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Stage IV Treatment Options

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Stage IV describes invasive breast cancer that has spread beyond the breast and nearby lymph nodes to other organs of the body, such as the lungs, distant lymph nodes, skin, bones, liver, or brain.

You may hear the words “advanced” and “metastatic” used to describe stage IV breast cancer. Cancer may be stage IV at first diagnosis, called “de novo” by doctors, or it can be a recurrence of a previous breast cancer that has spread to other parts of the body.

Treatment to the breast

  • surgery, radiation, or both may be used, depending on many individual factors

Treatment to the lymph nodes

  • enlarged lymph nodes may be treated if they are causing discomfort or other symptoms


  • chemotherapy is almost always recommended

Hormonal therapy

  • if the cancer is hormone-receptor-positive, hormonal therapy is almost always recommended

Targeted therapy

  • targeted therapy will be used to treat cancers that have certain characteristics, for example, cancers that are HER2-positive or cancers that are HER2-negative but have a BRCA1 or BRCA2 mutation; there are a number of targeted therapies that are approved to treat metastatic breast cancer, and new therapies are constantly being studied

Treatment to other parts of the body

  • radiation is most commonly used to relieve specific signs or uncomfortable symptoms; surgery may be used to control specific symptoms

Learn more in Metastatic Breast Cancer Treatment and Planning.

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