Decisions about how to treat metastatic or recurrent breast cancer are based on a combination of factors that include specific information about the cancer, your preferences, and your health.

• Because breast cancer can now be discovered at a much earlier stage, most women will not have metastatic or recurrent disease.
• Although most metastatic breast cancer cannot be cured, you can live for several years with treatment that will improve the quality of your life.
• The type of treatment you receive depends on your general state of health and how active you are (performance status).

Initial treatment

The treatment you receive depends on your symptoms, the area of your body involved, and whether your breast cancer has spread. Treatment may include:

• Hormone therapy with medicines such as tamoxifen or an aromatase inhibitor. These medicines are used if your breast cancer has estrogen receptors. Aromatase inhibitors are only used if you have already completed menopause.
• Trastuzumab (Herceptin), for HER-2 breast cancer. It is used to stop the cancer from coming back and to control breast cancer that has spread.
• Chemotherapy with medicines such as doxorubicin, taxol, or cyclophosphamide.
• Bisphosphonates, to reduce bone pain, fractures, and spinal cord compression caused by metastatic disease in the bones.
• Radiation treatments, to destroy cancer cells that are causing problems in a specific area.
• Surgery for a local recurrence. For example, you might have a mastectomy if breast cancer has returned to your breast after you had breast-conserving surgery. Some studies have shown better survival rates for women who have the primary tumor removed even when the cancer has already spread.⁶
• Corticosteroids, to reduce inflammation and swelling caused by metastatic disease of the brain and spinal cord.

Clinical trials that test new medicines and new combinations of medicines are ongoing. Talk with your doctor about participating in a clinical trial.

The length of time between visits to your doctor depends on the type of treatment you are receiving and your response to the treatment.

Emotional needs

If you have recently been diagnosed with metastatic or recurrent breast cancer, you may experience a wide variety of emotions. There is no "normal" or "right" way to react. You may feel angry or frustrated and may second-guess your previous treatments. And you may lose hope. But recurrent or metastatic breast cancer can be treated successfully. Some women live for many years, managing their cancer like a long-term health problem. The treatment decisions you and your doctor made in the past were the right ones at that time. But now, new decisions must be made and treatment objectives must be explored.

Get the support you need. There are many different types of support programs, including individual or group counseling and support groups. Some groups are formal and focus on learning about cancer or dealing with feelings. Others are informal and social. All types of support help you explore your feelings and develop coping skills. Thanks to the Internet, it’s also possible to find women who are very willing to listen to you and share their own experiences through online support groups and chat rooms. Studies have found that people who take part in support groups have an improved quality of life, sleep better, and feel more like eating. Contact your local chapter of the American Cancer Society to help you find a support group. Talking with other people who may have had similar feelings can be very helpful.