Facing stage 4 breast cancer can be challenging because it’s the most serious and life threatening stage of breast cancer. However, treatment and lifestyle changes can help improve outcomes.

Stage 4 breast cancer is also called metastatic breast cancer or advanced breast cancer. At this stage, cancer that developed in your breast has spread to other areas of your body. Cancer cells might have traveled through your lymphatic system to your lungs, bones, liver, brain, or other organs.

Most often, stage 4 breast cancer develops long after you first receive a cancer diagnosis. But in rare cases, the cancer may already have progressed to stage 4 by the time of diagnosis.

Read on to learn about the outlook for stage 4 breast cancer and what may be done to improve outcomes.

Breast cancer is categorized into five stages from 0 to 4. Stage 4 is the most advanced. Using another staging system, it can also be referred to as distant breast cancer, which means the cancer has spread from its original location.

According to the National Cancer Institute, an estimated 31.9% of people who receive a diagnosis of distant-stage breast cancer live for at least 5 years after diagnosis. This percentage is lower than those in earlier stages because survival rates depend on the extent and location of metastasis (spread).

Is stage 4 breast cancer considered terminal?

Stage 4 breast cancer is not curable and can be terminal. However, various factors and advancements in treatment can improve your outlook.

Can stage 4 breast cancer go into remission?

As a result of developments in treatment, it’s possible for stage 4 breast cancer to go into remission. This means the cancer will not be detected on tests. But in most cases, the cancer has a high risk of recurring later on.

Is long-term survival possible?

While it’s rare, there have been cases of people who survived for more than 10 years after a diagnosis of stage 4 breast cancer.

According to a 2016 study, about 13% of women who receive a diagnosis of primary stage 4 breast cancer live for 10 years after their diagnosis. “Primary” refers to someone’s first cancer diagnosis. This means that this statistic does not apply to recurrences.

A 2019 study also found that 13% of people who received a diagnosis of the human epidermal growth receptor 2 (HER2)-positive subtype of stage 4 breast cancer reached and maintained remission by 10 years after diagnosis.

The 2016 study also found that women under the age of 50 years who received a stage 4 breast cancer diagnosis had a higher chance of surviving for 10 years than older women did.

Various factors can affect your longevity and quality of life with stage 4 breast cancer:

  • Cancer subtype: Different breast cancer subtypes behave differently. Aggressiveness and treatment options vary, so subtypes may affect the outlook.
  • Tumor location: Breast cancer most often spreads to the lungs, liver, bones, or brain. According to a 2019 study, the 5-year survival rates for breast cancer are highest for cancer that has spread to bone.
  • Demographics: According to a 2023 study, adults ages 40 years or younger have better 5-year survival rates than middle-aged or older adults. More aggressive breast cancer also tends to affect more women than men, and white people tend to have higher survival rates than people in other racial or ethnic groups.
  • Treatment: A 2020 study found that a combination of surgery and radiation improved outcomes for stage 4 cancer more than radiation alone. A 2022 study showed similar 3-year survival rates for people with stage 4 breast cancer who were treated with systemic medication or with surgery, but surgery did reduce tumor growth.

If you have stage 4 breast cancer, it’s important to work with an oncologist to develop your treatment plan. This will involve medical treatment and lifestyle strategies.

Medical treatment

Since the cancer has spread to other areas of your body, systemic treatment will likely be necessary to stop tumor growth and spread.

Your specific breast cancer characteristics and medical history will determine which treatment options your oncologist recommends. Treatment may include:

Diet

When you have stage 4 breast cancer, you may experience periods of weight gain and weight loss. This can be caused by stress, a lack of energy for exercise, or a side effect of cancer treatment, such as nausea.

Although it may be hard, try to choose foods that provide enough nutrients to support your body. Consider foods such as lean meats, eggs, low fat dairy, nuts, beans, and fruits and vegetables. Keep high calorie options such as milkshakes on hand for days when you don’t feel like eating. And do your best to stay hydrated.

When you do eat, opt for small, frequent meals and incorporate ginger into your diet to ward off nausea. If you experience symptoms such as diarrhea, switch to easy-to-digest foods like apples, toast, crackers, broth, and bananas. These foods can still provide you with some necessary nutrition.

When in doubt, ask your doctor about your nutritional needs. They might recommend increasing certain foods or drinks and limiting others.

Exercise

While more research is needed, a 2021 study suggests that getting regular exercise may be a factor in reducing breast cancer occurrence and mortality.

But it’s important to talk with your doctor before starting an exercise program. If your blood counts are low or your levels of electrolytes (such as potassium and sodium) are imbalanced, most healthcare professionals won’t recommend exercising because you could put yourself at risk for further harm.

Your doctor may also recommend that you avoid working out in public places because of the risk of exposure to germs.

Safety is also important, as treatments and fatigue can cause balance and numbness issues.

Ultimately, it’s essential that you listen to your body and that you don’t push yourself on the days when you aren’t feeling up to working out.

Having stage 4 breast cancer presents unique challenges in comparison with earlier stages of the disease.

If you’ve already been through earlier stages of cancer, you’re now gearing up for a new experience. Metastatic breast cancer can cause additional symptoms that you may not have dealt with before, as well as new or stronger side effects from treatment.

Here are a few coping strategies that can be helpful:

  • Gather information: Talk with your doctor and find out everything you can about your diagnosis, outlook, and treatment options. Doing this can help you feel more in control.
  • Do fun things: To help take your mind off the fear and stress, make time for activities you enjoy, such as spending time with loved ones, creating art, journaling, listening to music, or spending time with a pet.
  • Stay connected: You might feel the need to withdraw from social connections after your diagnosis, but try to resist this urge. Surrounding yourself with friends and loved ones can help you find much-needed emotional support during this difficult time.
  • Get peer support: In addition to family and friends, it can be really helpful to reach out to a support group for people with breast cancer. There may be an in-person support group at the facility where you receive treatments. You can also find groups to join online or on social media or download Healthline’s Bezzy Breast Cancer app.

A diagnosis of stage 4 breast cancer, whether it’s a first diagnosis or a recurrence, can bring up a range of emotions. You might feel angry or scared or even experience a numb feeling. There isn’t a wrong or a right way to feel.

A diagnosis of stage 4 breast cancer can feel daunting because it’s the most serious stage of the disease. But undergoing treatment and making necessary lifestyle changes can greatly improve your outlook.

Researchers are continuing to examine different treatment options for stage 4 breast cancer. You might consider participating in clinical trials to help researchers better understand breast cancer and develop potential cures.

Your healthcare team can help you assess the potential benefits and risks of experimental treatments.