Each year, millions of people are diagnosed with breast cancer. In fewer cases, the cancer spreads to other parts of the body, referred to as metastatic breast cancer. Metastatic disease is diagnosed in only 20% to 30% of breast cancer patients.
Risk factors for bone metastases in breast cancer.
According to the chief of the oncology division at Northwestern Medicine Lake Forest Hospital, MD, Dean Tsarwhas, “the most common place for breast cancer to spread to is the bones, although the disease can seed anywhere,” Health said. Bone metastases occur in nearly 70% of breast cancer patients who progress to develop stage 4 malignancy.
What are the implications of metastatic breast cancer to the bones for a patient’s prognosis and course of treatment? Here is all you need to know about breast cancer that has spread to the bones, according to experts.
Why Does Breast Cancer Grow?
Metastatic breast cancer is the term used to describe when cancer cells invade other body areas outside the breast and the surrounding lymph nodes. When cancer cells invade your skeletal system, they replace the healthy cells in certain areas of your bone. Tumors, or cancerous lesions, appear later.
This is also known as metastatic breast cancer, which occurs when the cancer recurs after treatment and spreads to the bone. It can also occur if cancer is not treated promptly or does not respond to treatment.
Researchers do not know what exact mechanism malignancies take in order to spread. Nancy Lin, MD is a medical oncologist at Dana-Farber Cancer Institute where she treats patients who are diagnosed with breast cancer, “we know that at some point, the cancer manages to find its way into the bloodstream and then through that, is able to get to other parts of the body,” she said to Health.
Though there are some theories, it is still not known why some cancers metastasize to certain locations. According to Weill Cornell Medicine hematologist and oncologist Evelyn Toyin Taiwo, MD, certain types of breast cancer can metastasize to the bone if they contain estrogen receptors. Estrogen receptors may set up an environment that fosters the proliferation of rogue cancer cells. More research is needed to understand the relationship.
Although the spine is the most common site, metastatic cancer can involve any part of the skeletal system. Other areas include.
- Hips of the Femur
- Upper arm, skull, and ribs
Indicators of Bone Metastatic Breast Cancer
According to all three medical professionals, one of the most typical signs of metastatic breast cancer in the bone is sudden, increasing discomfort in the bones or joints. “I always tell patients to inform me if there’s pain that’s not getting better,”
Sometimes, individuals confuse the pain with the existing conditions of arthritis or other chronic pain conditions that they may have. Whenever there is new pain, women with breast cancer need to be very aggressive. A new fracture or a fracture that occurs for no known reason can be another sign of metastasis in bones. Cancer might weaken and brittle bones.
“New lumps or bumps in the lymph node area could be an indicator of metastatic or recurrent breast cancer, too,”
In addition to these symptoms and indicators, metastatic breast cancer in the bones will have some of the following more generalized symptoms:
The American Cancer Society. cancer symptoms and signs.
- Loss of unusual or unexplained weight
- Fatigue
- Loss of hunger
Bone Metastasis Treatments
Usually, there is no cure for breast cancer that has spread to the bones. Usually, medical professionals concentrate on controlling symptoms and reducing the rate at which cancer spreads. “The focus really is trying to extend life and maintain quality of life,” stated Dr. Taiwo.
Conventionally, physicians advise patients on the use of traditional medicines, which include immunotherapy and chemotherapy. They also test targeted therapy for specific cancer types, including hormone therapy for breast cancer that is estrogen receptor-positive.
Many of the drugs used to strengthen bones, like Prolia (denosumab), may be helpful. These medications reduce the likelihood of fractures by slowing down the deterioration of bone. Many treatments are similar to those that osteoporosis patients have.
In addition, local radiation therapy can reduce pain and kill bone cancer cells. Since lesions in bone can be painful, treatment may improve a person’s quality of life.
The American Cancer Society. Therapy for breast cancer stage IV (metastatic).
Furthermore, we look for any bones that might lead to a fracture,” Dr. Lin said. In such cases, doctors often send their patients to orthopedic surgeons for preventive surgeries to fix bones.
Orthopedic surgeons can use medical-grade bone cement to support and seal pre-existing fractures. For pain-free movement, they may perhaps advise joint replacement surgery.
Choong PF, Paglian L, and Seehorn H. A surgical viewpoint on multimodal management of bone metastases.
Expectancy of Life and Prognosis
The prognosis for metastatic breast cancer in the bones is usually worse than that of early-stage breast tumors. The relative survival rate after five years is roughly 29%. Accordingly, the five-year survival rate for individuals with metastatic breast cancer is almost 29% higher than that of those without the disease.
According to some statistics, it seems that metastatic breast cancer in the bones has among the highest survival rates for any type. A study conducted in 2019 monitored the survival rates for patients with stage 4 breast cancer over five years through data. Based on the metastatic site, different rates were calculated by the researchers. With 50.5% of patients surviving more than three years, they found that those with bone metastases had the highest OS rate.
The three-year OS rate for patients with metastases in the brain is 19.9%. The three-year OS rates for patients with metastases in the lung and liver are 37.5% and 38.2%, respectively.
Estimates from other studies indicate that 51% of patients with metastatic breast cancer in the bones survive for a year. After five years, the survival rate is 13% Remember that these figures are estimations rather than absolutes.
How responsive it is to treatment increases the survival chances of an individual. Other factors include such elements that influence an individual’s prognosis.
- Age All other diseases or pre-existing illnesses
- Where cancer cells are metastasized and the type of malignancy
Along with treatment advancements, metastatic breast cancer life expectancy and treatment have improved dramatically. “We have many more options for [metastatic] cancer patients living longer,” While the drugs and therapies of today cannot cure it, they can greatly extend and improve a person’s life.
Metastatic breast cancer in the bones cannot be cured. However, there are still various options available to a doctor that may treat symptoms, reduce the growth of cancer, and extend life. Despite a number of factors that influence the prognosis, the five-year survival rate is estimated at around 29%.
