How long can you live with stage 4 breast cancer? (2023)

Life expectancy in stage 4 breast cancer (metastaticbreast cancer) is very different. Everyone is different, and factors such as age, general health, type of breast cancer, and even where in the organs the cancer has spread (metastasized) can affect the results of treatment.

There is no cure for stage 4 cancer, so it may be helpful to look at long-term survival rates and other information to learn more about the cancer.forecast, the result.However, keep in mind that the data also has limitations and not everyone may find the current research useful.

This article presents the 5-year survival rates for people with stage 4 breast cancer, but also includes variables to consider when discussing these survival rates.

Five-year survival rates

The American Society of Clinical Oncology (ASCO), based on 2022 data from the National Cancer Institute and the American Cancer Society, reports a 5-year overall survival rate of 29% for women with metastatic breast cancer. The 5-year survival rate is 22% for men living with the disease.

However, cancer survival statistics do not immediately reflect treatment changes that improve breast cancer care. These advances include:

• HER2targeted therapies
• the adition ofbisphosphonate
• Newer Immunotherapeutics

Although not as effective in breast cancer as in some other types of cancer, immunotherapy drugs have led to apermanent response, or long-term response, for at least some people with advanced breast cancer.

Oligomestasis and treatment

Another area of ​​treatment that is changing is the treatment ofOligometastasis. In the past, people with metastatic disease (whether at a single site or at multiple sites) were treated at the same time with common treatments for metastatic cancer, such as:chemotherapyoHormonal therapy.

Research has begun to see the benefit of treating oligometastasis, which is defined as one or just a few metastases in a specific organ. These isolated metastases can be treated with:

• Operation
• proton therapy
• Stereotaxic radiation therapy of the body

For some cancers and metastases in some regions (eg.lung cancerwith brain metastases), treatment has prolonged life and sometimes results in long-term survival. Future advances could lead to similar improvements in life expectancy.

Variables of breast cancer and survival

Life expectancy in stage 4 breast cancer is influenced by many factors. Some of these factors may be "actionable," meaning there are things people can do that could affect their prognosis.

You cannot change other factors such as age or type of cancer. There are also many exceptions to the general rules. Some people with a very poor prognosis survive for many years or decades, while others with an excellent prognosis may live less than most.

Some factors associated with survival are:

• type: Some types of breast cancer are associated with better survival rates than others.
• To alter: Although breast cancer has a reputation for being more aggressive in younger women,young womanthey are more likely to be long-term survivors of breast cancer than older women.
• receiver status: People who havepositive receptors, if the estrogen receptor,Progesteronehuman epidermal growth factor receptor or receptor 2 (HER2), tend to live longer than those with negative receptors, particularlytriple negativeDisease.
• Metastasis localization: Bone metastases from breast cancer are associated with a higher survival rate than metastases in other regions, such as the lungs, liver, and brain.
• treatment options: This includes treatment of oligometastases. A 2019 study found that treating this type of spread (usually up to five areas) can sometimes significantly improve survival.
• Physical activity:Activity and exercise can improve survival. A study of 103 people diagnosed with stage 4 breast cancer found that being active for an hour or more a day resulted in longer survival times.
• Emotional and social support: People who have a supportive partner are more likely to live longer, and having a partner is one of the factors associated with long-term survival.
• General health: General health plays a large role in survival rates and also affects what treatments a person can tolerate.

Complications of advanced breast cancer, such asblood clot, fractures,malignant pleural effusions, and more can reduce the expected life expectancy.

Variables that do not affect survival

Not all factors affect the prognosis of stage 4 breast cancer. Just as there are factors that go hand in hand with a better or worse prognosis, there are some factors that don't seem to make much of a difference.

People tend not to understand these factors either. They include:

• How aggressive is your treatment (general)
• have a positive attitude

Treatment goals for metastatic breast cancer are often different from those for early-stage disease. For early breast cancer, the goal is often aggressive to reduce the risk of the cancer coming back.

By contrast, with stage 4 disease, the goal is often to use as little treatment as possible to control the disease (at least for now). Studies have found that more aggressive treatment does not improve survival rates but reduces quality of life.

While a good attitude can improve your well-being, it has not been shown to affect survival rates. On the other hand, almost 42% of people diagnosed with breast cancer have breast cancer.distress.Trying to appear positive instead of expressing your concerns can be detrimental to your overall health.

Who are the long-term survivors?

Being a long-term survivor is generally defined as surviving five years or more after a diagnosis of stage 4 breast cancer.

Living 10 years or more is not uncommon, and that10-year survival ratefor basic orone more timemetastatic breast cancer is around 13%. (This rate is based on de novo cases or cases where stage 4 was the initial diagnosis.)

Characteristics

Although there is a significant degree of variability, the long-term survivors are:

• You are more likely to be younger (this is in contrast to early-stage breast cancer, where survival rates are lower for younger people with the disease)
• They are more likely to have estrogen receptor, progesterone receptor, and/or HER2-positive tumors.
• Less likely to have other medical conditions (comorbidities).
• Less likely "visceral" metastases, such as abdominal andLebermetastasen
• tend to have a higher household income
• Better to have a partner

Long-term survivors are also more likely to be diagnosed with early-stage (de novo) breast cancer than early-stage breast cancer that has come back at distant sites.

In several studies, the duration of response after the first treatment for metastatic breast cancer was associated with survival.However, it can be difficult to predict who might survive for a longer period of time based on currently available measurements.

Recently, research has begun to focus on people who survive longer than expected, or "outliers," to gain insight into genetics and other factors that could make a difference.

How to deal with stage 4 breast cancer

Managing stage four breast cancer is challenging and different from managing early-stage disease. Those who originally faced early-stage breast cancer not only have to deal with cancer again, but this time they are not faced with a disease that can be cured.

Metastatic breast cancer is usually associated with more symptoms, such as bone pain due to bone metastases.chopwith liver metastases. On top of all this (and despite all the "awareness" that has arisen), people with stage 4 disease can feel left out of the breast cancer community.

Support

Support is very important and some studies suggest that social support even improves survival time.Family and friends are key, but participating in a breast cancer support group or community is also extremely helpful.

These communities give you the opportunity to connect with others facing the same challenges.

Many people with stage 4 breast cancer prefer a social community dedicated to metastatic breast cancer. When living with metastatic cancer, it can be difficult to hear others talk about common problems in the early stages, such as hair loss or the chance of pregnancy. You may have completely different concerns, such as B. how long you will live.

Be your own lawyer

The relationship betweenself defenseand survivability is unclear, but being your own defender can't stop you from maximizing your survivability. For example, some studies show that informed decision making can be improved in people who are attuned to the symptoms of breast cancer.

Oncology is changing rapidly and it is difficult for any oncologist, even those who specialize in breast cancer, to keep up with the latest research and clinical trials.

It may also be helpful to get a second opinion, particularly from one of the larger cancer centers, e.g. B. a cancer center designated by the National Cancer Institute.

Some occasions do not require a trip to the reviews. There are now clinical trial matching services where a care navigator can help match your tumor and its characteristics to ongoing clinical trials around the world.

Larger cancer centers may offer remote second opinions, where an oncology team can review your medical information and speak with you over the phone about treatment options that may not be available elsewhere.

Palliative care and coping

Dealing with the many symptoms that stage 4 breast cancer can present can be frustrating and daunting, and sometimes people wonder if they need to feel sick for the rest of their lives. Anxiety and depression are also serious for some people with advanced disease.

Feliz,PalliativpflegeTeam office hours are now offered at many cancer centers. Although hospice care is a form of palliative care, palliative care can also be helpful for early curable tumors.

Summary

In stage 4 breast cancer, the spread (metastasis) of the disease changes the priorities that people have at the beginning of the diagnosis. Treatment options vary, but so does your perspective on the progression of the cancer.

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 that affect a cancer diagnosis, including recipient status and associated therapies, affect the outcome.

The life expectancy of people with stage 4 breast cancer is also evolving as a result of new research. Your health care team can help you understand your condition, make informed decisions, and connect you and your loved ones with support resources.