Metastatic breast cancer (also called stage IV) is breast cancer that has spread to another part of the body, most commonly the liver, brain, bones, or lungs.
Cancer cells can break away from the original tumor in the breast and travel to other parts of the body through the bloodstream or the lymphatic system, which is a large network of nodes and vessels that works to remove bacteria, viruses, and cellular waste products.
Breast cancer can come back in another part of the body months or years after the original diagnosis and treatment. Nearly 30% of women diagnosed with early-stage breast cancer will develop metastatic disease.
Some people have metastatic breast cancer when they are first diagnosed with breast cancer (called “de novo metastatic”). This means that the cancer in the breast wasn’t detected before it spread to another part of the body.
A metastatic tumor in a different part of the body is made up of cells from the breast cancer. So if breast cancer spreads to the bone, the metastatic tumor in the bone is made up of breast cancer cells, not bone cells.
Being diagnosed with metastatic breast cancer can be overwhelming. You may feel angry, scared, stressed, outraged, and depressed. Some people may question the treatments they had or may be mad at their doctors or themselves for not being able to beat the disease. Others may deal with diagnosis of metastatic breast cancer in a matter-of-fact way. There is no right or wrong way to come to terms with the diagnosis. You need to do and feel what is best for you and your situation.
Keep in mind that metastatic disease is NOT hopeless. Many people continue to live long, productive lives with breast cancer in this stage. There are a wide variety of treatment options for metastatic breast cancer, and new medicines are being tested every day. More and more people are living life to the fullest while being treated for metastatic breast cancer.
While metastatic breast cancer may not go away completely, treatment may control it for a number of years. If one treatment stops working, there usually is another you can try. The cancer can be active sometimes and then go into remission at other times. Many different treatments — alone, in combination, or in sequence — are often used. Taking breaks in treatment when the disease is under control and you are feeling good can make a big difference in your quality of life.
The symptoms of metastatic breast cancer can vary greatly depending on the location of the cancer. This section covers the symptoms of breast cancer that has spread to the bone, lung, brain, and liver, and the tests used to diagnose metastatic breast cancer.
Bone Metastasis: Symptoms and Diagnosis
The most common symptom of breast cancer that has spread to the bone is a sudden, noticeable new pain. Breast cancer can spread to any bone, but most often spreads to the ribs, spine, pelvis, or the long bones in the arms and legs. Learn more.
Lung Metastasis: Symptoms and Diagnosis
When breast cancer moves into the lung, it often doesn’t cause symptoms. If a lung metastasis does cause symptoms, they may include pain or discomfort in the lung, shortness of breath, persistent cough, and others. Learn more.
Brain Metastasis: Symptoms and Diagnosis
Symptoms of breast cancer that has spread to the brain can include headache, changes in speech or vision, memory problems, and others. Learn more.
Liver Metastasis: Symptoms and Diagnosis
When breast cancer spreads to the liver, it often doesn’t cause symptoms. If a liver metastasis does cause symptoms, they can include pain or discomfort in the mid-section, fatigue and weakness, weight loss or poor appetite, fever, and others. Learn more.
After a diagnosis of metastatic breast cancer, it’s helpful to take all the time you need to gather information and make decisions about your treatment. Learn about the medical specialists that may be involved in your care, treatment options, genetic testing, taking a break from treatment, and more.
Doctors sometimes recommend surgery for metastatic breast cancer in order, for example, to prevent broken bones or cancer cell blockages in the liver. Learn more.
Chemotherapy is used in the treatment of metastatic breast cancer to damage or destroy the cancer cells as much as possible. Learn more.
Your doctor may suggest radiation therapy if you’re having symptoms for reasons such as easing pain and controlling the cancer in a specific area. Learn more.
Hormonal therapy medicines are used to help shrink or slow the growth of hormone-receptor-positive metastatic breast cancer. Learn more.
Targeted therapies target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Learn more.
Local Treatments for Distant Areas of Metastasis
Local treatments are directed specifically to the new locations of the breast cancer such as the bones or liver. These treatments may be recommended if, for example, the metastatic breast cancer is causing pain. Learn more.
Genetic Testing and Metastatic Breast Cancer Video
A licensed certified genetic counselor discusses the benefits of genetic counseling and genetic testing for people with metastatic breast cancer and a woman living with metastatic breast cancer shares why she chose to undergo genetic counseling. Learn more.
Complementary and Holistic Medicine and Metastatic Breast Cancer
Practices such as acupuncture, massage, hypnosis, meditation, and yoga can help ease the symptoms of metastatic breast cancer, lessen treatment side effects, and improve quality of life. Learn more.
Clinical Trials for Metastatic Breast Cancer
Clinical trials for metastatic breast cancer are an important step in discovering new treatments and improving the standard of care. They can also help eligible patients receive new treatments. Learn more.
Taking a Break From Treatment for Metastatic Breast Cancer
Many people with metastatic breast cancer decide at some point to take a break from treatment or to stop treatment. This page covers some of the issues to consider when weighing those decisions. Learn more.
A metastastic breast cancer diagnosis can be a lot to manage, physically and emotionally. Read about ways to live with metastatic breast cancer, including working after your diagnosis, facing fears, getting emotional support, and more.
If you’re thinking about stopping treatment for metastatic breast cancer, learn about issues to consider such as managing symptoms, organizing your finances, choosing a hospice program, and more.
Learn about common terms you may hear after being diagnosed with metastatic breast cancer, lowering the cost of metastatic breast cancer care, and more.
Breastcancer.org’s original podcast series features insights from medical experts and people living with breast cancer on topics such as personal finance after a breast cancer diagnosis, sexual health and metastatic disease, and more.
Read blog posts by and about people living with metastatic breast cancer. Topics include diet and exercise after a diagnosis of metastatic breast cancer, strategies for coping with “scanxiety,” and more.
In this online forum, anyone managing the ups and downs of a metastatic breast cancer diagnosis can ask questions, share information and experiences, and give and receive support.
Dozens of members of the Breastcancer.org community share their personal stories of living with metastatic disease.
Read about the latest research findings on treatments for metastatic breast cancer.
Special thanks to Musa Mayer, author, patient advocate, and publisher of Advanced Breast Cancer: A Guide to Living with Metastatic Disease and AdvancedBC.org.
The medical experts for Metastatic Breast Cancer are:
- Marisa Weiss, M.D., chief medical officer of Breastcancer.org; breast radiation oncologist, Lankenau Medical Center, part of Main Line Health, a five-hospital health system in the suburbs of Philadelphia, PA
- Brian Wojciechowski, M.D., medical oncologist, Riddle, Taylor, and Crozer Hospitals, Delaware County, PA
- Sameer Gupta, M.D., M.P.H., medical oncologist, Bryn Mawr Hospital, Bryn Mawr, PA
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Breastcancer.org and 29 other organizations have formed the Metastatic Breast Cancer Alliance to increase our ability to help patients and improve outcomes for those living with metastatic breast cancer and their families.