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When you find out you have advanced breast cancer, called metastatic or stage IV cancer, you probably have a lot of questions. That's understandable.

"The goals of therapy are to prolong life while at the same time maintaining a good quality of life," says Julie Gralow, MD, of the Seattle Cancer Care Alliance and the University of Washington School of Medicine.

Though there is no cure, "there is no question that patients are living longer with metastatic disease, and our patients have many more treatment options than even just a few years ago," Gralow says.

It helps to know about each of those options, so you're prepared to talk about the plan your doctor recommends. Remember that every case is different, so your treatment may not be the same as that of another person with breast cancer. You should talk to your doctor about which treatment is right for you.

 

Surgery

Most people with breast cancer will need surgery on their affected breast or breasts. In rare cases, your doctor may also recommend surgery to remove a tumor that's spread to another organ. They typically recommend that if the breast cancer is very limited in its spread.

"When that happens, we can sometimes go in and remove that -- for example, if there's just one small spot on the liver," Gralow says.

Surgery may also help if you have stubborn pain, a weak bone that needs to be stabilized, or another problem.

 

Radiation

You can't get radiation therapy on a breast that's had radiation before. But you may need radiation to shrink tumors in other parts of your body.  It can:

  • Stop the cancer from growing and keep symptoms under control. You might, for example, get radiation on a tumor that presses on your backbone to make you more comfortable.
  • Control bleeding or pain from cancer that's spread to the bone or liver.

For some people, doctors may use "stereotactic" treatment -- highly focused radiation -- to target spots in the liver or the lungs.