Metastatic breast cancer (MBC) is advanced (stage 4) breast cancer that has spread to other parts of the body. Although this cancer originates in breast tissue, imaging tests may reveal tumors in the bones, brain, liver, and other organs as well.
Some people may receive an initial diagnosis of localized stage 4 breast cancer. When this cancer spreads, or metastasizes, it’s then known as MBC. This can happen months or years after an initial diagnosis.
Treatment for metastatic cancer is an ongoing process. So, the longer someone lives with MBC, the greater the cost of treatment.
Cancer treatments vary from person to person, but might include:
Treatment isn’t the only cost associated with MBC, though. You may also have indirect costs, like lost wages and paying for transportation to and from appointments.
Here’s how an MBC diagnosis can affect your finances, plus resources to help you find financial support.
People diagnosed with MBC typically have higher medical expenses than those diagnosed with early stage breast cancer.
MBC treatment is focused on preventing the cancer from getting worse and improving quality of life.
Cost of MBC by age
Breast cancer can develop in people of all ages, yet the costs associated with MBC are often higher in women ages 18 to 44.
Even though women under age 45 make up less than 10 percent of breast cancer diagnoses, they’re often diagnosed at an advanced stage, so they typically live longer with the condition.
Research from 2020 estimates that the monthly cost of treating MBC in women between ages 18 and 44 is about $4,463. The estimate for the average monthly cost of treating MBC in women with stage 1 breast cancer, on the other hand, is $2,418.
Cost of treating MBC with insurance
The good news is that many health insurance plans cover breast cancer, including coverage for:
- doctor’s office appointments
- other services
But even with health insurance, many people living with MBC can expect some out-of-pocket costs — especially if you have a high-deductible health insurance plan.
The deductible is the amount you pay out of pocket before your insurance provider pays for a claim. Deductibles vary, but some can go as high as $5,000 to $13,000 per year for family coverage.
In some cases you’re also responsible for coinsurance. This is a fixed percentage that you pay per claim after meeting your deductible.
Cost of MBC treatment by type
The type of MBC treatment you receive also impacts how much you’ll pay. You’ll likely receive a combination of treatments. These might include:
- targeted drugs
You may also receive surgery and radiation therapy to shrink tumors and increase life expectancy.
If you receive chemotherapy, the average allowed cost through insurance on the day of chemotherapy is $34,153.
Radiation therapy can cost $12,015 through insurance, and you might have coverage for an additional $3,316 for prescription drugs.
Other inpatient and outpatient treatments (which might include targeted therapy and immunotherapy) can cost $20,555 and $33,853, respectively
Some people diagnosed with MBC will have cancer treatments for life, which may be 10 or more years of living with the condition. The longer a person lives with cancer and receives treatment, the higher their medical costs, especially if they’re admitted to the hospital.
Cost of MBC treatment by location
Keep in mind, too, that your location also impacts how much you’ll pay for MBC treatments. If you live in an area with a higher cost of living, you might pay more for cancer treatments.
The cost of MBC treatment isn’t the only financial concern. A breast cancer diagnosis can impact every area of your life.
You don’t have to tell your employer about a cancer diagnosis.
Be mindful, though, that your cancer treatments might interfere with your work schedule or affect your work performance. So at some point, you might choose to share your diagnosis.
An inability to work during treatment can result in lost wages and financial stress. Other factors will also come into play, like the type of work you do and whether you’re covered by insurance.
According to the Family and Medical Leave Act, you might be able to take up to 12 weeks of unpaid leave from your job per year.
If you have unused vacation time or personal leave, you may be able to take time off and still receive a paycheck. Additionally, you might be eligible to receive short-term disability through your employer or perhaps even long-term disability benefits.
Doctor’s office visits
You’ll likely have copayments for follow-up care or treatments. Copayments vary depending on your insurance plan, but you might pay a $25 or $50 copay per appointment to see a family doctor or oncologist.
Scheduling and attending doctor’s office visits is also likely to mean missing work hours or days.
You’ll also have transportation costs when traveling to and from your doctor’s office and cancer treatment locations.
This cost rises depending on the frequency of treatments and might include extra expense for gas, tolls, and hospital parking. Additional expenses may be involved if you have to stay in hotels or travel longer distances to see a particular specialist.
As breast cancer advances, you might need outside help with housework, at an added expense. You might also need additional child care during treatments, as well as at-home care or long-term care.
Many people living with chronic conditions seek counseling to help manage their mental health. You may also invest in:
- alternative treatments
- pain management
- dietary changes
- other items to support your care
An MBC diagnosis has its financial challenges, but a few resources can help you better manage the cost. You may also want to discuss your options with your care team.
CancerCare is committed to providing emotional, practical, and financial support to help you cope with a cancer diagnosis. Along with counseling, support groups, and educational workshops, the organization offers limited financial assistance for copays and other cancer-related costs.
You might qualify for financial assistance with Family Reach if you’re actively getting MBC treatment within the 50 states; Washington, D.C.; Puerto Rico; or a U.S. territory. This support can help reduce some of your out-of-pocket costs.
American Cancer Society
Susan G. Komen
The Susan G. Komen assistance program is available to people receiving cancer treatment who meet certain income limitation requirements. It provides limited financial assistance as well as information on local resources and breast cancer education.
The Pink Fund
If you’re undergoing MBC treatment have have lost all or part of your income, you might qualify for assistance through the Pink Fund. This organization can provide 90 days’ worth of nonmedical cost-of-living expenses, which can ease some of the financial strain.
Some people diagnosed with MBC may live with the disease for 10 years or longer. During this time, the cost of treatment can soar.
Between medication, treatment, and other indirect costs, the financial aspect of living with MBC can be daunting.
Health insurance covers breast cancer treatments, but it doesn’t cover everything. Understanding what’s covered can help you plan for expenses.
For costs that health insurance doesn’t cover, you might qualify for financial assistance through one of several organizations.