What Is Stage 4 Breast Cancer
What is stage 4 breast cancer? Also referred to as stage iv breast cancer, is considered stage 4 once it has spread beyond the breast tissue and nearby lymph nodes to other organs or parts of the body. In most cases, breast cancer will spread to the bones, lungs, or liver. Not as often, but in some cases, breast cancer can also spread to other organs such as the brain.
A stage 4 breast cancer diagnosis is confirmed by examining factors of the American Joint Committee on Cancer TNM system, which includes:
- Size of the tumor
Take the breast cancer quiz to learn more about stage 4 breast cancer.
When Can Metastatic Breast Cancer Occur
Most often, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced breast cancer. This is sometimes called a distant recurrence.
Some people have metastatic breast cancer when they are first diagnosed . This is called de novo metastatic breast cancer.
Is There Hope For Stage Iv Cancer Patients
Advances in the field of medicine, especially in cancer research and technology in the last two decades, have shown that there is hope for the future.
Each year, new data emerges from a scope of technology that is ever-expanding and helping to provide patients with a new lease on life. However, like any new information, its important to evaluate it judiciously and be realistic about what is possible.
Its also important to remember that there is still life after a cancer diagnosis, even if it is in stage IV.
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Relative Survival Rate By Stage
The survival rates by stage are based on the stage at the time of diagnosis. Youâve probably been given a number and letter for your cancer stage. Here, the terms localized, regional, and distant are used instead of numbers and letters. Hereâs what they mean and the 5-year relative survival rates for each:
- Localized breast cancer is only in the breast. This includes stage IA , some IIA , and some IIB . The 5-year relative survival rate is 99%.
- Regional breast cancer has spread to nearby tissue or lymph nodes. This includes stage IB , some IIA , some IIB , and all stage III . The 5-year relative survival rate is 86%.
- Distant breast cancer has spread to other parts of the body. This includes stage IV, pronounced âstage 4â). The 5-year relative survival rate is 28%.
Prognosis For Metastatic Breast Cancer
Metastatic breast cancer isnt the same for everyone who has it. According to the National Breast Cancer Foundation, your symptoms at stage 4 will depend on the degree to which the cancer has spread in your body.
Although metastatic breast cancer has no current cure, it can be treated. Getting the right treatment can increase both your quality of life and longevity.
Life expectancy for breast cancer is based on studies of many people with the condition. These statistics cant predict your personal outcome each persons outlook is different.
The following factors can affect your life expectancy with metastatic breast cancer:
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Local Or Regional Treatments For Stage Iv Breast Cancer
Although systemic drugs are the main treatment for stage IV breast cancer, local and regional treatments such as surgery, radiation therapy, or regional chemotherapy are sometimes used as well. These can help treat breast cancer in a specific part of the body, but they are very unlikely to get rid of all of the cancer. These treatments are more likely to be used to help prevent or treat symptoms or complications from the cancer.
Radiation therapy and/or surgery may also be used in certain situations, such as:
- When the breast tumor is causing an open or painful wound in the breast
- To treat a small number of metastases in a certain area, such as the brain
- To help prevent or treat bone fractures
- When a cancer is pressing on the spinal cord
- To treat a blood vessel blockage in the liver
- To provide relief of pain or other symptoms anywhere in the body
In some cases, regional chemo may be useful as well.
If your doctor recommends such local or regional treatments, it is important that you understand the goalwhether it is to try to cure the cancer or to prevent or treat symptoms.
Why Does Metastatic Breast Cancer Happen
Most often, metastatic cancer occurs because treatment didnt destroy all the cancer cells. Sometimes, a few cells remain dormant, or are hidden and undetectable. Then, for reasons providers dont fully understand, the cells begin to grow and spread again.
De novo metastatic breast cancer means that at the time of initial diagnosis, the breast cancer has already spread to other parts of the body. In the absence of treatment, the cancer spreads.
There is nothing you can do to keep breast cancer from metastasizing. And metastatic breast cancer doesnt happen because of something you did.
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Availability Of Data And Materials
The data that support the findings of this study are available from the NCR but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the NCR.
Treatment For Advanced Breast Cancer
Treatment of metastatic breast cancer aims to control the growth and spread of the cancer, to relieve symptoms, reduce pain, and improve or maintain quality of life.
The treatment recommended by doctors will depend on which treatments are likely to control the breast cancer and what side effects the person can cope with. Treatment options may involve:
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What Doesnt Affect Survival
Just as there are factors associated with a better or worse prognosis, there are some factors that do not appear to make a big difference. These are generally less understood by the general public:
- Aggressiveness of treatment
- Having a positive attitude
The goal of treatment for metastatic breast cancer is often very different than that of early-stage disease, and this can raise anxiety among patients and loved ones of patients. 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 . 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. In fact, holding in negative emotions in order to appear positive may be detrimental to your health in general.
Antibodies And Cell Staining For Flow Cytometry
The staining panel, monoclonal antibody clones, and sources are shown in Supplementary Table S. Antibodies in direct surface staining tubes were directly conjugated with fluorophores. Staining for perforin and granzyme B was done after samples were fixed with 2% paraformaldehyde and permeabilized with PBS containing 0.1% saponin, 1% BSA, and 0.1% sodium azide. Staining for FoxP3 was performed after cells were fixed and permeabilized with the Biolegend FOXP3 Fix/Perm Buffer Set . One million cells were stained in each sample on ice for 20min in approximately 200l of staining buffer and rinsed twice. Staining tubes that were not fixed/permeabilized were subjected to 100ng/ml propidium iodide in the second rinsing step to mark dead cells. The BD IMK kit was used to determine the percentages and absolute counts in whole blood of the following mature lymphocytes: T lymphocytes , B lymphocytes , helper/inducer T lymphocytes , cytotoxic T lymphocytes , and natural killer lymphocytes . BD Trucount tubes were used for determining absolute counts.
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Importance Of Regular Screenings For Breast Cancer
Regular screening can also help improve survival rates by ensuring that breast cancer is detected and treated early.
However, the study also highlighted that not meeting the guidelines was associated with socioeconomic factors like lower income and lack of access to health insurance. Overall, public health agencies are trying to ensure that all women are able to receive timely screening and treatment.
Can Stage 4 Breast Cancer Go Into Remission
Stage 4 breast cancer can go into remission, meaning that it isnt detected in imaging or other tests. Pathological complete remission indicates a lack of cancer cells in tissues removed after surgery or biopsy.
But its rare to take tissue samples while treating stage 4 breast cancer. This could mean that although treatment has been effective, it hasnt completely destroyed the cancer.
Advances in stage 4 breast cancer treatments are helping to increase the length of remission.
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What Can I Expect While Living With Metastatic Breast Cancer
Your care team will monitor you every few months to check if the cancer is responding to treatment, and also to see if you are having any side effects. The process of restaging the cancer includes:
- History/physical exam.
- Imaging tests, including CTs and bone scan or PET scan.
Before your scans or tests, its normal to feel anxiety. It may help to bring a friend or family member to the appointment with you.
Stage 4 Breast Cancer: Prognoses And Solutions
Breast cancer cases have doubled in the last 20 years. Women die more often from this disease than all other cancers. Cancers develop inside our bodies, from our own cells that have mutated for some reason. Scientists all over the world have been fighting over the cause of cancer for decades and have come to the conclusion that the diseases destructive mechanisms are triggered by not one but many factors.
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Symptoms Of Metastatic Breast Cancer
The symptoms of stage 4 breast cancer depend on the location of the cancer and where it has spread in your body.
- If breast cancer has spread to your bones, you may notice a sudden new bone pain. Breast cancer most commonly spreads to your ribs, spine, pelvis, or arm and leg bones.
- If it has spread to your brain, you may experience headaches, vision or speech changes, or memory problems.
- Breast cancer that has spread to your lungs or liver usually causes no symptoms.
The main treatments for stage 4 breast cancer are targeted drug therapies that destroy cancer cells wherever they are in your body.
These treatments may include:
- hormone therapy, which stops or slows the growth of tumors by preventing your body from producing hormones or interfering with the effect of hormones on breast cancer cells
- chemotherapy, where drugs given orally or through an IV travel through your bloodstream to fight cancer cells
- immunotherapy, which uses drugs that stimulate your immune system to destroy cancer cells
- a combination of these therapies
The following are the common treatment options for different types of stage 4 breast cancer.
Treatment Of Stage Iv Breast Cancer
Stage IV cancers have spread beyond the breast and nearby lymph nodes to other parts of the body. When breast cancer spreads, it most commonly goes to the bones, liver, and lungs. It may also spread to the brain or other organs.
For women with stage IV breast cancer, systemic drug therapies are the main treatments. These may include:
- Some combination of these
Treatment can often shrink tumors , improve symptoms, and help some women live longer. These cancers are considered incurable.
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How To Prevent Breast Cancer
There is no guaranteed way to prevent breast cancer. Reviewing the risk factors and modifying the ones that can be altered can help in decreasing the risk.
Following the American Cancer Societyâs guidelines for early detection can help early detection and treatment.
There are some subgroups of women that should consider additional preventive measures.
- Women with a strong family history of breast cancer need genetic testing such as HER2-Positive and BRCA Gene tests. Discuss this with a health care provider and meet with a genetic counselor who can explain what the testing can and cannot tell and then help interpret the results after testing.
- Chemoprevention is the use of medications to reduce the risk of cancer. The two currently approved drugs for chemoprevention of breast cancer are tamoxifen and raloxifene , which also blocks the effect of estrogen on breast tissues. Their side effects and whether these medications are right for an individual need to be discussed with a health care provider.
- Aromatase inhibitors are medications that block the production of small amounts of estrogen usually produced in postmenopausal women. They prevent reoccurrence of breast cancer but are not approved at this time for breast cancer chemoprevention.
- For a small group of patients who have a very high risk of breast cancer, surgery to remove the breasts may be an option. Although this reduces the risk significantly, a small chance of developing cancer remains.
Diagnostic Tests That Inform The Clinical Stage
Many methods are used to detect and stage cancer. Some of the common tests include:
Biopsy: The doctor uses a needle to extract breast tissue or fluid, which is then sent to a lab. There, various techniques are used to examine different attributes, such as hormone receptor or HER2 status.
Tumor markers: Rapidly dividing cancerous cells interrupt some of the normal mechanisms of cell growth. This causes the cell to overproduce certain molecules. Lab tests detect these compounds, known as tumor markers, in blood or tissue samples.
Imaging techniques: Several different scans are used to examine characteristics of your cancer. Below are some of the noninvasive imaging techniques you might encounter:
- MRI scans use magnets and radio waves to generate detailed pictures of your tissues.
- CT scans use X-rays to look at your organs. Nuclear scans trace the flow of an injected safe radioactive dye in your body.
- PET scans are similar to nuclear scans but specifically examine glucose consumption in the bodysince cancer cells use more glucose than normal cells.
- Ultrasound imaging uses sound waves to see inside your body.
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Facts You Should Know About Triple
- Triple-negative breast cancer is an uncommon kind of breast cancer in which the cancer cells test negative for three common markers, the estrogen receptor , progesterone receptor , and a protein involved in cell growth known as HER2.
- The triple-negative status of a cancer means that anti-hormonal therapies and therapies targeted against the HER2 protein are not effective.
- About 10%-20% of all breast cancers are triple-negative.
- Doctors usually treat triple-negative breast cancers with surgery, chemotherapy, and in many cases, radiation therapy.
- Triple-negative cancers have a more aggressive course than other breast cancers and are more likely to recur over the first few years after diagnosis. After 5 years, the likelihood of recurrence decreases.
- A majority of cases of breast cancer in women with a BRCA-1 mutation are triple-negative.
Myth #: The Mental And Emotional Experience Of People With Mbc Is The Same As That Of Earlier
People with MBC report hearing comments such as, At least you have a good type of cancer, Arent you glad so much research on breast cancer has been done?, Fortunately you have so many options. These might comfort people with early-stage breast cancer, who can look forward to one day finishing treatment and moving on but people with MBC dont have that luxury. They know they will be in treatment for the rest of their lives. They also know that their life is likely to be shorter than theyd planned.
Mentally and emotionally, people with MBC have a completely different experience. For them, the whole ringing the bell idea does not work, says Dr. Gupta. I have patients who are coming in once a week and have to plan their lives around their treatment. The whole pink brigade idea is very upsetting to them.
Fortunately, more and more people with MBC are speaking up and calling attention to how their experience differs from that of people with earlier-stage breast cancer. People with MBC live with cancer always in the background of their lives, but with new and emerging therapies, many are living longer and maintaining their quality of life.
Clearly, the experience of metastatic breast cancer is quite different from early-stage breast cancer. But there are so many patients who understand just what youre going through. Read more about Living with Metastatic Breast Cancer and join our discussion forum for people with stage IV/metastatic disease.
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What Are Cancer Survival Statistics
A key part of making a prognosis is looking at survival rates. These are numbers researchers collect over many years in people with the same type of cancer. These numbers are based on large groups of people. For breast cancer, there are two main measurements:
Breast cancer survivalrates reflect the percentage of women who are alive 5 years or longer after their diagnosis. This means the numbers are based on women who were found to have breast cancer at least 5 years ago. Advances in diagnosing and treating cancer have led to steadily improving survival rates, so the outlook for women diagnosed today is likely better.
Relative survival rates donât take into account the cause of death. Theyâre a measure of the percentage of people with cancer who have lived for a certain time after diagnosis, compared with people who did not have cancer.