When breast cancer spreads to other parts of the body it is known as metastatic breast cancer (MBC), or metastatic disease. MBC is also sometimes referred to as advanced stage breast cancer or stage IV breast cancer.
Although there is no cure for MBC, it is treatable. Thanks to new treatments developed through clinical trials, women with MBC are often able to lead full, active lifestyles with a good quality of life.
We sat down with Rachel Freedman, MD, MPH, a breast oncologist with the Susan F. Smith Center for Women’s Cancers at Dana-Farber, to learn more:
Are there different types of MBC?
The different types of breast cancer are often defined base on a cancer’s “receptors”, such as estrogen receptor and human epidermal growth factor receptor 2 (also called HER2). There are also newer techniques we are starting to use that help define cancers based on genes within a cancer, but more research is needed on how to best use this information in selecting treatments.
What percent of patients are diagnosed with MBC?
Approximately 10 percent of patients will have their initial diagnosis of breast cancer made when it is metastatic. As far as women who are initially diagnosed with earlier stages of breast cancer, approximately 30 percent of these patients will have a recurrence that results in metastatic breast cancer. The risk of a recurrence depends on the features of the breast cancer, including the size of a tumor, degree of lymph node involvement, as well as the biological features of the cancer.
Is there any way to prevent MBC?
There is no fool-proof way to prevent MBC, but there are some things that can reduce the risk:
- Women age 40 or older should strongly consider screening for breast cancer, and anyone with a strong family history of the disease should consider screening earlier.
- People diagnosed with early-stage breast cancer should follow recommendations from their doctors and nurses with regard to chemotherapy, radiation, or hormonal treatments. This will help lower the chances for recurrence.
It is important to remember that although there are risk factors for breast cancer such as family history, estrogen exposure, and past radiation to the chest, none of these factors put patients at risk specifically for MBC.
How is MBC treated?
Treatments for MBC are aimed at attacking cancer cells wherever they are in the body, rather than focusing on a specific body part. These “systemic” treatments help control the cancer, help women live longer, and maximize quality of life. These treatments can include therapies that target estrogen (such as tamoxifen and aromatase inhibitors), those that target the HER2 expression (such as trastuzumab/Herceptin), chemotherapy, and clinical trials. Dana-Farber is currently conducting more than 30 clinical trials to study the effects of new, targeted drugs on metastatic breast cancer. Much of the research work performed at Dana-Farber has resulted in treatment breakthroughs and new standards of care for patients with metastatic disease.
Where can MBC patients find support?
There are many ways MBC patients can find support, and patients should use their treatment team as a resource. At Dana-Farber, we have an incredible social work team, support groups, as well as the metastatic disease cohort, a group that follows women with MBC and gives them the opportunity to interact with other patients. In addition, there are a number of online support groups and resources like the Metastatic Breast Cancer Network, breastcancer.org, Susan G. Komen for the Cure, and the Metastatic Breast Cancer Alliance, among others.
Is there any new MBC research to share?
There have been many advances in metastatic breast cancer treatment over the past few years. Several new treatments have been FDA-approved for MBC and there are many more to come. We now have a greater understanding of the various subtypes of breast cancer, which is helping us identify new treatment options through clinical trials, tailored specifically for patients with metastatic breast cancer. We are confident that all of our research will translate into improvements for women with metastatic disease in the years to come. The best way to learn about new clinical trials is to speak with your provider.
The Susan F. Smith Center for Women’s Cancers at Dana-Farber will host its annual Metastatic Breast Cancer Forum on Saturday, Oct. 18, 2014, from 9 a.m. – 12:30 p.m. The event, sponsored by EMBRACE (Ending Metastatic Breast Cancer for Everyone), is open to all patients with MBC and their families. To register, call 617-632-4915 or email embrace@partners.org.
The Susan F. Smith Center at Dana-Farber and the Metastatic Breast Cancer Network will also host a live video webchat on the latest treatments and research for metastatic breast cancer on Wednesday, Oct. 29, 2014, at 1 p.m. with Eric Winer, MD, director of the Breast Oncology Program. To submit your questions for Dr. Winer, email webchats@dfci.harvard.edu and tune in live here: http://www.dana-farber.org/webchats.
It is 17 years after Radiation and Adriamycin, 5-fluorouracil and cytoxin I have been feeling symptoms of Fibromyalgia ( for the past 8 years +). Is there any connection to my breast cancer and /or treatment ? Is this just a separate ”disease” altogether ? Thank you for your input, Yvonne Anderson
Dear Yvonne —
We are sorry to hear about your health trouble. We spoke with Dr. Freedman about this question:
“Hi Yvonne. It is unlikely that these symptoms you are now having are related to the treatments you received 17 years ago. If you don’t have a diagnosis of active breast cancer that is under treatment, I would say that the joint symptoms are likely unrelated. I would start by talking to your doctor/nurse so that your history can be teased out and your symptoms can be evaluated.”
I hope this is helpful and wish you all the best.
How often should one get an MRI of the remaining breast ( post mastectomy/ radiation/chemotherapy ) vs. a plain Mammogram. Should one get a scan of the ” reconstructed ” breast post mastectomy ? Thank you, Yvonne Anderson
Dear Yvonne —
We spoke with Dr. Freedman about this question as well:
“This is a long answer. There is no recommended screening for a reconstructed breast because there is no more tissue. Most women only need a mammogram on the other side and any addition of MRI should be discussed with your treatment team.”
Thank you for the interest in our Insight blog. Wishing you all the best.
Is there any correlation with Fibromyalgia and Status Post Mastectomy with concomitant Radiation & Chemotherapy ( Adriamycin, Cytoxin and 5-Fluoro-Uracil )?
Thank you,
Yvonne Anderson