Newly Diagnosed or Seeking a Second Opinion
Seeking care from specialists in metastatic breast cancer is important whether you are newly diagnosed or are in the middle of your treatment. As a comprehensive cancer center, we use the latest treatments and can enroll you in clinical trials that are testing new therapies. Our team has helped develop many of the drugs for metastatic breast cancer used today.
We also offer you a wealth of resources to help you cope with your diagnosis and its effect on you and your family. Support groups, medical family therapy, palliative care specialists, and financial counselors can support you every step of the way.
Diagnosing Metastatic Breast Cancer
While it is possible for metastatic breast cancer to be found at your initial diagnosis, it is more common for breast cancer to return years after you’ve completed treatment. In either case, a variety of tests help us identify how extensively cancer has spread. They also provide information on the subtype of breast cancer in the metastases and possibly the underlying genomic changes in the tumor. We use this information to recommend the best treatments for you.
You may undergo several types of imaging tests, such as X-ray, MRI, and PET, CT, or bone scans. They help us identify the secondary site (such as the liver, bones, lung) where breast cancer has spread.
Biopsy
A biopsy removes cell and tissue samples from the secondary site for evaluation under a microscope. This helps us determine if there are any differences between your original and current breast cancer diagnosis.
Additional Lab Tests
Blood work and tissue samples may be studied to determine the subtype of breast cancer. For example, we test for:
- Hormones such as estrogen and progesterone that may be responsible for tumor growth. These types of breast cancer are called ER-positive and PR-positive (or hormone receptor-positive). They respond initially to endocrine therapy-based treatments.
- A protein called human epidermal growth factor receptor 2 (HER2), which is found in HER2-positive breast cancer. This aggressive cancer responds well to certain treatments.
When tests for ER/PR and HER2 protein are negative, the cancer is called triple-negative breast cancer. New medications such as immunotherapy are proving promising for some patients with this subtype.
Genomic Molecular Profiling
Blood work and tissue analysis may be performed to identify the genetic makeup of the tumor. These tests can identify vulnerabilities that may be treated with targeted therapies.
Metastatic Breast Cancer Treatment
The type of treatment you receive will depend on the type of breast cancer with which you are diagnosed. In general, the following treatments are used to treat metastatic (stage IV) breast cancer.
Hormone Therapy
If you are diagnosed with hormone-receptor-positive breast cancer (ER-positive or PR-positive breast cancer), hormone therapy drugs block, damage, or lower the production of the hormones to stop them from directing the cancer cells to grow and multiply. Targeted therapies are often added to endocrine therapy and have been shown to further slow the spread of growth and extend life.
Targeted Therapy for HER2-Positive Breast Cancer
Drugs that target the HER2 protein can help stop the cancer cells from growing. These drugs may be given in pill or IV form, sometimes in conjunction with chemotherapy. Many newer HER2 targeted agents are proving to be very effective.
Chemotherapy
Chemotherapy may be recommended at some point in your care for any breast cancer subtype.
Immunotherapy
Immunotherapy relies on the body’s immune system to recognize and destroy cancer cells. It can be used to treat some types of metastatic breast cancer, such as triple-negative, and may be used with chemotherapy.
Surgery
Surgery is not often used in the treatment of metastatic breast cancer but may be necessary to remove tumors causing pain.
External beam radiation therapy may be recommended as a palliative treatment to relieve symptoms, such as pain caused by tumors.
Additional Treatments
Depending on where cancer has spread, additional treatments may be recommended to manage symptoms such as pain, seizures, memory problems, trouble speaking, bone weakness or breaks, and loss of strength or mobility.
