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Metastatic Breast Cancer: Understanding the Significance of Stage IV

By Kiara Ford



The MBC ribbon is green, pink, and teal.

Most people, even those who have never experienced cancer, are familiar with the concept of stages used to classify the extent of the disease. It is through this awareness that much of the public has come to hold a deep fear of the highest classification, stage IV. This stage of breast cancer is also known as metastatic breast cancer, or MBC. Stage IV breast cancer has no cure. Because metastatic breast cancer is a life-threatening terminal diagnosis, it often carries associations that can make it difficult or uncomfortable to discuss.


Nevertheless, it is estimated that over 168,000 people in the United States alone are living with metastatic breast cancer. It is important that those living with MBC be included in conversations about breast cancer, including treatments, quality of life, and clinical trials. The unique experience of advanced breast cancer must be understood within the community. While October is recognized as Breast Cancer Awareness Month (BCAM) and October 13 has been designated Metastatic Breast Cancer Awareness Day, there is more we can do to foster a greater comprehension of stage IV breast cancer. People living with this terminal diagnosis need to be heard and seen. Metastatic breast cancer needs to have a seat and a voice at the table.


Continue reading to learn more about what metastatic breast cancer is and how it is diagnosed and treated.


What is metastatic breast cancer?

Metastatic breast cancer is the term used to describe when cancer that was originally located in the breast spreads, or metastasizes, to other distant parts of the body. Cancer cells can spread in many different (sometimes concurrent) ways, such as traveling through the body via lymph nodes or the circulatory system, invading healthy cells or capillaries, and forming tumors in new locations in the body. Metastatic breast cancer is most often found in the bones, lungs, liver, and brain. Symptoms of metastatic breast cancer can vary based on where the disease has metastasized.


What are the symptoms of metastatic breast cancer?

General symptoms of metastatic breast cancer can include loss of energy or appetite, in addition to more specific symptoms varying based on where the cancer has spread.


People with metastasis to the bones may experience swelling, bone pain, and being more susceptible to fractures. Metastasis to the liver may cause jaundice, rash or skin irritation, abdominal pain, vomiting or nausea, and high liver enzyme counts in the blood. Metastasis to the lung can cause chronic cough, difficulty breathing, chest pain, and abnormal chest X-ray images. Metastasis to the brain can cause vomiting or nausea, behavioral changes, seizures, persistent and worsening headaches, and difficulty with vision, speech, and memory.


It is important to notify a doctor as soon as these symptoms emerge, particularly if you have already been diagnosed with breast cancer or have a family history of breast cancer. While these are general symptoms, it is important to know that symptoms do not always present. Therefore, it is important to stay up-to-date with your mammograms, breast screenings, doctors’ appointments, and follow-ups.


How is metastatic breast cancer diagnosed?

The diagnosis process for metastatic breast cancer often resembles that of other cancer types. It begins with a conversation with a doctor to analyze family history and current symptoms. This is followed by tests, the nature of which vary based on the symptoms experienced. Doctors may recommend genetic testing, imaging, blood tests, and/or biopsy. Those diagnosed with metastatic breast cancer have often already been diagnosed and treated for breast cancer in the past, and are experiencing recurrence. Only about 6-10% of people receive metastatic breast cancer as their initial diagnosis, referred to as de novo metastatic breast cancer.


How is metastatic breast cancer treated?

Treatment of metastatic breast cancer will vary based on the individual patient. Factors such as where the cancer has metastasized, genetic predisposition, biomarkers discovered through biopsy, and personal goals will shape individual treatment plans.


If the cancer is recurrent, doctors will also factor in previous treatments when deciding on the best course of action. Typically, surgery and radiation therapy are more difficult in cases where the cancer is widespread, but they may be useful in some circumstances, particularly in managing symptoms caused by the cancer. Most often, treatment for hormone-positive metastatic breast cancer consists of hormonal therapies and chemotherapy in order to shrink or slow the growth of cancer cells. Treatment will also aim to manage the symptoms caused by the cancer, in order to focus on not just quantity, but quality of life.


Clinical trials aim to develop new treatments for metastatic breast cancer, and can provide additional treatment options for those living with MBC. Learn more in the Clinical Trials section of our website and on the Breast Cancer Conversations podcast.


There is currently no cure for metastatic breast cancer. Ongoing MBC research is dedicated to understanding causes and risk factors, creating new treatment options, and improving the comfort of those living with metastatic breast cancer.


SurvivingBreastCancer.org offers meetups and programs tailored specifically for those living with metastatic breast cancer. Join us at Thursday Night Thrivers or an upcoming installment of our MBC Webinar Series!




MBC Resources:

Join Our Thursday Night MBC Meetup

Newly Diagnosed with MBC

Living With MBC


MBC Stories:

Chapter Three of My Breast Cancer Journey

My De Novo MBC Story: I’m Not Going to Give Up on My Diagnosis

HOPE is my Favorite Four-Letter Word



On the Podcast: Breast Cancer Conversations


Finding Strength and Joy in Parenting with Metastatic Breast Cancer



About the Author:

Kiara Ford is a recent graduate of Emerson College, where she majored in communication studies and minored in health and society. She is currently a community health worker trainee with the non-profit organization Asian Women for Health. She is passionate about patient advocacy and health equity, and hopes to raise awareness and increase understanding of patients’ rights through her work.



From the Same Author:

Breast Cancer and Healthcare Access Within the Hispanic Community

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