When a woman is first diagnosed with breast cancer -- any stage of breast
cancer -- one of her greatest fears is "What if it's spread?"
Not long ago, a diagnosis of metastatic breast cancer, meaning the disease
has spread well beyond the breast into places like the bones, lungs, or liver,
meant it was time to get your affairs in order. In the 1970s, only 10% of women
were still alive five years after a diagnosis of metastatic breast cancer,
according to a comprehensive review by the MD Anderson Cancer Center in
Houston, published in January 2004.
Why are you recommending this procedure? What are the options?
What are the risks? How do they compare with the benefits?
How do I prepare for surgery?
What type of anesthesia will I have?
What happens during and right after surgery?
Who do I talk to about breast reconstruction?
How long will I be in the hospital?
Are there any complications?
When can I go back to work and resume normal activities?
What are the risks of lymphedema?
Before surgery, your surgeon should...
Today, say the MD Anderson researchers, as many as 40% of women with
recurrent or metastatic breast cancer survive at least five years. "More
and more, both doctors and patients approach it as a chronic condition,"
says Eric Winer, MD, director of the Breast Program at Boston's Dana-Farber
Cancer Institute. "We can't cure it, but we can manage it for many
Managing metastatic breast cancer as a chronic condition isn't the same as
managing a disease like diabetes. "Diabetes, ultimately, can shorten one's
life, but that's over the horizon of a few decades," Winer says.
"With breast cancer metastases, the majority of women know that this is
an illness that's ultimately going to take their life. That may not be in a
year or two or three, but it certainly tends to be in less than a
However, enormous treatment improvements do mean that thousands of women are
living longer and better lives even though they have metastatic breast
Treatments for Breast Cancer that Has Spread
Treatments for metastatic and earlier-stage breast cancer are very
different. For earlier-stage breast cancer -- particularly for women who are
relatively young and healthy -- doctors will often advise a very aggressive,
rigorous course of treatment aimed at getting rid of the cancer completely. The
side effects can be difficult, but there's a finish line in sight: initial
breast cancer treatment usually lasts no more than six to nine months.
With metastatic cancer, some form of treatment will be a fact of life more
or less from now on. This means the treatment philosophy changes. "We're
looking to gain maximal control of the tumor at the lowest possible cost in
terms of toxicity," says Clifford Hudis, MD, chief of the Breast Cancer
Medicine Service at New York's Memorial Sloan-Kettering Cancer Center.