Am I a Candidate for Local Treatment of Distant Metastasis?

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You may be a candidate for local treatment of distant metastasis if:

  • Metastatic breast cancer is causing pain or other symptoms that are affecting your day-to-day life and function.
  • You have just one or two areas of metastasis and doctors believe they can completely remove the cancer, possibly preventing future problems. This is called oligometastatic disease.

Examples of how metastatic breast cancer can affect functioning include:

  • tumors press on critical areas of the brain or spinal cord
  • bone metastases weaken the bone so much that it is poses a risk of fracture
  • lesions in the lung make it hard to breathe
  • tumors interfere with normal liver function

The goal of local therapies is to improve these symptoms and prevent the cancer from causing further problems.

Some doctors also consider local treatments for carefully selected patients with stage IV breast cancer who aren’t experiencing major symptoms. If you’re generally feeling well and have just one or two cancerous growths in one area of the body, local treatment may be an option. In making this decision, you and your doctor have to consider whether the potential benefit — getting rid of those growths — is likely greater than the risk of side effects from the treatment. Since there is currently no cure for metastatic breast cancer, the goal of many treatment strategies is to increase the odds of a long period in which there is no evidence of disease (NED).

If you’re in this situation, you can use the following questions to help guide your discussion with your doctor:

  • Your overall health and level of function: How healthy do you feel? How well are you functioning? Are you able to be fairly active during the day and engage in normal activities?
  • Whether you’re age 65 or older: Do you have any age-related health conditions or complications?
  • The extent of the cancer: Is the breast cancer in one area or many? If just one area, do you have one growth or just a few? How large are the areas? (Local treatment may be an option if there are one or two small tumors in a single area.)
  • The cancer’s characteristics: Less aggressive cancers — such as those that are estrogen-receptor-positive or low-grade — tend to be more treatable.
  • Likelihood of complete removal (if surgery is being considered): Is it likely that all of the cancer can be removed if you have surgery?
  • Time between your original diagnosis of breast cancer and diagnosis with metastasis: If you were successfully treated for an earlier-stage breast cancer in the past, how much time passed before your stage IV diagnosis? Did you have at least a few years with no evidence of disease before metastases appeared? In general, how well has the breast cancer responded to treatment until now?

If local treatments are recommended, whether for symptom relief or cancer control, your doctor will include another specialist, such as a radiation oncologist, interventional radiologist, or a surgeon who specializes in procedures involving the bone, brain, spine, lung, liver, or other affected area. Together you can come up with the treatment plan.

The rest of the pages in this section explain treatment options by site.

Stage IV cancer treatment also may involve treatment for pain. To learn more, visit Breastcancer.org’s section on Treatments for Pain.


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