What you should know about stage 4, or the most advanced, type of breast cancer
Breast cancer develops when cells in the breast change and start growing and multiplying uncontrollably, based on information provided by the MedlinePlus database of the National Library of Medicine. According to the NCI, cancer cells can metastasize or break away from their primary site in the body and travel to other parts of the body through the bloodstream or lymph nodes, which are components of the immune system, where they form new tumors.
It consequently ends in metastatic breast cancer, which is popularly termed stage 4 as being the most aggressive form and cannot be cured. According to the American Cancer Society, the common places metastatic breast cancer develops include the brain, lungs, liver, and bones.
Stages 1–3 make up a large portion of breast cancer diagnoses. NCI statistics based on data from 2012-2018 find that only about 6% of cases were metastatic at diagnosis. A November 2019 study in the journal BMC Cancer found that the disease can still metastasize from early stages and metastasizes in about 20–30% of cases. Early detection is paramount.
A May 2017 journal study in Cancer Epidemiology, Biomarkers & Prevention established that by the start of 2017, more than 150,000 cisgender women in the United States had metastatic breast cancer. Owing to better screening and tremendous therapeutic advances over the years, the survival rate doubled between 1992–1994 and 2005–2012, even though the number of patients increased.
Reasons
According to MedlinePlus, breast cancer is typically caused by changes in your DNA (genetic material). These can be inherited or acquired through environmental and lifestyle factors.
There are several modes that breast cancer spreads through. In a study done on the journal Seminars in Cancer Biology in August of 2019, it’s shown that only 0.02–0.1% of the cells may avoid the body’s natural defenses, meaning the most cancer cells are destroyed once they pass through the body. However, the NCI reports that these cells could continue to grow into new tumors provided that the environment is “favorable” throughout.
Even if you were diagnosed or started treatment early, metastasis can still occur. According to the August 2019 paper, it is not known why some people get breast cancer and it spreads.
Risk Factors
At any age, there are several risk factors of breast cancer. According to MedlinePlus, these include:
- Being born female gender assignment
- Age: Becoming older
- Hormonal treatment or radiation
- After the age of menopause, obesity: According to MedlinePlus, menopause is described as the end of a person’s menstrual cycle for one year without a comorbidity.
- Alcohol consumption: A study that was published in the journal Progress in Molecular Biology and Translational Science in October 2017 reported an increased risk with three to six glasses of wine per week.
- According to the article on October 2017, dense breast tissue also tends to make mammography or another common screening method fail in diagnosing breast cancer.
- According to the October 2017 article, reproductive history aspects such as getting your period earlier than age 11 or starting menopause later than age 55 are linked with high exposure to estrogen, a hormone for female sex characteristics according to the NCI.
- Living a sedentary lifestyle
Signs and symptoms:
The location in which the cancer has metastasized may influence the manifestations of metastatic breast cancer. Reports by the NCI indicate that other symptoms may also be induced by more minor diseases, such as mastitis-a common infection among nursing women-or certain medications. In case you feel something is amiss, however, do not delay in contacting your doctor.
According to the American Cancer Society, the most common signs of metastatic breast cancer, regardless of where it has spread, are:
- Weakness or fatigue
- Unexplained weight loss
- Loss of appetite
- Pain
Depending on where your cancer has spread, the following are the most common signs and symptoms:
- Bone: Swelling, new, unexplained pain in the hip or lower back, and bone fractures or breaks that occur more easily
- Liver: Some digestive signs and symptoms, including rash, itchy skin, jaundice (yellowing of the skin), and nausea, vomiting, or abdominal pain
- Lungs: Chest pain, coughing, and shortness of breath
- Brain: Headaches, dizziness, difficulty speaking or seeing, nausea or vomiting, seizures, behavioral changes, and memory issues
Diagnosis
Depending on where the doctor thinks your cancer may have spread, different diagnostic techniques might be used. Whether you have a history of breast cancer also affects the tests. The following are common test types used in identifying metastatic breast cancer.
- Imaging tests These include PET scans, MRIs, CT scans, X-rays, and ultrasounds. It depends on the possible location of your cancer which one your doctor might recommend.
- According to the ASCO, blood tests have the ability to detect within the blood tumor proteins, occasionally referred to as tumor markers or biomarkers, though all biomarkers are not actually caused by cancer.
- The NCI states that biopsies are when a professional removes and examines your cells or tissues from questionable locations.
Normally, diagnosis begins when you report to your doctor a new, unexplained symptom and you have a history of breast cancer. Imaging and testing are prompted by this. For example, your doctor may give you an X-ray and bone scan to check for cancerous growths in your legs or knees if you had breast cancer in the past and your pain is getting worse. Not all metastatic breast cancer is caused by breast cancer with increased discomfort in another location.
In addition to the breast-specific biopsies and blood tests, your provider may use additional tools in case you have no prior history of breast cancer but you do experience symptoms. That is, an earlier stage of a breast cancer diagnosis may not appear the same. After that, the provider will conduct tests to determine the stage. Preliminary tests may include:
- Physical examination: During a clinical breast exam, one can check the breasts and armpits for any unusual lumps or other symptoms.
- Medical history: Some people may inherit the risk of breast cancer.
- Imaging tests specific to the breast: These include MRI, ultrasonography, or mammography. As reported by the American College of Cardiology (ACS), regardless of symptoms, women over 40 (over 30 if your clinician determines you are at high risk) should undergo regular mammograms.
Therapy
Though there is no current cure for metastatic breast cancer, there are growing varieties of therapeutic choices that could extend or enhance your life. The NCI states that treatments for metastatic breast cancer are the same as those for breast cancer in its early stages.
# Treatment for metastatic breast cancer
Treatment for metastatic breast cancer depends upon the subtype of the disease and your postmenopausal or premenopausal status.
In addition, you can qualify to receive new drugs and experimental treatments through clinical trials. Also, you can get many types of treatment simultaneously.
The NCI says the following are some examples of therapy:
- Hormone therapy: The treatment usually removes or dampens the action of some hormones that cause some types of cancer growth.
- Chemotherapy: This is a treatment where the growth of cancer cells is stopped by using drugs. Chemotherapy can be administered intravenously or orally. The drug can subsequently either kill or prevent the division of cancer cells throughout the body.
- Radiation therapy: In an effort to destroy or halt the proliferation of cancer cells, physicians make use of x-rays and other types of radiation.
- Compared to chemotherapy or radiation therapy, targeted therapy targets specific cancer cells and causes less damage to healthy cells
.
- Surgery: Radiation therapy may be given following the removal of cancer from a specific organ in some cases.
- Chemotherapy with immunotherapy: It is a treatment which includes chemotherapy and an immune-enhancing drug to combat the cancer.
You will be given palliative care according to the National Institute on Aging. This type of care is specialized medical attention given to the discomfort and symptoms of a serious illness such as cancer. These palliative care professionals assist you in managing cancer-related problems such as side effects from cancer therapy.
Avoidance
Although there is no way of sure prevention of breast cancer, there are some changes that can be made to life for reducing the risk of it. According to MedlinePlus, you can reduce your risk of developing breast cancer by doing the following:
- According to the October 2017 paper, reduce
- alcohol intake and maintain a healthy weight while you pass through menopause.
- Work out
- Reduce the amount of estrogen to which you expose your body.
Consult your doctor about taking certain drugs or having a mastectomy, which is surgery to remove all or part of the breast, if you have a high genetic risk of developing breast cancer.
No screening or treatment can guarantee that breast cancer will not have spread. Routine screenings like mammograms and appropriate early-stage treatment can help prevent its spread. Call your health care professional immediately if you are experiencing any breast cancer signs or symptoms, or you are a breast cancer survivor experiencing new ones.
