Breast Cancer

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Advanced Breast Cancer—Recurrent or Metastatic

Advanced breast cancers are those that come back (recur) after treatment or are diagnosed as stage IV (metastatic).

Local Recurrence

If breast cancer comes back in the breast or near the mastectomy site, it is called a local recurrence. The treatment you receive for a local recurrence depends on the treatment you had initially. If you had a lumpectomy or other breast-conserving surgery, a local recurrence in your breast will probably be treated with a mastectomy. If you had a mastectomy, a recurrence will be treated by removing the tumor, if possible, and then giving you radiation therapy. In either case, your next step may be to receive hormonal therapy, chemotherapy, or both.

Metastatic Breast Cancer or Distant Recurrence

Breast cancer cells can travel through the lymph system or through the blood to reach other parts of the body, such as the bones. This is metastatic breast cancer. Although tumors appear outside the breast, such as in the liver, lungs, brain, lymph nodes, or bones, these are not new cancers; they are breast cancer.

In some cases, breast cancer has already metastasized, or spread, by the time a woman discovers that she has breast cancer. In some cases, localized breast cancer that was treated comes back later in other parts of the body. This may be referred to as a distant recurrence or as metastatic breast cancer.

Outlook

Metastatic breast cancer is generally seen as an incurable disease. However, even some metastasized breast cancer can be cured, particularly if it has never been treated before. Even when metastatic cancer isn’t curable, new treatments may put your cancer in remission and give you a good quality of life for many years—even decades, in some cases. Many women who were treated elsewhere for their primary breast cancer come to Seattle Cancer Care Alliance (SCCA) if their disease metastasizes.

If you have metastatic breast cancer, SCCA can offer you new medical procedures and treatments, as well as access to clinical studies that your community doctor may not know about or have access to. No one at SCCA will tell you that a diagnosis of metastatic breast cancer is not serious, but there is hope.

Treatment

Treatment for metastatic disease may include surgery, chemotherapy, or radiation, or a combination of these treatments. It may include hormonal therapies or targeted biological therapies, such as trastuzumab (Herceptin), lapatinib (Tykerb), everolimus (Afinitor), pertuzumab (Perjeta), or trastuzumab-DM1 (T-DM1).

Your treatment will depend on a number of factors, including the type of treatment you received in the past, if any, and the symptoms you are experiencing now. Radiation therapy can be used to shrink tumors in the brain or in the bones. Bone metastases may also be treated with drugs that help prevent the breakdown of bone and may also prevent bone metastases in breast cancer patients.

Clinical Studies

Ask your doctor about taking part in clinical studies of promising treatments for metastatic disease. Read more about participating in studies, find information about breast cancer clinical studies that are currently open and accepting patients at SCCA, and be sure to check the current list of open Phase 1 studies for patients with advanced breast cancer.

Support

Some women find that their treatment for metastatic disease is easier to tolerate than the chemotherapy they received during their first diagnosis with breast cancer. The emotional aspects of coping with advanced breast cancer may be more demanding than the medical treatment. SCCA has resources such as support groups and social workers and chaplains who are trained to provide the support you may need.