What is metastatic breast cancer?
Metastatic breast cancer occurs when cancer that started in the breast spreads to another part of the body. It’s also known as stage 4 breast cancer. There isn’t a cure for metastatic breast cancer, but it can be treated for a certain length of time.
The prognosis for metastatic breast cancer and the length of time between a stage 4 diagnosis and the onset of end-of-life symptoms varies greatly among people with this type of cancer.
Research suggests that about 27 percent of people diagnosed with metastatic breast cancer live at least five years after their diagnosis.
Regardless of what stage of cancer you have, it’s important to be informed. This will give you a better idea of what’s ahead.
Metastasis occurs when cancer spreads from the location where it started to another part of the body. If breast cancer spreads beyond the breast, it tends to appear in one or more of the following areas:
If the cancer is confined to the breast, it usually isn’t life-threatening. If it has spread, it becomes more difficult to treat. That’s why early diagnosis and treatment of breast cancer is so important.
It’s when the cancer spreads to another part of the body that the disease is diagnosed as metastatic.
Successful breast cancer treatment can often eliminate cancer completely from the body. However, the cancer can recur in the breast or in other parts of the body. This can happen months to years later.
At its earliest stage, there are usually no obvious symptoms of breast cancer. Once symptoms do appear, they can include a lump that can be felt in the breast or under the armpit.
Inflammatory breast cancer may present with redness and swelling. The skin may also be dimpled, warm to the touch, or both.
If diagnosed at a later stage, symptoms in the breast may include a lump, as well as one or more of the following:
- skin changes, such as dimpling or ulceration
- nipple discharge
- swelling of the breast or arm
- large, hard palpable lymph nodes under your arm or in your neck
- pain or discomfort
You may also see noticeable differences in the shape of the affected breast.
Advanced stage 4 symptoms may also include:
- difficulty sleeping
- digestion difficulties
- shortness of breath
Difficulty catching your breath can signal that your breast cancer may have spread to your lungs. The same is true for symptoms such as chest pain and a chronic cough.
Breast cancer that has spread to the bones may make the bones weaker and more likely to fracture. Pain is common.
If your breast cancer has spread to your liver, you may experience:
- yellowing of the skin, which is called jaundice
- abnormal liver function
- abdominal pain
- itchy skin
If breast cancer metastasizes to the brain, symptoms may include severe headaches and possible seizures, as well as:
- behavior changes
- vision problems
- difficulty walking or balancing
If the many treatment options for metastatic breast cancer stop working or you decide to discontinue treatment for quality of life or other reasons, your doctor may suggest transferring to hospice or palliative care.
This usually happens when you and your doctor decide to stop cancer-directed treatment and switch the focus of your care to symptom management, comfort, and quality of life.
At this point, a hospice team will provide your care. This team often can include:
- social workers
- chaplain services
Some side effects that may occur during treatment or if you’ve decided to discontinue treatment may include:
Fatigue is common side effect of the treatments used for metastatic breast cancer, as well as a symptom of late-stage cancer. It may feel as though no amount of sleep can restore your energy.
Pain is also a common complaint among people with metastatic breast cancer. Pay close attention to your pain. The better you’re able to describe it to your doctor, the easier they can help find the most effective treatment.
Loss of appetite and weight loss
You may also experience a loss of appetite and weight loss. As your body slows down, it demands less food. You may develop difficulty swallowing, which can make it hard to eat and drink.
Fear and anxiety
This can be a time of great anxiety and fear of the unknown. Some people may find comfort in spiritual guidance at this time. Meditation, chaplain services, and prayer can be helpful depending on your spiritual or religious beliefs.
Other side effects
Trouble swallowing may lead to breathing troubles at the end of life. Shortness of breath can also develop from mucus buildup in the lungs or other respiratory problems related to breast cancer.
You and your healthcare team can work together to manage symptoms. Some things, like lifestyle changes, can be done at home with the help of loved ones, while others may require doctor advice and supervision.
Talk to your doctor about the best options for easing symptoms and improving your quality of life.
Certain modifications to your environment and daily activities can make living with metastatic cancer symptoms more manageable.
In many cases, breathing difficulties can be managed. Propping up pillows so you can sleep with your head slightly elevated can make a big difference. Making sure your room is cool and not stuffy may also help.
Talk with your doctor or a respiratory specialist about breathing techniques that might help you breathe more easily and help you relax. In some cases, you may need supplemental oxygen.
You may also need to adjust your eating habits. You may have a reduced appetite and changes in your senses of smell and taste may also make you less interested in food.
Try to experiment with different foods or supplement your diet with protein drinks that are high in calories. This can help you strike a balance between a smaller appetite and maintaining enough strength and energy to get through the day.
Your doctor may prescribe medications to ease any pain or anxiety.
Opioid medications are often provided for pain in a variety of methods:
- by mouth
- by using a skin patch
- by using a rectal suppository
A pain medicine pump is sometimes needed to administer appropriate levels of medication.
Opioids can cause considerable drowsiness. This may interfere with an already compromised sleep schedule. If fatigue and sleeping problems are affecting your quality of life, solutions such as adjusting your sleep schedule or even where you sleep might help.
Doctors and other members of your healthcare team can better manage your care if you report your symptoms, concerns, and what is or isn’t working.
Connecting with others and sharing your experiences and worries can also be therapeutic.