When Breast Cancer Spreads
If your cancer spreads beyond your breast and the nearby lymph nodes, it's considered advanced, or metastatic. The most common places it spreads to are the lymph nodes, liver, lungs, bones, and brain.
Even if it isn't curable, there are treatments that can help manage your 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," Mayer says.
A Different Treatment Schedule
Treatments for advanced breast cancer may go on without an end date to keep the disease under control. You'll visit the clinic on a regular basis, and you'll get to know your 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 it's not working well or has bad side effects, 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 will also need hormone therapy if your cancer is sensitive to (meaning fueled by) the hormone estrogen or progesterone. Some people can take targeted treatments, which are drugs that 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 get imaging tests to see inside your body. This is one way that doctors check on how your treatments are working and whether the disease has spread. Common imaging tests include:
- CT scans, where an X-ray machine circles around as you lie on a table
- Bone scans with a shot that helps show areas with cancer. Your doctor may call this 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 disease.