Prognosis for metastatic breast cancer (2023)

Metastatic breast cancer, or stage 4 breast cancer, has spread to other organs and can cause new symptoms. There is no cure, but treatments are available and survival rates continue to improve over time.

When your doctor has made a diagnosismetastatic breast cancer, it means that the cancer has progressed to what is known as stage 4.

Stage 4 breast cancer refers to cancer that has spread beyond the breast tissue and local lymph nodes to other areas of the body.

To understand the prognosis or outlook for stage 4 breast cancer, it is helpful to know about the process of metastasis. When cancer "metastasizes," it has spread beyond the part of the body where it originated.

In the case of breast cancer, a stage 4 diagnosis could mean that the cancer has spread to organs outside the breast, such as the bones or lungs. In this article, we take a look at what to expect with metastatic breast cancer, from prognosis to treatment.

In accordance withAmerican Cancer Society (ACS), the 5-year survival rate after diagnosis for people with stage 4 breast cancer is 28%. This percentage is significantly lower than in previous phases. For all stages, the 5-year overall survival rate is 90%.

Because survival rates are highest in the early stages of breast cancer, early diagnosis and treatment are critical. But remember: Proper treatment for stage 4 breast cancer can improve quality of life and longevity.

Metastatic breast cancer is not the same for everyone who has it. In accordance withNational Breast Cancer Foundation, Stage 4 symptoms depend on how far the cancer has spread in your body.

Although there is currently no cure for metastatic breast cancer, it can be treated. The right treatment can increase your quality of life and longevity.

(Video) Treatment of Metastatic Breast Cancer

Life expectancy for breast cancer is based on studies involving many people with the disease. These stats cannot predict your personal outcome - everyone has a different perspective.

The following factors can affect your life expectancy with metastatic breast cancer:

  • your age
  • your overall health
  • Hormone receptors and HER2 receptors on cancer cells
  • the types of tissue that the cancer has affected

The symptoms of stage 4 breast cancer depend on the location of the cancer and the extent of the body.

  • If breast cancer has spread to the bones, you may notice sudden new bone pain. Breast cancer often spreads to the ribs, spine, pelvis, or bones of the arms and legs.
  • If it has spread to the brain, you may experience headaches, vision or speech problems, or memory problems.
  • Breast cancer that has spread to the lungs or liver usually causes no symptoms.

The main treatments for stage 4 breast cancer are targeted (systemic) drug therapies that kill cancer cells anywhere in the body.

These treatments can include:

  • hormonal therapy, which stops or slows the growth of tumors by stopping your body from making hormones or by interfering with the way hormones work on breast cancer cells
  • chemotherapy, where oral or intravenous drugs travel through the bloodstream to fight cancer cells
  • immunotherapy, which uses drugs that stimulate the immune system to kill cancer cells
  • a combination of these therapies

In some cases,OperationÖradiotherapyIt can be used to treat stage 4 breast cancer.

(Video) What is the Treatment for Metastatic Breast Cancer?

The following are common treatment options for different types of stage 4 breast cancer.

hormone receptor positive cancer

This type of cancer has cells with estrogen receptors, which are proteins that can bind to some substance in the blood known as ER positive (or ER+). Instead, you may have cancer cells that are called PR-positive (PR+) progesterone receptors, or you may have both.

Hormone receptor-positive breast cancer is usually treated with hormone therapy drugs that block estrogen receptors (such asTamoflexine) or which lower the levels of estrogen (aromatase inhibitors such as letrozole) in your body.

hormone receptor-negative cancers

This type of stage 4 breast cancer does not have ER+ or PR+ receptors, so hormone therapy drugs do not work.

Chemotherapy may be more effective in hormone receptor-negative breast cancer than in hormone receptor-positive breast cancer.

HER2 positive cancer

Human epidermal growth factor receptor 2 (HER2) is a protein found on the surface of breast cells. WithHER2 positive breast cancer, there are abnormally high levels of HER2 proteins that cause cancer cells to grow and spread rapidly.

Along with chemotherapy, this stage 4 breast cancer is often treated with the targeted drug trastuzumab (Herceptin), a synthetic antibody that binds to the HER2 protein on cancer cells and stops them from growing. These drugs are given by intravenous infusion.

HER2-negative cancer in women with a BRCA gene mutation

HER2-negative breast cancer does not have many HER2 proteins. A BRCA gene mutation (an acronym for BReast Cancer) is caused by damage to the DNA that makes up the gene.

If there is a mutation, the gene can no longer suppress the growth of cells with damaged DNA. As a result, the gene is no longer as effective in preventing breast cancer.

In 2018, the FDA approved the oral drugtake(Lynparza), for the treatment of HER2-negative metastatic breast cancer in women with a BRCA gene mutation.

HER2-negative cancers in women with a PIK3CA gene mutation

Ögen PIK3CAproduces the alpha protein p110 (p110α), which is essential for cell growth and other important functions. When this gene mutates, cells can replicate out of control and cause various types of cancer. This includes breast cancer.

Chemotherapy may not be effective for HER2-negative stage 4 breast cancer in women with a PIK3CA gene mutation because they are less sensitive to chemotherapy drugs.

The FDA has approved the oral drugalpelisibe(Piqray) in 2019 for treating this specific type of breast cancer. Alpelisib is a "PI3K inhibitor" that must be given in combination with the hormone treatment fulvestrant (Faslodex).

triple negative breast cancer

In this type of breast cancer, the breast cancer cells do not have ER+ or PR+ receptors. They don't overproduce the HER2 protein, so hormone therapy isn't very effective.

Instead, stage 4 triple-negative breast cancer is usually treated with chemotherapy. Depending on the location of the metastases, radiation therapy may also be an option.

(Video) Survival Advantage Observed in HER2+Breast Cancer With Brain Metastasis

There is currently no cure for stage 4 breast cancer, but with treatment it can often be controlled for years.

People with metastatic breast cancer need treatment for the rest of their lives. When a particular treatment is no longer effective, a different treatment regimen may be tried.

Stage 4 breast cancer can occurRemission, meaning it will not be detected on imaging or other tests. Pathologic complete response (pCR) indicates a lack of cancer cells in tissues removed after surgery or biopsy.

But it's rare to take tissue samples during treatment for stage 4 breast cancer. This could mean that while the treatment was effective, it didn't completely destroy the cancer.

Advances in the treatment of stage 4 breast cancer are helping to prolong the duration of remission.

Metastatic breast cancer is considered a chronic disease, so it doesn't go away or come back.

(Video) Understanding Breast Cancer Survival Rates

But in recent years, people under the age of 50 have seen a particularly sharp drop in breast cancer death ratesCenters for Disease Control and Prevention (CDC).

These decreases are due in part to the improvementclassificationand treatment of the disease.

There are some general facts you should know about your breast cancer outlook:

  • Breast cancer is the most common cancer diagnosis in the United StatesNational Cancer Institute (NCI).
  • Many people with breast cancer are living longer than ever before. Over time, the number of deaths from breast cancer has decreased significantly.
  • The American Cancer Society estimates approximately281.550new breast cancer diagnoses in 2021.

The stage of breast cancer at the time of diagnosis plays an important role in prognosis.

In accordance withNCI, has the best prognosis in the 5 years following a breast cancer diagnosis when the cancer is diagnosed and treated at an early stage.

Keep in mind that everyone is different and your response to treatment may not be the same as someone else's, even at Stage 4. Researchers continue to test differentlytreatment optionsfor metastatic breast cancer. The prospects are improving every year.

Talk to your doctor to learn more about individual factors that can affect your outlook.

Read this article in Spanish.


1. Breast Cancer Survival Rate
(Mount Sinai Health System)
2. Metastatic Bone Cancer: Bone Pain When Breast & Prostate Cancer Spreads
3. When Breast Cancer is No Longer Curable - Mayo Clinic
(Mayo Clinic)
4. New Jersey Mom Recovers from Stage 4 Breast Cancer Diagnosis
(RWJBarnabas Health)
5. New Treatments for Metastatic Breast Cancer
(Dana-Farber Cancer Institute)
6. Hopeful Advances In Metastatic Breast Cancer
(Concord Hospital)
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