When Breast Cancer Spreads
Sujana Movva, MD
If your cancer spreads beyond your breast and the nearby lymph nodes, it's called advanced cancer, or metastatic cancer. The most common places it spreads to are the liver, lungs, bones, and brain.
News that your cancer has spread is scary, but there are many treatments that work for metastatic breast cancer.
"The majority of women with metastatic breast cancer can move forward with their therapies while continuing their regular lifestyle -- working, taking care of their families, exercising, and traveling," says Erica L. Mayer, MD, MPH, of the Dana-Farber Cancer Institute in Boston.
"We often think of metastatic breast cancer as a chronic disease, like diabetes," says Mayer.
A Different Treatment Schedule
Treatments for advanced breast cancer may go on without an end date, to keep the cancer under control. You'll visit the clinic on a regular basis and you'll get to know the health care team.
"If the treatment works, you'll stay on it as long as it's working well without side effects," says Rita Nanda, MD, of the University of Chicago's breast cancer program. If not, your doctor will try different treatments.
Your doctor is likely to suggest chemotherapy because it travels through your entire body. "Metastatic breast cancer is a whole-body disease," Mayer says.
You may also need hormone therapy. Targeted drugs are another option. They work directly on the changes within cancer cells. These combinations can make chemotherapy work better.
Sometimes surgery or radiation can help ease symptoms.
Regular Tests Keep Tabs on Your Cancer
Occasionally, you'll have imaging tests to see how treatments are working and whether the cancer has spread. Common imaging tests include:
- CT scans, where an X-ray machine circles around as you lie on a table
- Bone scans with an injection that helps show areas with cancer (scintigraphy)
- PET scans with a special camera and a tracer chemical that goes in your arm by IV
"CT scans examine the chest and abdomen," says Richard J. Bleicher, MD, of the Fox Chase Cancer Center in Philadelphia. "You can see something on organs like the liver or sometimes the bones."
Sometimes results are combined for a PET CT scan. A computer merges the images to find hot spots that may be cancer.
Your doctor will tell you how often you need these tests, based on the stage of your cancer.