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6% of breast cancer patients get diagnosed at the metastatic stage. However, even if the disease is detected in time, there is a 30% risk of recurrence and metastasis. This stage of the disease is the most difficult to treat and requires a special approach.
Modern medicine offers hope for patients with distant metastases in breast cancer. Protocols used for treatment in leading international cancer centres are enabling a survival rate twice as high as 20 years ago.
You can find out more about what care can be provided for breast cancer metastases and where you should go first in our article.
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When does breast cancer form metastases?
Breast cancer metastases are tumours that form in distant organs at stage 4 of cancer. This is because the cancer cells separate from the original tumour, enter the bloodstream and lymphatic system, and take root in other parts of the body. In breast cancer, metastases most commonly affect the bones, liver, lungs and brain, but can occur anywhere. Metastases may occur many years after the primary tumour has been removed. This happens because a course of chemotherapy or radiotherapy has failed to destroy 100% of the malignant cells. In this case, the breast cancer is said to have recurred and appropriate treatment is prescribed.
Given the risk of recurrence, all patients who have undergone treatment for breast cancer should have an oncology check-up at the time prescribed by their doctor. This will allow timely detection of metastases, and a better prognosis for treatment.
It is not possible to say definitively which symptoms indicate the development of breast cancer metastasis, as the signs vary considerably depending on the location of the tumour. Patients who have survived the disease should therefore keep a close eye on their health and report any ailments to their doctor.
Depending on the location of the metastases, they can manifest themselves through symptoms such as:
Breast cancer metastasis to the bones and spine:
Pain;
Brittle bones, prone to fractures;
Hypercalcaemia (elevated calcium in the blood);
Compression of the spinal cord;
Liver metastases in breast cancer:
Often asymptomatic;
Pain and discomfort in the middle lobe of the abdomen;
Loss of appetite and weight;
Weakness and fever;
Breast cancer metastasis to the lungs:
Often asymptomatic;
Pain in the lung area;
Shortness of breath;
Coughing;
Breast cancer metastasis to the brain:
Headache;
Speech disorders;
Visual disturbances;
Memory problems;
Metastasis to the ovaries in breast cancer:
Pelvic discomfort;
Abdominal bloating;
Uterine bleeding;
Metastasis to the skin in breast cancer:
Change in skin colour;
Prolonged rash;
Hard, painless bumps.
Just like a primary breast tumour, metastases are divided into three large groups, depending on the presence of specific receptors on their cell walls. This classification allows doctors to individually select the treatment that will be most effective for the individual patient.
Hormone-sensitive tumours | Hormone-sensitive tumours are sensitive to oestrogen and/or progesterone. They account for 60-75% of all cancers. This form of cancer most often occurs in post-menopausal women. It responds well to treatment, in particular hormonal therapy, and has the lowest risk of five-year recurrence.
In most cases, hormone-sensitive breast cancer forms metastases in the bones. |
HER2 positive tumours | About 15-20% of breast tumours are associated with the human epidermal growth factor receptor 2 (HER2) gene. HER2-positive breast cancer grows faster than estrogen-sensitive tumours. With the invention of anti-HER2 therapy, the prognosis for treating patients has greatly improved.
HER2 breast cancer is more likely than other cancers to metastasise to the brain. |
Triple-negative tumours | Triple-negative breast cancer does not have specific receptors that can be targeted and therefore have a more difficult prognosis. These tumours are more aggressive and grow quickly. Triple-negative breast cancer usually forms metastases in the lungs and brain. Most recurrences occur within 5 years after the removal of the primary tumour. All patients under 60 years of age with triple-negative breast cancer should be tested for BRCA gene mutations. |
BOOKING FOR CANCER TREATMENT ABROAD
MediGlobus is ready to assist you in arranging treatment abroad for stage 4 breast cancer. We will help you with selecting a clinic, finding a doctor and making travel arrangements. During your stay abroad, our coordinators will stay in touch with you around the clock.
How quickly do metastases in breast cancer spread?
The rate at which metastases form depends on how aggressive the cancer is. This is determined by laboratory diagnosis of the tumour cells obtained during the biopsy.
Research from the Massachusetts Institute of Technology shows that 99.98% of metastatic cells die before they can form a tumour.
The spread of metastases in breast cancer is gradual. According to the Robert W. Franz Cancer Research Centre, the average time it takes for a metastatic tumour to form during diagnosis is two to five years.
This period is considered critical in the treatment of cancer patients. To prevent the development of metastases after the removal of the primary site, several courses of combined chemotherapy, radiotherapy or hormone therapy are usually carried out. They aim to destroy the invisible cancer cells and prevent them from growing again. During this time, it is important to undergo all routine check-ups prescribed by your doctor. The doctor will carry out a range of diagnostic procedures that can detect the growth of metastases.
Read: Diagnosing breast cancer metastases
Examinations for breast cancer metastases include:
Blood tests for cancer markers (CA 15-3, CA 27.29, CEA);
Biopsy of the tumour;
Biopsy of a signal lymph node;
An ultrasound of the internal organs;
A chest X-ray;
Magnetic resonance imaging (MRI) of the body;
Positron emission tomography (PET);
Osteoscintigraphy of the bones.
During the initial diagnosis of breast cancer, the doctors usually run Src gene tests. Its presence indicates an increased risk of metastasis. Such patients are monitored more closely by oncologists.
Is it possible to prevent the development of breast metastases?
In some cases, yes. The first measure doctors resort to when treating breast cancer is to prevent the development of metastases. Once the primary tumour has been removed, the cancer cells stop circulating in the body, significantly reducing the risk of metastasis.
Surgery is followed by adjuvant therapy. This is a combination of chemotherapy and radiation therapy aimed at destroying the malignant cells that have remained in the body. The appropriate period of treatment for the disease is called latency, or cancer hibernation. Depending on the type of tumour, this stage can last from 5 to 20 years.
The effectiveness of adjuvant therapy depends on the body’s response and the rate at which cancer develops drug resistance.
Treatment of breast cancer metastases
A US National Cancer Institute (NCI) study has shown that the five-year survival rate for patients with metastatic breast cancer has risen from 18% to 36% since 1994.
Treatment for stage 4 breast cancer depends on which organ cancer has spread to. In addition, the treatment plan is influenced by factors such as:
hormone receptor and/or HER2 levels in the tumour;
gene mutations in the tumour;
specific symptoms;
previous cancer treatments;
whether the patient has menstruation;
general health.
For patients with stage 4 breast cancer, the main treatment is a systemic therapy. This includes chemotherapy, hormone therapy, immunotherapy, targeted therapy or a combination of these.
Surgical treatment of breast cancer metastases
Surgery is rarely used to treat stage 4 breast cancer. However, it can sometimes be recommended to remove liver or bone metastases in breast cancer. This is especially true for tumours that cause pain, circulatory problems or other symptoms. In this case, palliative care is referred to.
Cryotherapy for metastatic breast cancer
Cryotherapy can be used to remove inoperable breast metastases. It is a minimally invasive procedure. The doctor inserts a special probe into the affected organ, through which freezing argon gas is delivered to the tumour. This has a destructive effect on cancer cells.
Hormone therapy for breast cancer metastases
Hormone therapy is effective in treating metastases of hormone-sensitive tumours. The treatment lowers estrogen levels and blocks estrogen activity in the body, which prevents cancer from continuing to grow. The American Society of Clinical Oncologists (ASCO) recommends different types of hormone therapy depending on the stage of cancer and menopausal status. Treatment usually lasts as long as there is a therapeutic effect; after that, doctors may prescribe other medicines.
Chemotherapy treatment at stage 4 breast cancer
Chemotherapy is one of the main treatments for distant metastases in breast cancer. As a rule, the course of therapy lasts as long as the drugs are effective. If cancer stops responding to the drugs, oncologists can almost always pick up new ones or supplement them with targeted therapy. Combination chemotherapy is more effective and is recommended if the patient can tolerate aggressive treatment.
Targeted therapy
Based on the genetic analysis of the tumour cells, the oncologist can recommend specific drugs to which cancer will be sensitive. All drugs that work on the main tumour are also able to fight the metastases. Because of their selective mechanism of action, targeted therapies cause less damage to healthy cells.
Radiation therapy
Radiotherapy for breast metastases is prescribed to relieve the patient’s pain, reduce the risk of bone fracture, reduce internal bleeding when the tumour invades, and relieve pressure on the nerve or airway. The dosage and duration of treatment are chosen individually for each patient, depending on the size and location of the tumour and the combination with other treatments.
Stereotactic radiosurgery
Stereotactic radiosurgery is used to treat metastases of breast cancer to the brain. This treatment is an alternative to surgical removal of the tumour in patients with limited metastases or neoplasms at unresectable sites. Compared with radiotherapy to the brain, stereotactic radiosurgery is less toxic to the body.
One of the problems that can arise during the treatment of breast cancer is the development of resistance to anti-tumour drugs. To combat this phenomenon, oncologists use combination therapies whenever possible.
BOOKING A CONSULTATION WITH AN ONCOLOGIST
A consultation with an experienced oncologist is an opportunity to receive personalised advice for the most effective treatment of breast cancer metastases. These appointments are available both in-person and online, with the option of travelling to the clinic for treatment. With MediGlobus you can book an appointment with the doctor without waiting in line and start treatment immediately.
Where to go for treatment for breast cancer metastases?
Resume
Breast cancer metastases are tumours that form in distant organs at stage 4 of cancer. In breast cancer, metastases most often affect the bones, liver, lungs and brain. Symptoms of metastases in breast cancer depend on the location and may cause pain as well as dysfunction of the affected organ.
The average time taken for detectable metastatic tumours to form is 2 to 5 years. Adjuvant therapy is used to prevent their development and patients should undergo regular cancer check-ups after discharge.
Treatment of stage 4 breast cancer depends on which organ the cancer process has spread to. Techniques used include surgical removal of metastases, chemotherapy, radiation therapy, targeted therapy, hormonal therapy, cryotherapy and stereotactic radiosurgery. There are a large number of drugs that have been approved to treat breast cancer, and if one loses effectiveness, it is almost always possible to find an alternative.
Some of the leading clinics where experts recommend going for treatment of stage 4 breast cancer with metastases are Liv, Koç, Medicana Ataşehir (Turkey), Teknon and Quiron Torrevieja (Spain), Vienna Private Clinic (Austria), BLK and Fortis clinics (India).
BOOKING FOR TREATMENT ABROAD
To book an appointment for treatment abroad for stage 4 breast cancer, click on the button below and fill in the form. Our coordinators will call you back within 30 minutes. They will provide you with all the necessary information and help with travel arrangements.
Sources:
- 1. National Breast Cancer Foundation
- 2. Breast Cancer: Basic and Clinical Research: Targeting Breast Cancer Metastasis
- 3. American Society of Clinical Oncology: Breast Cancer – Metastatic: Statistics
- 4. Journal of Internal Medicine: Breast cancer as a systemic disease: a view of metastasis
- 5. Cell: Tumor Metastasis: Molecular Insights and Evolving Paradigms
- 6. Experimental Hematology & Oncology: Breast cancer brain metastases: the last frontier
