Metastatic breast cancer (also called stage IV) is cancer that has spread to other parts of the body outside of the breast and lymph nodes, such as the lungs, liver, bones or brain. Many factors determine the best course of treatment for metastatic breast cancer, including where it has spread, your symptoms and the type of tumor (for example, if it is hormone receptor positive or negative). While metastatic breast cancer cannot be cured, there are numerous treatment options and many people are able to live long, happy lives after this diagnosis. New treatments are continually being developed.
Treatment for metastatic breast cancer may include any combination of the following therapies, either together, separately or in sequence.
Hormone therapy is often used when tumors are hormone receptor positive. Examples include tamoxifen, fulvestrant and aromatase inhibitors such as letrozole. They often can help slow or stop the growth of the cancer, and can shrink some tumors.
Targeted therapies block cancer growth by targeting specific characteristics of breast cancer cells. These treatments may be an option for women with metastatic breast cancer that is hormone receptor-positive, women with metastatic breast cancer that is HER2/neu-positive, women with triple negative breast cancer, and women with metastatic breast cancer that is HER2-negative, with mutations in the BRCA1 or BRCA2 genes.
Immunotherapy uses medications that target immune checkpoint inhibitors, which are proteins on immune cells that have turned off the body’s immune response. Breast cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immunotherapy drugs target these checkpoint proteins and stimulate the body to recognize and attack breast cancer cells.
Chemotherapy may be used in women with metastatic breast cancer that is hormone receptor-negative, has not responded to hormone therapy, has spread to other organs or has caused symptoms. Chemotherapy may be given alone or in combination with immunotherapy in women with metastatic breast cancer that is hormone receptor-negative and HER2-negative.
Surgery and/or radiation therapy may be used to remove cancer that has spread to areas such as the brain, spine or lung, to support and strengthen bones, and to prevent or relieve pain or other symptoms.
Clinical trials testing new breast cancer treatments and treatment combinations are continually being developed, and we offer our patients enrollment in applicable clinical trials.