One of the most serious breast cancer stages is stage 4 or metastatic breast cancer. This is a serious diagnosis because it means that the cancer has found ways to spread around the body. When a cancer has spread, for example, through the bloodstream or lymph system, it is known as metastatic cancer. Cancers that have spread are named after the place in the body where they started. For example breast cancer that has spread to the lungs is not lung cancer but rather metastatic breast cancer. This spreading of a cancer around the body is sometimes referred to as metastatic disease.
The facts about metastatic breast cancer
When breast cancer spreads to other parts of the body it is classified as Stage 4 breast cancer or metastatic breast cancer. Breast cancer cells can spread by different means including:
- Healthy cells being invaded by cancer cells
- Cancer cells infiltrating the lymph system or bloodstream and being carried around the body
- Cancer cells that have already spread causing tumours in new areas of the body
Metastatic breast cancer can spread all around the body but there are some more likely places for it to spread to, these include the liver, the lungs, the brain, the skeletal system and the lymph nodes. If you have a diagnosis of breast cancer, it is important to remain aware and keep on the look out for metastatic breast cancer symptoms.
Metastatic breast cancer risk factors
Because of the many factors involved, it is not possible to predict which breast cancers will spread around the body. These factors include:
- Whether the breast cancer is growing quickly or slowly
- The stage and spread of the breast cancer at first diagnosis
- The type of breast cancer
Early signs of metastatic breast cancer
The first sign that breast cancer cells have spread often comes from symptoms affecting the lymph nodes on the same side of the body as the original breast cancer. These include swellings under the armpits, in the arms or hands, or around the breastbone or collarbone.
Metastatic breast cancer in the bones
If breast cancer cells spread to the bones, symptoms may include:
- Painful or aching bones that can’t be relieved by rest
- Bone weaknesses, breaks or fractures
Hypercalcaemia can occur when calcium is discharged into the bloodstream by bones that have been damaged by advanced metastatic breast cancer. Symptoms of hypercalcaemia can include:
- Tummy pain, constipation and/or nausea
- Mood changes
- A confused state
It is important to report new symptoms to the doctor as they occur. A doctor might recommend tests including MRI scans, PET scans, X-rays, bone scans and/or bone marrow tests. As with any cancer, the aim of treatment for metastatic breast cancer in the bone is to control both the cancer itself and the impact it is having on the patient. Treatments for tackling the cancer that has spread to the bones include:
- Hormone therapy
- Cancer drugs
- Surgery or treatment to strengthen bones
Metastatic breast cancer in the liver
If breast cancer cells spread to the liver, symptoms might include:
- Nausea and loss of appetite
- Jaundice (yellowed skin and eyes)
- Pain in the liver area (the right side of the abdomen)
By reporting suspected new cancer symptoms to your doctor as they occur, you can make sure that metastatic breast cancer is treated as soon as possible. Tests might include ultrasound scans, blood tests to test liver function, CT scans (3D imagining) and/or PET scans (3D imaging).
The aim of any treatment for cancer in the liver is to control it and reduce the impact of symptoms. Treatments for breast cancer that has spread to the liver include:
- Hormone therapy
- Targeted cancer drugs
Metastatic breast cancer in the lungs
If breast cancer cells spread to the lungs, symptoms might include:
- Persistent coughing (including the production of blood)
- Difficulty catching breath
- Recurring or stubborn chest infections
- Pleural effusion (fluid between the lungs and chest wall)
Some of these symptoms might be due to other conditions but they should still be discussed with a doctor. Tests that a doctor might suggest include, PET scans (3D imaging), CT scans (3D imaging) and/or chest X-rays. Secondary lung cancer does not usually have a cure but it and its symptoms can be controlled by palliative treatment. These treatments might include:
- Hormone therapy
- Targeted cancer drugs
Metastatic breast cancer in the brain
If breast cancer spreads to the brain, symptoms will depend on which part of your brain has been affected by a tumour, they might include:
- Behaviour changes and/or confusion
- Problems with eyesight
- Weakness, nausea and vomiting
If you have an existing breast cancer, it is important to report these symptoms to a doctor as they occur. Recommended tests might include, CT scan (3D imaging), physical examination, MRI scan (3D imaging) and/or a biopsy of the tumour. Treatments for this type of cancer that has spread to the brain include:
Metastatic breast cancer prognosis
It is very natural to worry about a diagnosis of metastatic cancer but it is important to remember that individual prognoses are dependent on a wide range of factors including the areas of the body the cancer has spread to, the speed of cancer growth and how well a cancer reacts to treatment.
Talking to medical and support specialists can be very helpful and can help you with decision-making regarding your treatment and care. Survival to five-years for stage 4 or metastatic breast cancer is 15% and treatment focuses on controlling the growth, spread and symptoms it causes.
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