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Breast cancer is characterized by the abnormal and rapid growth of cells in breast tissue. Metastatic breast cancer is the most advanced stage of invasive breast cancer in which the cancerous growth has metastasized (spread to other parts of the body). According to the Metastatic Breast Cancer (MBC) Network, an estimated 20-30% of all breast cancer cases will become metastatic. Metastatic breast cancer is often difficult to treat, especially if the cancer has spread to more than one site outside of the local breast area. According to a 2012 study published in scientific journal Current Oncology, the median survival rate for metastatic breast cancer is approximately 2 – 3 years, despite the significant advancements in management techniques by scientists and researchers.
Metastatic breast cancer develops when earlier stages of breast cancer either go undiagnosed or progress despite best treatment efforts. Scientists and researchers are not sure of what causes cancerous cell growth to occur in breast cancer patients. The leading theory on the cause of breast cancer revolves around gene mutations. This comes out of research that found that mutations to certain genes, such as the BRCA1 and BRCA2 genes, can influence cancerous cell growth. The source of gene mutation is still a large research question. Some BRCA gene mutations are inherited, while others are acquired. Theorized causes of acquired gene mutation include certain chemicals, radiation, and other environmental factors.
The following factors may influence your risk of developing metastatic breast cancer:
Metastatic breast cancer is characterized by the spread of cancerous growth to other parts of the body such as the bones, liver, or lungs. Sites of cancerous growth beyond the breast are known as metastases. According to the American Cancer Society, the following tests can be used to detect and asses cancerous growth throughout the body:
Biopsy. A biopsy tests a sample of cells for cancerous growth. Biopsies are usually conducted after other imaging tests have been performed and have indicated the presence of potentially cancerous growth. Most biopsies are outpatient procedures, though certain cases may require brief hospitalization/monitoring depending on the location and size. Different types of biopsies include:
Mammogram. Mammograms utilize x-rays to produce images of the breast. In order to get the best visual of the breast, the breast is tightly pressed between two plates. Flattening the breast between the plates may cause pain or discomfort, but the procedure typically only lasts a few seconds.
Ultrasound. Ultrasounds utilize sound waves to produce images. Ultrasounds may be used to assess cancerous growths in the breast tissue or other areas of the body.
Magnetic resonance imaging (MRI). MRIs use magnetic and radio waves to produce detailed images of the body. MRIs can be used in combination with injections of contrast dyes to highlight cancerous areas.
Nipple discharge exam. Nipple discharge can be a sign of cancerous growth. A nipple discharge exam involves the collection and microscopic examination of nipple discharge to test for the presence of cancerous cells.
Ductal lavage and nipple aspiration. In a ductal lavage, a catheter (thin tube) is inserted into the nipple after the area is given local anesthesia. A saline solution is injected through the catheter to rinse the nipple duct and collect cells for examination. A nipple aspiration also tests for the presence of cancerous cells, though it is less invasive as it uses suction cups placed externally on the nipple instead of a catheter insertion. These tests are only performed on women with a high risk of developing breast cancer.
Blood tests. Blood tests can be used for many different purposes, including testing for the presence of certain proteins in the blood.
Metastatic breast cancer can present itself in many different ways, depending on where the cancer has metastasized to. The National Breast Cancer Foundation lists the following as potential symptoms of metastatic breast cancer according to common locations of metastases:
Metastasis in bone
Metastasis in brain
Metastasis in liver
Metastasis in lungs
The following may also be signs of metastatic breast cancer:
The prognosis for metastatic breast cancer varies from patient to patient, as it is dependent on the type of metastases and the individual’s response to treatment. Unfortunately, metastatic breast cancer is still considered to be an incurable disease. The median survival rate following a diagnosis of metastatic breast cancer is about 2-3 years. This number is a median, meaning that there are a considerable number of patients who live both shorter and longer than this statistic.
Living with metastatic breast cancer can be a difficult task due to its advanced state and potential treatment side effects. The following tips can help you live more comfortably with metastatic breast cancer:
According to the US Preventative Service Task Force, the guidelines for breast cancer screening are as follows:
Since cancerous growth has spread beyond the local breast area in metastatic breast cancer, surgical options are less likely to be considered since they cannot eliminate all of the cancerous growths with one procedure and may further weaken the patient. Treatment for metastatic breast cancer is mainly focused on the management of symptoms and the slowing of overall cancer growth. Treatment options for metastatic breast cancer include:
Hormone therapy including anti-estrogens, which stop the production of estrogen, aromatase inhibitors, which lower the level of estrogen in the body but do not stop its production, and other hormones such as megestrol acetate and fluoxymesterone. Hormone therapy may be accompanied by the removal of the ovaries (oophorectomy), radiation therapy directed at the ovaries, or ovarian suppression using lutenizing hormone-releasing hormone (LHRH) in order to slow the rate of estrogen production by the ovaries.
Side effects of hormone therapy include:
Chemotherapy using one of four types of chemotherapy agents: alkylating agents, anthracyclines, antimetabolites, and microtubule inhibitors.
Side effects of chemotherapy include:
Targeted therapy, which work to stop particular cellular functions that lead to the reproduction of cancer cells. Targeted therapy drugs used to treat stage IV breast cancers include:
Side effects of targeted therapies include:
Alternative and complimentary therapies including:
Metastatic breast cancer and its treatments may cause considerable pain. To help keep patients comfortable throughout their disease and treatment, doctors may prescribe the following pain management treatments:
For more information on pain management, visit thirdAGE’s pain management condition center.
Since metastatic breast cancer is considered to be incurable, many patients and doctors choose a palliative approach to treatment. In palliative treatment, doctors and patients focus on physical and emotional comfort during treatment rather than aggressive elimination of the disease. This can help a patient relieve stress, anxiety, and pain while they live with their disease. Palliative care for metastatic breast cancer may include:
For more information on palliative care, visit the thirdAGE palliative care condition center.
There are many complimentary techniques that can help manage treatment side effects, reduce overall pain, and help to increase general wellness throughout breast cancer treatment. These include:
Acupuncture, a form of traditional Chinese medicine in which small needles are inserted at points around the body to restore the flow of bodily energy. It has been proven to reduce overall stress, stimulate the immune system, and reduce bodily inflammation. Acupuncture can be used as either a complimentary therapy (i.e., to reduce side effects of chemotherapy) or as an alternative therapy (to boost the immune system to fight off cancer cells).
Herbal therapies, Because the risk of cancerous cell growth increases with overall body inflammation, the use of anti-inflammatory herbs may help to decrease the risk of developing breast cancer. Anti-inflammatory herbs include:
Clinical research on the effectiveness of herbal therapies is limited as it is still ongoing. However, many of these herbs have been used in other medicine forms (such as traditional Chinese medicine and aryuvedic medicine) as anti-inflammatory medicines for centuries.
Mind/body techniques, which help to strengthen the mind and body connection in order to reduce anxiety, stress, and improve overall health. These include:
Massage. Massage has been proven to reduce anxiety, pain, and fatigue as well as increase immune function in cancer patients. According to the Pacific College of Oriental Medicine, a 2003 study of 230 cancer patients found that patients who received one 45-minute massage each week for a month felt less pain and took eight fewer doses of pain medication than those who did not receive massages. Massage therapy has also been shown to increase the body’s NK cell level (which are crucial in fighting off cancerous growth) as well as inhibit inflammatory stress hormones such as cortisol. There are many different types of massage that may be beneficial for breast cancer patients. To find a licensed therapeutic masseuse, visit The American Massage Therapy Association.
Chiropractic therapy. Chiropractic therapy focuses on the alignment of the body’s skeletal system in order to promote overall wellness and reduce pain.
Prayer/spiritual therapy. According to the National Cancer Institute, a study of 418 cancer patients found that a higher level of meaning and peace led to a decline in depression and psychological distress. The effect of prayer on recovering patients is still a topic of debate. While some believe that the power of others praying can produce extraordinary results, a 2006 study published by the American Heart Journal found a slight negative correlation between prayer and recovery. Patients that knew they were receiving prayer experienced a slightly higher rate of complication than those that did not know they were receiving prayer.
Support Groups. Local or online support groups can significantly bolster a patient’s confidence and feeling of security. Studies have long shown that support groups help to decreased stress, anxiety depression, and treatment complications. To find a support group in your area, visit your local hospital or The American Cancer Society.
If you are caring for someone with metastatic breast cancer, consider the following tips:
Contact a doctor if you experience any of the following:
Persistent:
Unexplained pain or soreness in any area of the body
To find a breast cancer specialist, click here
You may want to ask your doctor the following questions following a metastatic breast cancer diagnosis:
For more information on metastatic breast cancer, visit:
or more information on metastatic breast cancer, visit:
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