The Ultimate Guide to Stage 4 Breast Cancer
Stage 4 breast cancer is an advanced stage.
It is also known as Metastatic or secondary breast cancer in which the cancerous cells spread beyond the breast and nearby lymph nodes.
Symptoms may vary according to the location of your metastases, but common ones include bone pain, shortness of breath, and fatigue.
Treatment options for stage 4 breast cancer may include chemotherapy and other advanced forms.
While at stage 4, breast cancer cannot be cured, treatment can help to manage symptoms and improve quality of life.
As per Cancerresearchuk, around 25 % of women will survive their cancer for half a decade or more after they are diagnosed.
This article will highlight the symptoms, prognosis, and treatment options associated with breast cancer stage 4.
Classification of Stage 4 breast cancer
The spread of metastatic cancer is often categorized according to the distance it has traveled from the primary tumor. It can be classified as,
Regional metastatic breast cancer
In this case, the primary tumor has metastasized (traveled) to the adjacent lymph nodes.
Axillary lymph nodes are the most common target. However, supraclavicular and internal mammary lymph nodes can also be affected.
Distant metastatic breast cancer
Metastatic breast cancer occurs when the cancerous tumor has spread to other body parts.
They include the bones, lungs, liver, and brain.
Metastasis from breast cancer can spread to the skin and other organs.
Most cases of advanced breast cancer occur years after its initial diagnosis.
Symptoms
In some cases, patients with metastatic breast cancer may not experience the same symptoms as those with early-stage disease.
And sometimes, there are no signs at all.
If a patient experiences any changes in their condition, they should consult their doctor.
The following are a few of the most typical symptoms of advanced breast cancer, stage 4.
- Swelling of the abdomen or jaundice
- Symptoms of brain cancer such as headaches and dizziness
- Lung cancer-related breathing difficulties and chest discomfort
- Spread of tumor cells to the bones or spinal cord, causing bone discomfort or fractures
Breast cancer symptoms may also change depending on the location of the disease. For reference,
- Pain, nipple discharge, a lump, or thickening in the breast or underarm may be signs that the breast or chest wall has been damaged
- Pain, fractures, or drowsiness from elevated calcium levels are all possible signs that cancer has progressed to the bones
- Breathing problems, coughing, chest pain, and exhaustion are all possible signs that cancer has gone to the lungs
- Patient may experience malaise, tiredness, edema in the extremities, and skin discoloration or yellowing if the cancer has reached the liver
- Cancer that has progressed to the central nervous system (CNS) may cause pain, memory loss, headache, blurred or double vision, trouble with mobility, or seizures
Diagnosis
To develop an effective treatment strategy, getting a complete picture of the spread of breast cancer is crucial.
The following tests and resources will likely be used by your doctor to identify breast cancer’s early and late stages.
Localized breast cancer
Specific follow-ups are essential to diagnose localized breast cancer. These include,
- Sonography/Ultrasound Checkup
This imaging method uses high-frequency sound waves (ultrasound waves) to generate a picture of the body’s internal structures.
- Magnetic resonance imaging (MRI)
This method uses magnetic fields and radio waves to make detailed pictures.
- Analyses of blood chemistries
A blood sample is obtained to determine how much of a material is being secreted by your organs and tissues.
An abnormally high or low concentration of a chemical could indicate health issues.
- Breast biopsy
During a biopsy, cells or tissues are surgically removed for microscopic examination by a pathologist.
A biopsy is the gold standard for confirming a preliminary breast cancer diagnosis.
Advanced breast cancer
Your doctor will run some diagnostic procedures to determine the advanced form of breast cancer. These include,
- Sentinel lymph node biopsy
Lymph nodes are typically the first target of breast cancer invasion. A sample of cells from a sentinel lymph node is taken for analysis during a sentinel biopsy.
- A radiograph of the chest or Chest x-ray
With this comprehensive imaging of the chest, doctors may be able to determine whether the cancer has progressed to the bones.
- Computed Tomography (CT scan)
Computerized Axial Tomography (CAT) scan uses a computer and an X-ray scanner to produce detailed images of the body’s internal organs and structures. To better visualize the inside organs, a dye may be used.
- Bone scan
Bone metastasis, or the spread of cancer cells to the bone, is what this test is for. Through this technique, scanners can detect minute amounts of radioactive material introduced into the blood.
- Positron Emission Tomography (PET scan)
A PET scan is a high-resolution imaging technique that uses a radioactive substance to detect cancer cells in the body. It works as a tracer.
Prognosis
In some rare cases, the cancer may have already reached stage 4 when a person is first diagnosed.
Dealing with breast cancer at this stage can be pretty difficult.
There is no cure for stage 4, but treatments can keep it under control for years.
The prognosis can be improved by adhering to the treatment plan prescribed by your doctor and maintaining a healthy lifestyle.
Those with metastatic breast cancer will require lifelong treatment.
If one treatment becomes ineffective, another may be tried.
Metastatic breast cancer is a long-lasting illness, so it doesn’t go away and come back.
Treatment
Doctors recommend Systemic therapies to treat secondary breast cancer.
These therapies rely on medication rather than surgery or radiation.
These therapies aim to reduce tumor size, limit tumor growth, alleviate symptoms, and enhance quality of life.
When one therapy stops functioning, or its side effects become intolerable, it may be necessary to switch to another.
Most individuals with cancer receive a combination of treatments.
Drug-based treatments can be broken down into four groups.
Hormonal therapy
Hormonal therapy works by blocking the effects of female hormones (Estrogen and Progesterone), which can slow or stop the growth of cancer cells.
Typical forms of hormonal therapy for breast cancer include,
- Aromatase inhibitors
- Selective Estrogen Receptor Modulators (SERMs)
- Gonadotropin-releasing hormone (GnRH) agonists
To improve the outcomes, it is typically used with other treatments, such as chemotherapy.
Hormonal therapy may not be effective for all patients and can have side effects, including hot flashes and vaginal dryness.
Chemotherapy
Chemotherapy is a treatment option when the cancer cells have spread to other body parts.
It uses drugs to kill or stop cancer cells from growing and dividing.
The therapy is typically administered into the veins, although some forms can be taken orally.
Chemotherapy drugs are designed to target fast-growing cells, which include cancer cells.
However, it also damages the healthy cells in the body, which can have side effects such as nausea, hair loss, and fatigue.
Chemotherapy is often combined with other treatments, such as surgery, radiation therapy, or targeted therapy, to improve outcomes.
While chemotherapy can be effective in treating stage 4 breast cancer, it may not be effective for all patients.
Immunotherapy
Immunotherapy works by uplifting the body’s immune system to fight cancer cells.
These drugs target the proteins in cancer cells that can suppress the immune system.
As a result, the immune system recognizes and attacks the cancer cells.
Common types of immunotherapy used to treat breast cancer include checkpoint inhibitors and monoclonal antibodies.
Immunotherapy is typically used in combination with other treatments, such as chemotherapy or targeted therapy.
While immunotherapy can be effective in treating some types of breast cancer, it may not be effective for all patients and can have significant side effects.
These include fatigue, coughing, nausea, rash, loss of appetite, and autoimmune reactions.
Targeted drugs
Targeted drugs can be effective in treating stage 4 breast cancer by blocking specific molecules that are involved in the growth and spread of cancer cells.
For example, HER2-positive breast cancer, which makes up about 20% of all breast cancer cases, can be treated with drugs that target the HER2 protein.
Whereas, hormone receptor-positive breast cancer, which accounts for about 70% of all cases, can be treated with drugs that block the action of Estrogen.
These targeted drugs can slow down or even stop the growth of cancer cells, which can help prolong survival and improve the quality of life for patients with stage 4 breast cancer.
Other treatment options and clinical trials
In some cases, your Oncologist might not recommend surgery or radiation.
During that time, clinical trials might help qualified patients to receive new treatments and state-of-the-art care.
Organizations like National Cancer Institute (NCI) support clinical trials to help doctors improve available treatments.
These trials can even help them compare new methods and protocols with the current standard care.
Irrespective of treatment, ask your doctor for guidance through the process in advance.
They will help you explain how it would work and will lift your spirits.
During treatment, doctors will perform tests to determine how well the treatment works.
Stats
The fredhutch reports that more than 155,000 people in the United States are coping with metastatic breast cancer.
Women with breast cancer in the early stages have a 20%-30% chance of developing metastatic conditions.
Without treatment, metastatic breast cancer has a median survival time of only three years.
The disease claims the lives of 40 thousand people every year.
The five-year relative survival rates by age at the time of diagnosis are as follows,
- Women younger than 45 – 88%
- Ages 45-54 – 91%
- Ages 55-64 – 91%
- Ages 65-74 – 92%
- Women 75 or older – 86%
Finding social and emotional support
If you’re dealing with breast cancer, it’s vital to be around people who can help you through your treatment and recovery.
The path may be difficult, but you are not alone.
Inquire about the availability of a local support group from your physician.
Joining a group online or on a social networking site is another option.
Talk to your doctor if you have questions regarding your diagnosis, possible treatments, or local resources.
If you need help in your search, a counselor or social worker may also be able to locate a local support group for you.
Outlook
By 2023, the American Cancer Society predicts that around 297,790 women will be diagnosed with breast cancer.
Stage 4 breast cancer is an advanced and life-threatening form of breast cancer.
While breast cancer cannot be cured at this stage, treatment options are available to manage symptoms, improve quality of life, and extend survival.
Patients should closely associate with their healthcare team to develop an individualized treatment plan.
It is also crucial to see a doctor who can understand your unique circumstances and goals.
Open hands from family, friends, and support groups can also play a vital role in helping patients manage the challenges of living with stage 4 breast cancer.
Frequently Asked Questions
What is the final stage of breast cancer?
Stage 4 breast cancer, often called metastatic breast cancer, is the ultimate stage of the disease and occurs when the cancer has spread to other parts of the body from the breast and adjacent lymph nodes.
How fatal is Stage 4 breast cancer?
Stage 4 cancer is a devastating disease. The five-year survival rate for it is just around 25%. Age, overall wellness, cancer stage, and location affect prognosis and survival time.
Is Stage 4 cancer terminal?
Cancer at stage 4 is believed to be very advanced and often results in death. However, the prognosis can differ depending on the individual’s overall health and response to treatment. However, cancer is not always fatal.
Has anyone ever survived Stage 4 cancer?
It is scarce, yet stage 4 cancer survivors do exist. Cancer types, locations, stages, treatments, patient health, and therapy responses all affect prognosis and survival.
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