Most types of cancer, including breast cancer, possess the ability to spread to other parts of the body. This migration from an original tumor to another part of the body is known as metastasis. Metastasis is the major cause of death from cancer. Cancer can spread through several different routes. Cancerous cells, or small clumps of cells, can invade healthy tissues near the site of the original tumor. They may also migrate through the bloodstream or lymph vessels to distant parts of the body. At the new site, these cells attach to and invade healthy tissue. Although most cancers are capable of spreading virtually anywhere, the most common place for breast cancer to spread is the bones. It may also metastasize to the brain, liver, or lungs.

How a Stage 4 Diagnosis is Made

Doctors use various methods to gather information about suspected breast cancer. Tests help doctors characterize tumors, and provide information about staging. Biopsy is one such test. A small sample of tissue is removed for examination. This is usually done before surgery to remove the tumor—a procedure called lumpectomy—or removal of the whole breast—or mastectomy. In the laboratory, a specialist examines the tissue for the presence of cancerous cells. The aggressiveness and other characteristics of these cells may also be determined. A mammogram, or breast x-ray, can identify the size and location of tumors in the breast. Other tools—including, MRI, CT scan, PET scan, bone scan, or blood tests—can determine if the cancer has spread to distant parts of the body. If tumors have spread beyond the breast and nearby lymph nodes, the cancer is classified as metastatic, or stage 4. Metastatic tumors may invade bones, skin, or major organs. 

Treatments to Manage Stage 4 Breast Cancer

When cancer migrates beyond the site of an original tumor, it’s virtually impossible to find all the places where it may have spread. For this reason, doctors use both local and systemic treatments. Local treatments target tumors growing in a specific part of the body. Radiation is an example of a localized treatment that can be used to relieve pain and complications at a secondary tumor site, such as the spine or liver. Systemic treatments are used to inhibit the growth of cancerous tumors throughout the body. This may include chemotherapy, hormone treatments, and targeted therapies. Various therapies work differently, and may have different side effects. Targeted therapies are among the most advanced treatments used to prevent cancer cells from multiplying. These treatments tend to cause less harm to surrounding tissues than chemotherapy. Treatment goals for Stage 4 breast cancer include shrinking tumors, or slowing their growth, reducing pain and complications, improving quality of life, and significantly prolonging survival.


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Understanding a Stage 4 Diagnosis

If you have been diagnosed with stage 4 breast cancer, the best thing you can do is work closely with a doctor (or team of doctors) whom you trust. Be open with your doctor, expressing any concerns regarding your symptoms, your treatment, and your prognosis. Do your homework, making sure you understand the recommended treatments and why they were recommended. Finally, stay on track with all treatment options that you and your doctor have chosen.