When Breast Cancer Spreads

Video Transcript

Keerthi Gogineni, MD, Winship Breast Oncologist. <br>Pond5. <br>AudioJungle.

KEERTHI GOGINENI: Metastatic breast cancer is when a woman, or potentially a man, has a cancer that started in the breast and then spread to an area outside of the breast. And so when we think about this, we're thinking about cancer that's gone from the breast into the lungs, or the liver, or the bones, or the brain. There's going to be some group of women for whom the breast cancer they had in a sense distributed seeds, and at some point those seeds find roots and they grow in a different part of the body. Thankfully, most people who have breast cancer are not going to develop metastatic disease. But there is going to be some group of women that will develop that, and it really depends on the kind of breast cancer that someone was diagnosed with. So women who have hormone positive breast cancer are women who could have a recurrence a long time after they were first diagnosed. So that could be in the span of the following 10, 15 years. There are women who have something called triple negative breast cancer. That kind of breast cancer tends to show up fast. So these women typically, if they're going to have metastatic disease, it would develop within the first two to three years of a diagnosis. And then women who have something called HER2-positive breast cancer are potentially going to have metastatic disease develop somewhere between those two windows. And so in terms of thinking about treatment plans, one of the goals was to try to make sure that we're addressing the symptoms that the cancer might be causing, but also trying to really think hard about the quality of life and the length of life. You're trying to put together a treatment plan that's going to address those different aspects.

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 so you’re able to do everyday things, adjusting for how you feel.

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. If it doesn’t work 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.

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

Every once in a while, 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 an IV infusion that helps show areas with cancer. Your doctor may call this scintigraphy.

PET scans with a special camera and a tracer chemical that goes into your arm by IV.

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.

WebMD Medical Reference Reviewed by Neha Pathak, MD on January 30, 2018

Sources

SOURCES:

Erica L. Mayer, MD, Dana-Farber Cancer Institute, Harvard Medical School.

Rita Nanda, MD, associate director, University of Chicago Breast Cancer Program; assistant professor of medicine, University of Chicago.

Richard J. Bleicher, MD, director, breast fellowship training program, professor, Fox Chase Cancer Center.

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