arms or legs |
|---|---|
| Brain | • dizziness • headaches • slurred speech • seizures • vision issues • memory problems |
| Liver | • abdominal swelling • jaundice • poor appetite • fatigue • weight loss • fever |
| Lungs | • shortness of breath • persistent cough • general chest discomfort or pain |
A doctor may perform a variety of tests to identify and look for cancer spread throughout the body, including:
- bone scans
- chest X-rays
- CT scans
- MRI scans
- PET or PET CT scans
- blood tests
- biopsy
There is currently no cure for metastatic breast cancer. However, treatment may help:
- slow or stop the spread of the cancer
- relieve the symptoms
- improve quality of life
- prolong life
Treatment for metastatic breast cancer is typically different than before the cancer has spread. That said, with treatment, a person can live for several months or years with metastatic breast cancer.
A person should work with a doctor to understand their treatment options, which may include:
- chemotherapy to damage or destroy cancer cells throughout the body
- radiation therapy to control cancer growth in specific areas and ease symptoms such as pain
- targeted therapy, which targets specific receptors and abnormal growth pathways to help prevent growth
- hormone therapy to help to shrink or slow the growth of hormone receptor-positive metastatic breast cancer
- clinical trials, which test new medications or therapies aiming to improve cancer care
Complementary and holistic medicine such as hypnosis, acupuncture, and yoga, as well as palliative care, may be used at the same time as the options above.
Treatment will continue until a person is no longer benefiting from it.
The natural history of metastatic breast cancer is that a person’s cancer becomes resistant to a given therapy over time. At that point, a doctor should discuss other options and next steps with the person.
If treatments are no longer effective at slowing cancer spread or alleviating the symptoms, a doctor may recommend stopping treatment. These decisions are made between the oncology team, the person with metastatic cancer, and the family.
It is important for an individual to discuss how they are doing and what their goals are continually with their healthcare team and loved ones so everyone can understand their priorities.
Even when people decide to stop receiving chemotherapy or similar treatments, they can still receive palliative care and complementary therapies to support their quality of life and relieve them of symptoms.
The outlook for metastatic breast cancer is different for each person and will depend on a few factors, such as:
- type of cancer
- organs affected
- a person’s general health status
- level of fitness
- previous treatments
A person’s outlook is typically estimated by using the 5-year relative survival rate.
This compares people with the same type of breast cancer to the general population to calculate how many people are still alive 5 years after their initial diagnosis.
The 5-year relative survival rate for metastatic breast cancer is
What is the most common route of metastasis for breast cancer?
Metastasis for breast cancer most commonly spreads to the bones, liver, brain, and lungs.
Where does breast cancer usually metastasize first?
Metastatic breast cancer most often affects the bones first.
How long after breast cancer can it metastasize?
How fast breast cancer will metastasize is hard to predict and varies for each person. Some people’s initial breast cancer diagnosis may indicate metastasis, while for others the cancer may metastasize decades after treatment or their initial diagnosis. Early detection of breast cancer can greatly decrease the risk of complications and metastasis.
Metastatic, or stage 4, breast cancer occurs when the cancer cells have spread to other areas in the body. It often affects the bones, brain, liver, and lungs.
There is currently no cure for metastatic breast cancer. Treatment focuses on slowing the growth and spread of the cancer as well as reducing the symptoms and improving a person’s quality of life.
A medical oncologist prescribes medication to help shrink or slow the growth of tumors to help relieve symptoms or increase life expectancy. This specialist will monitor for drug resistance and side effects. The medical oncologist will be the main point of contact, but they may work with a team of people — including nurse practitioners, physician assistants, and nurses — who work together to coordinate care.
Radiation therapy is not one of the main treatments for metastatic breast cancer, but doctors sometimes use it to treat certain symptoms or complications. For example, an oncologist may recommend radiation therapy to shrink a tumor that is causing pain. A radiation oncologist works with a radiation therapist to provide radiation therapy, monitor how the body responds, and manage side effects.
Surgery is not one of the main treatments for metastatic breast cancer, but doctors sometimes use it to treat certain symptoms or complications. For instance, a surgical oncologist or other surgeon may conduct surgery to remove a tumor that is causing pain, bleeding, or breathing difficulties. A plastic surgeon may use surgery to rebuild or reshape the breast after surgery.
Palliative care can help improve quality of life. Palliative care specialists may prescribe treatments to help relieve metastatic breast cancer symptoms and medication side effects. If a person decides to stop receiving active cancer treatment, and the oncology team anticipates the person has less than 6 months to live, they may also recommend hospice care. These specialists can help meet end-of-life care and planning needs.
Most cancer centers have social workers dedicated to supporting people with cancer. They may also be known as patient navigators. These individuals can help a person manage concerns related to finances, employment, transportation, health insurance, and family life. They can connect a person to resources within the cancer clinic and community to better support their individual needs.
Managing metastatic breast cancer can be emotionally draining. It may contribute to stress, anxiety, depression, or other mental health challenges. A psychologist, clinical social worker, or licensed mental health counselor can help diagnose and treat mental health conditions with talk therapy. If necessary, a psychiatrist can prescribe treatment for depression or anxiety.