Predict, discover and treat
Nearly a quarter of people with breast cancer experience metastases. Sometimes this is discovered immediately, more often it is much later. What exactly does it mean when you have to deal with metastatic breast cancer? How is it discovered and can it be treated?
We distinguish three stages of breast cancer:
- The pre-stage (Carcinoma in situ, also called stage 0) The tumor has not yet grown beyond the boundary of one mammary gland or milk duct. About 10 percent of patients have this precancerous stage when they are diagnosed with breast cancer.
- Early stage (no metastases). The early stage is divided into different stages (I, II a/b or III a/b) depending on tumor size and the number of affected lymph nodes.
- Late stage (metastases present, also called stage IV)
Metastases
Nearly a quarter of people diagnosed with breast cancer experience metastases. These metastases are found at diagnosis in 5 percent of patients. However, they usually show up later, often years after the original tumor was treated. Metastases occur when cancer cells spread to other parts of the body via the lymphatics or blood vessels. There they settle and divide again, so that a tumor develops in that part of the body as well.
In breast cancer, metastases often end up in the bones (85 percent), lungs (15-25 percent), liver (40-50 percent) or brain (6-16 percent) in addition to the lymph nodes. When such metastases are found, healing is no longer possible. However, that does not mean that someone has also been treated.
Predicting metastatic breast cancer
Unfortunately, it is not (yet) possible to predict who will have to deal with metastases and who will not. Fortunately, more and more is known about certain tumor characteristics that indicate an increased risk. Think of the size of the tumor, the status of the lymph nodes, presence of the HER2 protein and the rate of cell division. More and more tests are also becoming available that can predict the risk of metastasis based on the genetic profile of the tumor. The so-called MammaPrint, for example. In addition, doctors take into account the reduction of the risk due to possible treatment with drugs because of former breast cancer.
How is metastatic breast cancer detected?
Metastases are usually discovered by complaints such as pain (bone pain, morning headache, chest pain), tightness, shortness of breath and/or nausea. If you – as a former breast cancer patient – have these kinds of complaints for a longer period of time, it is therefore important to call your GP or specialist. Breast cancer metastases cannot be actively detected. There are studies with, for example, sound (an ultrasound), ionizing rays (X-rays) or radioactive isotopes (nuclear scans) to discover the metastatic cancer cells at an early stage.
Treatment options for metastatic breast cancer
As mentioned, a cure for metastatic breast cancer is no longer possible. The treatments that are available try to maintain the quality of life, reduce pain and where possible reduce the disease. This is called palliative treatment. Treatment for metastatic breast cancer depends on the characteristics of the tumor, your condition and previous treatments. If possible, hormone and immunotherapy are applied. For tumors refractory to hormone or immune treatment, chemotherapy is the only remaining option (besides radiotherapy and supportive measures).
Life expectancy in metastatic breast cancer
Depending on the sensitivities (receptors) of the metastases and the aggressiveness of the breast cancer, this phase can last from months to years. In some cases, this form of breast cancer can become a chronic disease if it is not an aggressive tumor that responds well to hormone treatment, for example. This happens much faster with an aggressively growing tumor. The fear and uncertainty that this entails is of course heavy. It can be nice to seek support from fellow sufferers, for example via the forum of Breast cancer association Netherlands. You can also seek professional help. Specialized counselors can help deal with the fear of death and create a plan for the future to help with practical questions.
