Stage 4 breast cancer:survival rate, symptoms, treatment, prognosis.Metastatic breast cancer, indicated by stage 4, indicates that cancer has advanced to the fourth phase.
Breast cancer that has spread into other areas of the body beyond the breast tissue and the local lymph nodes is considered stage 4.
Having a thorough understanding of how metastasis occurs can help in understanding the prognosis for stage 4 breast cancer. Cancer has spread beyond the original site in the body when it “metastasizes.”
Breast cancer diagnosed at stage 4 may mean that cancer has spread to other organs such as the bones or lungs. The purpose of this post is to discuss your options when it comes to metastatic breast cancer, including the prognosis and treatments.
Stage 4 breast cancer can currently not be cured, but it can be kept under control with treatment, frequently for years at a time. Metastatic breast cancer patients must continue to undergo treatment throughout their lives. Different treatment plans may be tried if the current treatment doesn’t work.
Women diagnosed with stage 4 breast cancer had a 28 percent survival rate after the diagnosis after five years, according to the American Cancer Society (ACS). This represents a much lower survival rate than in the early stages. All stages of cancer have a 5-year survival rate of 90 percent.
Because breast cancer survival rates are higher in the early stages, it is vital to detect and treat the disease as early as possible. Keep in mind, however, that you can live longer and have a better quality of life if you receive appropriate treatment for stage 4 breast cancer.
There are many symptoms that can accompany stage 4 breast cancer, depending on where cancer has spread throughout your body.
- A sudden increase in bone pain can be a sign that breast cancer has spread to your bones. The most common spread of breast cancer is to the ribs, spine, pelvis, or arm and leg bones.
- Symptoms include headaches, slurred speech, or memory loss when it has spread to the brain.
- Most women with breast cancer that has spread to their lungs or liver will not feel any symptoms.
Based on the extent of cancer’s spread, treatment is prescribed for symptom relief. Xgeva is a medication that relieves the pain from bone metastases by using radiation therapy and bisphosphonates such as pamidronate (Aredia) or zoledronic acid (Zometa) or denosumab.
Breast and adjacent lymph nodes harbor malignancies in Stage IV, which have spread to other parts of the body. It spreads most commonly to the bones, liver, and lungs when it spreads from the breast. Some of the disease’s spread can also affect the brain.
In women with stage IV breast cancer, the primary treatment is systemic medication therapy. Among the options are:
- Hormone therapy
- Targeted drugs
- Some combination of these
Some women may live longer after treatment by decreasing tumors (or decreasing their growth), alleviating symptoms, and extending their lives. Most women die from this type of cancer.
Cancer patients often continue to receive treatment until the disease recurs or the adverse effects become unmanageable. At this point, they might try other medications. In order to determine what medications to use in treating stage IV breast cancer, doctors look at the hormone receptor status of the cancer, the presence of HER2, and sometimes the discovered gene mutation.
Hormone receptor positive cancer
The first treatment of choice for women with hormone receptor-positive malignancies is hormone therapy (oestrogen or progesterone) (tamoxifen or an aromatase inhibitor drug). As part of combination therapy, a medication such as a CDK4/6 inhibitor, a PI3K inhibitor, or everolimus could also be used.
Tamoxifen or other treatments that stop the ovaries from producing hormones are frequently prescribed to women who are not yet menopausal.
Hormone receptor negative cancer
Chemotherapy is the primary treatment for hormone-negative tumors (tumors arising from estrogen and progesterone receptors) among women owing to the ineffectiveness of hormone therapy.
Triple negative breast cancer treatment
The administration of immunotherapy medications in conjunction with chemotherapy might be recommended for people with triple-negative advanced breast cancer whose tumour produces the PD-L1 protein.
In about one out of every five women who have triple-negative breast cancer, the PD-L1 protein is expressed. Women with TNBC with a BRCA mutation may be considered candidates for PARP inhibitors (such as olaparib or talazoparib).
Breast tumors with high levels of gene mutations known as microsatellite instability (MSI) or abnormalities in any of the mismatch repair genes (MLH1, MSH2, MSH6, and PMS2) can be treated by immunotherapy with the drug pembrolizumab. Pembrolizumab may also be an option for those with TNBC involving other genes or proteins.
There is no specific gene or protein change in TNBC that can be treated with chemotherapy alone or with the antibody-drug conjugate sacituzumab govitecan (Trodelvy).
HER2 positive cancer
Breast cells contain HER2 (human epidermal growth factor receptor 2), a receptor that responds to growth factors found in the epidermis. As a result of the increased HER2 protein levels within HER2-positive breast cancer, the cancer cells proliferate rapidly and spread quickly.
Trastuzumab (Herceptin) is a synthetic antibody that binds to the HER2 protein on cancer cells and prevents them from growing. It is frequently used in conjunction with chemotherapy to treat stage 4 breast cancer. Infusions of these medications are usually administered by intravenous infusion.
Local or regional treatment
Stage IV breast cancer is usually managed primarily with systemic drugs, although local and regional treatments such as surgery, radiation therapy, and regional chemotherapy may also be used.
Getting rid of all of cancer with these treatments is probably very unlikely, as they are only designed to treat certain parts of the body. More likely than not, these treatments are used to prevent or treat symptoms or complications of cancer.
Surgery and/or radiation therapy may also be used in certain situations, including:
- An open or painful wound in the breast (or chest) caused by a breast tumor
- For the treatment of a few metastases in one area, such as the brain
- For the prevention or treatment of fractures
- In cases where a tumor is pressing against the spinal cord
- If there is a blockage in the liver’s blood vessels
- Causing pain or other symptoms anywhere in the body
Chemotherapy that is administered directly to a specific area, like the fluid surrounding the brain and spinal cord (called intrathecal chemo), may be helpful in some cases, as well.
Often cancer can be shrunk or its growth stopped (sometimes for years) with advanced breast cancer treatment. In order to determine whether additional treatment options are available at this point, a number of factors must be taken into account, including previous treatments, the location of the cancer, a woman’s menopause status, general health, the desire to continue treatment, as well as changes in the hormone receptor status and HER2 status of the cancer cells.
Progression during hormone therapy
When hormone therapy has not been effective for hormone (oestrogen or progesterone) receptor-positive tumors in the past, switching to another type of hormone therapy can occasionally be helpful.
There is the possibility that exemestane, possibly in combination with everolimus (Afinitor), could be prescribed in addition to letrozole (Femara) or anastrozole (Arimidex).
Depending on the situation, patients may combine fulvestrant (Faslodex) or another aromatase inhibitor with a CDK inhibitor, such as fulvestrant (Faslodex). In the case of a PIK3CA mutation, fulvestrant plus alpelisib may be studied in conjunction with an aromatase inhibitor if the tumor has progressed.
The experience of metastatic breast cancer varies from person to person. The National Breast Cancer Foundation states that your symptoms at stage 4 will depend on where the disease has spread throughout your body.
It is possible to manage metastatic breast cancer even though there is no known treatment. A specialist can help you live longer and have a better quality of life by providing you with the right treatment.
A vast number of breast cancer patients have been studied to determine breast cancer life expectancy. There is no way to give a prediction based on these figures because each person’s situation is different.
Your life expectancy can be affected by the following factors with metastatic breast cancer:
- And general health
- And HER2 receptor expression on cancerous cells
- As well as the type of tissue infected by cancer
Takeaway:Stage 4 breast cancer
It is critical to know the stage of your breast cancer at the time of your diagnosis because it greatly affects your prognosis.
In accordance with the National Cancer Institute, early detection and treatment is the key to a high chance of survival in five years following a breast cancer diagnosis.
Even at stage 4, keep in mind that everyone’s response to treatment varies, and your response may not be the same as someone else’s. Research is still being carried out on various approaches to treating metastatic breast cancer. Things are getting better every year.
For more information on specific factors affecting your prognosis, speak to your doctor.
Read also: Importance of Microbiology in Medicine; Medicine definition, meaning; Ontology in medicine and nursing ; Breast Cancer Treatment; Inflammatory Breast Cancer; Metastatic Breast Cancer; Breast Cancer in Men
External resources: Cancer.org