Metastasized Breast Cancer: What You Need to Know
October is Breast Cancer Awareness Month, a time to remember and reflect upon prioritizing lifelong breast health. Of the 3.5 million people in the U.S. living with a personal history of breast cancer (all stages combined), an estimated 155,000 are diagnosed with Stage IV breast cancer, known as Metastasized Breast Cancer (MBC.)
Those diagnosed with MBC endure continued treatments for the rest of their lives to stabilize their health and achieve best quality of life possible, as there’s no known cure. Researchers continue an important quest worldwide to make MBC a treatable chronic illness, like HIV and diabetes, as MBC is the leading cancer cause of death in women under age 50 years and breast cancer is the 2nd leading cause of cancer deaths in U.S. women.
Sobering MBC Statistics
Additional MBC statistics:
- up to one-third, or 33%, of those with early-stage breast cancer develop MBC, even if told their early-stage breast cancer had been “cured.” Breast cancer can become MBC even decades after initial diagnosis.
- 10% of new breast cancer cases are determined to be MBC during initial diagnosis.
- Men and young women account for 1 in 6 MBC deaths.
- MBC ends 110 lives daily in the U.S.
- Only 7% of breast cancer research funds go towards MBC research.
- Those with MBC have a 26% chance of achieving a 5-year survival rate. The median survival rate after MBC diagnosis is 3 years.
- All deaths from breast cancer are caused by MBC.
- Family history is a breast cancer risk factor for less than 15% of those diagnosed, meaning 85% of breast cancers are not caused by family history.
October 13 is designated Metastatic Breast Cancer Awareness Day to recognize and encourage those facing the many challenges accompanying continuous, lifelong breast cancer treatments, plus increase awareness of the vital importance of breast health for women of all ages.
Your local Capital Women’s Care team of women’s health experts shares important information about MBC and breast cancer, including breast cancer prevention tips; known identified breast cancer risk factors that increase risk; preventative care and screening technologies to monitor and optimize breast health; and comprehensive overview of current and upcoming life-extending medications and treatments offering best quality, prolonged life for those with MBC.
What Is Metastatic Breast Cancer (MBC)?
Metastatic Breast Cancer (MBC) is treatable but not curable. Treatment continues throughout life and focuses on the prevention of further spread of the disease while managing accompanying symptoms. The goal is for patients to live a good quality life for as long as is possible.
Subtypes for early-stage breast cancer and MBC are the same:
- An estimated 65% of patients have Hormonal (estrogen or progesterone driven), also called ER+/PR+
- 20% have Her2+ (fueled by a protein identified as Her2 neu)
- and 15% have Triple Negative Breast Cancer (TNBC- which does not have any of the 3 above known biomarkers: ER, PR or HER2).
These numbers are approximate, because some people have more than one subtype (HER2+ and ER+) or their breast cancer subtype may change over time.
MBC spreads to the bones in 70% of those diagnosed. Other areas of the body potentially affected are the brain, lungs and liver.
Monitoring MBC
Because there is no known cure for MBC, treatment focuses on controlling the disease, taking a more measured, long-term approach to therapy, with more attention directed to long-term quality of life while reducing or preventing adverse side effects of treatments through synchronized palliative care.
Regular checkups, usually every 3 months, help monitor MBC and identify changes in health. Doctors use periodic imaging like CT, PET and bone scans and MRI imaging, plus blood tests to measure tumor markers and assess overall health. If metastases remain stable or shrink, assessment scans may be done less frequently.
Being stable means MBC hasn’t grown larger or spread within the body. No evidence of disease (NED) means metastases aren’t detectable on an imaging scan. Both scenarios are great news, but because breast cancer cells still circulate within the body of those with MBC, treatment continues. An MBC diagnosis means you’re never cancer-free.’
High Risk Indicators
If you have a strong family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes, you may have a high risk of getting breast cancer. You may also have a high risk for ovarian cancer. Talk with your Capital Women’s Care practitioner and relay a detailed family history to see if you wish to consider genetic testing options as part of your personal breast health plan.
Risk Factors that Can’t Be Changed
Researchers indicate several identified risk factors that are known to increase breast cancer risk, including:
- getting older. The risk for breast cancer increases with age. Most breast cancers are diagnosed after age 50.
- genetic mutations. Women who have inherited changes (mutations) to certain genes, like BRCA1 and BRCA2, are at higher risk of breast and ovarian cancer.
- reproductive history. Starting menstrual periods before age 12 and starting menopause after age 55 expose women to hormones longer, raising their risk of getting breast cancer.
- having dense breasts. Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
- personal history of breast cancer or certain non-cancerous breast diseases. Women who have had breast cancer are more likely to get breast cancer a second time. Some non-cancerous breast diseases such as atypical hyperplasia or lobular carcinoma in situ (LCIS) are associated with a higher risk of getting breast cancer.
- family history of breast or ovarian cancer. A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
- previous treatment using radiation therapy. Women who had radiation therapy to the chest or breasts (for instance, treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.
- exposure to the drug diethylstilbestrol (DES). DES was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage. Women who took DES, or whose mothers took DES while pregnant with them, have higher risk of getting breast cancer.
No matter what level your personal breast cancer risk or age, it’s important to prioritize and optimize your breast health.
Optimizing Your Breast Health
It’s important for women to establish a personalized breast health plan based on their family and personal health histories. Annual well-woman checks from your Capital Women’s Care practitioner are key to monitoring breast health, as annual breast checks can discern changes and initiate immediate investigation, offering best scenario for positive outcomes if problems are distinguished early. Additionally, monitoring your personal breast health each month through a breast self-exam and asking questions about your concerns contributes to maximizing breast health.
Young women under the age of 40 can be diagnosed with MBC. About 5% of new breast cancer cases and 3% of deaths occur within this age bracket annually. MBC is the leading cause of cancer deaths in this age group. For young women under age 50 years, 27% comprise new breast cancer cases and 16% of deaths.
According to the Centers for Disease Control (CDC), some warning symptoms that may indicate breast cancer include:
- new lump in the breast or underarm (armpit)
- thickening or swelling of part of the breast
- irritation or dimpling of breast skin
- redness or flaky skin in the nipple area or the breast
- pulling in of the nipple or pain in the nipple area
- nipple discharge other than breast milk, including blood
- any change in breast size and/or shape
- or pain in any area of the breast.
It’s important to note these symptoms can happen with other conditions that aren’t cancer and that you should understand changes within your breasts. If you have any signs or symptoms that worry you, prioritize scheduling an appointment with your Capital Women’s Care practitioner.
Preventative Care and Screening Technologies
In addition to monthly breast self-exams and annual well woman checkups, there are preventative care and screening technologies your Capital Women’s Care practitioner may recommend for monitoring your breast health, depending upon your family and personal health history of breast cancer:
- screening and diagnostic mammography, breast X-rays that distinguish abnormalities like lumps or masses
- magnetic resonance imagery (MRI) provides detailed pictures of areas within the breast
- breast ultrasound utilizes sound waves to take pictures of areas inside the breast
- biopsy removes tissue and/or fluid from the breast to be reviewed under a microscope. There are 3 types: fine-needle aspiration, core biopsy or open biopsy.
Reduce Your Breast Cancer Risk
Fortunately, extensive research and studies have identified several known breast cancer risks that can be changed, including:
- not being physically active. Women who are not physically active face higher risk of getting breast cancer.
- being overweight or having obesity after menopause. Older women who are overweight or have obesity have higher risk of getting breast cancer than those of normal weight.
- taking hormones. Some forms of hormone replacement therapy (those including both estrogen and progesterone) taken during menopause can raise risk for breast cancer when taken for 5+ years. Certain oral contraceptives also have been found to raise breast cancer risk.
- reproductive history. Having first pregnancy after age 30, not breastfeeding and never having a full-term pregnancy can raise breast cancer risk.
- drinking alcohol. Studies indicate a woman’s risk for breast cancer increases with the more alcohol consumed.
Research suggests other factors like smoking, exposure to cancer-causing chemicals and changes in other hormones due to night shift work also may increase breast cancer risk.
Hope for Those with MBC
Even though 7% of breast cancer research is devoted to MBC, scientists and researchers continue to push to greatly increase that percentage, prioritizing research and studies relating to life-extending medications and treatments for those with MBC:
- An experimental form of immunotherapy that uses an individual’s own tumor-fighting immune cells could potentially be used to treat those with MBC, according to results from an ongoing clinical trial led by researchers at the National Cancer Institute’s (NCI) Center for Cancer Research, part of the National Institutes of Health (NIH.)
- Baylor College of Medicine is investigating a potentially effective treatment for HER-2 mutant MBC.
- A new study describes what happens to MBC cells when they migrate from the primary site in the breast to soft tissues such as that of the lungs. Published in the journal Nature Cell Biology, the research could usher in a new era in the treatment of cancer.
- For the first time, a drug targeting a protein that drives breast cancer growth has been shown to work against tumors with very low levels of the protein.
- Michigan State researchers are revealing the molecular workings of how a certain form of MBC spreads to other parts of the body. In doing so, they’re creating new opportunities to spot and contain triple-negative breast cancer.
- A novel, automated liquid biopsy test in development by researchers at the Johns Hopkins Kimmel Cancer Center can accurately detect presence of cancer DNA in the blood of patients with MBC within 5 hours. The test, currently a prototype for research use only, potentially could be used to quickly help oncologists determine if cancer treatments are working.
- Mount Sinai researchers have discovered a previously unknown mechanism in which not-yet-malignant cells from early breast cancer tumors travel to other organs and, eventually, “turn on” and become MBC.
- A study led by researchers at RCSI University of Medicine and Health Sciences and the Beaumont RCSI Cancer Centre (BRCC) has revealed a potential new way to treat secondary breast cancer that has spread to the brain, using existing drugs.
- Researchers at Huntsman Cancer Institute at the University of Utah (U of U) develop new methods to identify personalized drug treatments for breast cancer.
- A study led by researchers from The University of Texas MD Anderson Cancer Center showed a significant overall survival benefit with ribociclib plus endocrine therapy for postmenopausal patients with hormone receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2-) MBC.
- Zhejiang University School of Medicine reports study findings of ratiometrically designed nano prodrug for triple-negative breast cancer treatment.
- A mutated gene found in more than 20% to 30% of breast cancer recurrences may help tumors become more aggressive and promote metastasis, according to a pair of new studies that uncover mechanisms behind these processes and point to new therapy targets.
- To identify what determines the organs affected by metastasis, a team from the University of Geneva (UNIGE), in collaboration with researchers from ETH Zurich, has identified a protein involved in this phenomenon. This discovery could lead to the development of therapeutic approaches to suppress metastasis.
In recent years, many therapeutic options have emerged for treating MBC, greatly improving survival rates, as well as new breast cancer therapies and promising new developments in breast cancer treatments.
Your Capital Women’s care team of compassionate, knowledgeable doctors, nurses and support staff is here to answer your questions and discuss your concerns relating to your personal breast health or any women’s health issue. Our premier health professionals prioritize the optimization of your health, so you enjoy a long quality life.
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