Metastatic (stage 4) breast cancer

Descripción general

Metastatic breast cancer is cancer that starts in the breast and spreads to other parts of the body. It also is called stage 4 breast cancer, stage IV breast cancer and secondary breast cancer.

Breast cancer begins when cells in the breast grow out of control. Sometimes these cancer cells break away and travel through the lymphatic system or the blood. Common sites where breast cancer spreads include the bones, brain, lungs and liver.

Breast cancers can spread at different speeds. Some grow and spread quickly, while others grow slowly and are less likely to spread. The type of breast cancer and other features of the cancer help determine how quickly it spreads.

Some people have metastatic cancer when they're first diagnosed. But cancer that has spread is more often discovered when cancer comes back after treatment for a previous breast cancer diagnosis. For most, a metastatic breast cancer also is a breast cancer recurrence.

Treatment for metastatic breast cancer usually starts with medicines that can help slow the growth of the cancer. Other treatments may depend on where the cancer spreads and what symptoms it causes.

When the cancer is advanced and has spread to other organs, it typically can't be cured. But treatment can help control the cancer effectively. Treatments may extend your life and help you to live as well as possible, for as long as possible. As treatments improve, people are surviving longer with metastatic breast cancer.

Síntomas

Metastatic breast cancer may not cause symptoms at first. When they happen, symptoms may depend on where the cancer spreads.

Common symptoms

Signs and symptoms of metastatic breast cancer include:

Pain.
Feeling very tired.
Shortness of breath.
Swollen lymph nodes.
Loss of appetite.
Weight loss without trying.

Symptoms of cancer that has spread to the bones

Breast cancer that spreads to the bones most often goes to the spine. Other common sites include the ribs, pelvis, skull, thigh bone and upper arm bone. Symptoms may include:

Pain in or around a bone.
Weakness in one part of the body.
Changes in feeling in one part of the body, such as numbness or tingling.
Bones that break without a clear cause.
Loss of control of the bladder and bowels.

Symptoms of cancer that has spread to the brain

Breast cancer that spreads to the brain may form one or more growths in the brain tissue. The cancer also can spread to the thin layers of tissue around the brain and spinal cord called the leptomeninges. Symptoms of cancer that spreads to the brain may include:

New headaches or changes in existing headaches, such as becoming more frequent or more severe.
Weakness in one part of the body.
Changes in vision.
Changes in balance and coordination.
Nausea and vomiting.
Seizures.

Symptoms of cancer that has spread to the liver

Breast cancer that spreads to the liver may cause symptoms such as:

Bloating or swelling of the belly.
Yellowing of the skin and the whites of the eyes.
Pain in the upper right side of the belly.

Symptoms of cancer that has spread to the lungs

Breast cancer may spread to the lungs or the thin tissue that surrounds the lungs, called the pleura. Metastatic breast cancer also can cause fluid to build up around a lung. This fluid buildup is called pleural effusion. Symptoms of cancer that spreads to the lungs may include:

Shortness of breath.
Cough.
Chest pain.

When to seek care

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you. If you were treated for breast cancer in the past, tell your healthcare team about your previous diagnosis and treatment.

Solicite una consulta

Causas

It's not clear what causes metastatic breast cancer. It happens when cancer cells in the breast break away from the area where they formed. The cancer cells may spread through the lymphatic system or enter the bloodstream. This lets the cells travel to other parts of the body.

After the cancer cells reach a new place, they face many challenges. They must avoid the body's immune defenses and adapt to conditions in the new environment. Some parts of the body are better able to support the survival and growth of metastatic breast cancer cells. These places include:

Bones.
Brain.
Liver.
Lungs.

Factores de riesgo

Metastatic breast cancer has the same risk factors as breast cancer in general.

Risk factors related to your personal medical history and your family's medical history include:

A family history of breast cancer. If a parent, sibling or child had breast cancer, your risk is increased. The risk is higher if your family has a history of getting breast cancer at a young age. The risk also is higher if you have multiple family members with breast cancer. Still, most people diagnosed with breast cancer don't have a family history of the disease.
A personal history of breast cancer. If you've had cancer in one breast, you have an increased risk of getting cancer in the other breast.
A personal history of breast conditions. Certain breast conditions are markers for a higher risk of breast cancer. These conditions include lobular carcinoma in situ (LCIS) and atypical hyperplasia of the breast. If you've had a breast biopsy that found one of these conditions, you have an increased risk of breast cancer.
Increasing age. The risk of breast cancer goes up as you get older.
Inherited DNA changes that increase cancer risk. Certain DNA changes that increase the risk of breast cancer can be passed from parents to children. The most well-known changes are called BRCA1 and BRCA2. These DNA changes can greatly increase your risk of breast cancer and other cancers, but not everyone with these DNA changes gets cancer.
Radiation exposure. Radiation treatments to the chest as a child or young adult raise the risk of breast cancer.

Risk factors related to reproductive history and hormone exposure include:

Beginning your period at a younger age. Beginning your period before age 12 increases the risk of breast cancer.
Beginning menopause at an older age. Beginning menopause after age 55 increases the risk of breast cancer.
Being female. Women are much more likely than men are to get breast cancer. But anyone with breast tissue can get breast cancer, including men.
Having your first child at an older age. Giving birth to your first child after age 35 may increase the risk of breast cancer.
Having never been pregnant. Having been pregnant one or more times lowers the risk of breast cancer. Never having been pregnant increases the risk.

Other risk factors include:

Dense breast tissue. Breast tissue is made up of fatty tissue and dense tissue. Fatty tissue is made of fat. Dense tissue is made of milk glands, milk ducts and fibrous tissue. If you have dense breasts, you have more dense tissue than fatty tissue in your breasts. Having dense breasts increases the risk of developing breast cancer and makes it harder to detect cancer on a mammogram. Talk with your healthcare team about other tests you might have in addition to mammograms to look for breast cancer.
Alcohol use. Drinking alcohol increases the risk of breast cancer. There is no safe amount of alcohol when it comes to breast cancer. The more alcohol you drink, the greater your risk.
Obesity. Obesity increases the risk of breast cancer.