What is Metastatic Breast Cancer?

Metastatic breast cancer is the term used to describe cancer that has spread from the original tumor site in the breast tissues in the body or to other organs. Metastatic breast cancer is the most advanced stage of breast cancer, or stage IV. Another name for metastatic breast cancer is advanced cancer or secondary cancer. If you have been diagnosed with breast cancer previously and your breast cancer comes back in your breast or in another part of your body, it may also be said you have a recurrence of your original cancer.

If cancer cells have spread past the breast and axillary lymph nodes to other areas of the body where they multiply and continue to grow. Breast cancer has the potential to spread to almost any region of the body. The most common region breast cancer spreads to is the bone, followed by the lung and liver. Generally, the reatment of metastatic breast cancer focuses on relieving symptoms and extending a woman’s lifetime.
A  diagnosis of metastatic breast cancer, for some women, may be their first diagnosis of cancer.

How does metastatic breast cancer develop?

From the original cancer in the breast, cancer cells can break away. This may happen after treatment or before treatment of the cancer in the breast, if some cancer cells are left. Via blood vessels or lymphatic vessels, cancer cells that break away can spread to other parts of the body. Lymphatic vessels are tiny vessels that usually collect fluid and dead cells, and run beside veins.

The original tumor site where the cells of cancer came from is called the primary cancer. In metastatic breast cancer, breast cancer is the primary cancer. When cancer cells travel around the body from the breast, they can lodge themselves in various body organs or tissues. These cells can begin to form breast cancer in a new place. This new cancer is called a secondary or a metastasis.

Most commonly, breast cancer spreads to one or more of the following sites:

• bones – one or more bones may be affected
• liver
• lungs.

Bone: Approximately 25% of breast cancers spread first to the bone. The bones of the ribs, spine, skull, pelvis and long bones of the legs and arms are most often affected. There are two types of bone metastases: osteolytic and osteoblastic. With osteolytic metastases, the cancer forming holes, eats away at the bone. This most often occurs in the hip, legs or pelvis. Actually, Osteoblastic metastases increase bone mineral density but also cause bones to fracture easily. Both types of bone metastases cause pain.

Lung: Women who die from breast cancer, between 60% and 70% of them have eventually had it spread to their lungs. In 21% of cases, the lung is the only site of metastatis spread. The most common signs of lung metastases are: dry cough and shortness of breath. But, women will not experience any symptoms in some cases; cancer will only be detected by chest X-ray or CT scan. In rare cases, part of the lung may be surgically removed if the cancer is confined to one area. In most cases, the cancer has spread itself throughout the lung and is more effectively treated by anti-cancer drugs or chemotherapy.

Liver: The third most common site for breast cancer to spread to is the liver. Two-thirds of women with metastatic breast cancer eventually have it spread to the liver. Symptoms of metastatic breast cancer liver are subtle at first but over time become increasing intense. Loss of appetite, weight loss, fever, and gastrointestinal disorders may indicate liver breast cancer metastases. Liver blood tests may first detect cancer in the liver. However, a liver biopsy is necessary to distinguish between cancerous tumors and other abnormalities.

This does not mean that if you are diagnosed with metastatic breast cancer then your cancer will spread to all these sites. Breast cancer may also spread to other regions of the body. Though these sites are less common, breast cancer may infect the bone marrow, ovaries, brain, eye, spinal cord, and other areas. If the breast cancer spreads to places near the breast such as the bones, skin or muscles of the chest, but does not spread to any other place in the body this is called locally advanced breast cancer.

Metastatic breast cancer prognosis and diagnosis

Metastatic breast cancer may also occur from a recurrence after initial of metastatic breast cancer treatment. There are three types of breast cancer recurrences: local, regional, and distant. Regional and Local recurrences are may be detected by mammogram or usually less serious than distant recurrences and seen as abnormalities with breast imaging exams (such as T-scan or ultrasound). Once a local or regional recurrence is detected, physicians will order a variety of other tests to determine whether the cancer has metastasized (spread) to distant organs. These tests include:

• Radionuclide bone scan: This procedure helps show whether a cancer has metastasized to bones.
• Chest x-ray: A chest x-ray can find tumors in your lungs or fluid in your chest.
• Computed tomography (CT): The CT scan is an x-ray procedure that produces detailed cross-sectional images of your body.
• Magnetic resonance imaging (MRI): MRI scans use radio waves and strong magnets instead of x-rays.
• Blood Tests

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