Treatments for metastatic breast cancer have changed the game for many patients.
Although breast cancer awareness has improved among the general population, fewer people are familiar with the realities of a metastatic breast cancer diagnosis. This advanced stage of breast cancer (also known as stage IV) means that the cancer has spread beyond the breasts to other parts of the body, such as the bones, lungs, or lymph nodes. (Learn more about metastatic breast cancer here.)
With this stage of breast cancer being less commonly diagnosed, especially among first-time breast cancer patients, some misunderstandings about the treatment and prognosis of metastatic breast cancer are inevitable. Clearing up these myths is crucial—especially for the patients themselves.
“It’s important to reassure patients as much as possible and to dispel preconceived notions,” says Amy Tiersten, MD, a breast oncologist at Dubin Breast Center at Mount Sinai Hospital in New York City.
Myth: Metastatic breast cancer is a death sentence.
It’s true that breast cancer becomes harder to treat at a more advanced stage, but metastatic breast cancer now has a variety of treatment options that may shrink tumors, reduce cancer growth, and help patients live longer. “Patients are living with the disease, in many cases for a long period of time,” says Dr. Tiersten.
Thanks to improved treatment options, Dr. Tiersten says you can think of metastatic breast cancer more like a chronic disease, like diabetes. It can’t be cured, and it requires ongoing management, testing, and making adjustments to medication regimens.
“It’s not true in every single case, but many patients with metastatic breast cancer can live good quantity and quality of lives,” says Dr. Tiersten. Learn more about treatments for metastatic breast cancer.
Myth: Breast cancer that spreads to the lungs is lung cancer.
Cancer cells are always named after the part of the body where the tumor originated, according to the American Cancer Society. Under a microscope, a cancer cell from lung cancer and breast cancer look structurally different. No matter where the breast cancer cells spread in metastatic breast cancer, they are is still considered to be breast cancer and treated as such.
Cancer cells can metastasize, or spread, by invading nearby cells, traveling through the bloodstream or lymph system, or lodging themselves in blood vessels, according to the National Breast Cancer Foundation. Even if a treatment is working well, it only takes one resistant cancer cell to spread the cancer to a new part of the body.
Myth: Metastatic breast cancer treatment is just like any other breast cancer treatment.
“Unlike treatment for early stage breast cancer where we give a defined length [of] time for treatment, treatment for metastatic breast cancer is an indefinite period of time,” says Dr. Tiersten.
Your doctor will continuously evaluate how well the treatment is working, based on not only the prevention of cancer growth but also your tolerance of side effects. If things are going well, you may stay on that treatment plan indefinitely.
Myth: Metastatic breast cancer can be cured.
New treatment options have helped to change the outlook for many patients with metastatic breast cancer, but there is still technically no cure for metastatic breast cancer. That said, it’s possible to live a life that’s virtually cancer-free for many years. “It’s certainly not unusual in this day and age to have patients get to a point where there’s no evidence of their disease on scans or through bloodwork,” says Dr. Tiersten.
But a tumor-free scan doesn’t mean it’s time to drop your treatment plan. Again, metastatic breast cancer is akin to a chronic disease that requires active maintenance.
“We keep [patients] on whatever treatment is keeping things under control,” says Dr. Tiersten. “A lot of patients can do very well with metastatic disease and live many years. [They can] do normal things, continue to work, go to bar mitzvahs and weddings, and live their lives.”
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It's important to reassure
patients as much as possible, and
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you have to dispel preconceived notions
there might be about metastatic breast
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cancer being a death sentence,
which it really is not anymore.
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And patients are living with the disease,
in many cases for a long period of time.
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We think of it more as a chronic disease,
that's not true in every single case, but
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many patients with metastatic breast can
live good quantity and quality of lives.
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We have great treatment for it.
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There's sometimes the misconception about,
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if someone has metastatic breast
cancer that's spread to the lung
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that it's not the same thing as a lung
cancer that actually starts in the lung.
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And the cells under the microscope
look very different.
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So the cells look like the original breast
cancer cells that started in the breast.
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And what can happen is even with best
efforts to eradicate the disease locally
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and give therapy to treat any microscopic
cells that might have traveled anywhere is
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that there can be just one cell
that's resistant to those therapies
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that can spread via small blood vessels or
small lymphatic channels.
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To another part of the body and
take hold there and
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grow to a point where it's in
some way clinically detectable.
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So unlike treatment for
early stage breast cancer,
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where we give a defined length of time for
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the treatment of metastatic breast
cancer is a indefinite period of time.
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And the way things work is
that we choose a treatment for
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a patient for a period of time,
usually repeat blood work and scans.
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If the treatment's working we continue
it indefinitely as long as it's
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either keeping the cancer from growing,
shrinking the cancer, and
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as long as the patient is
tolerating side effects.
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Some of the new treatments
that we have work so
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well that it's certainly not unusual in
this day and age to have patients get to
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a point where there's no evidence of their
disease on scans or through blood work.
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And we keep them on whatever treatment
is keeping things under control and
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a lot of patients can do very
well with metastatic disease and
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live many years sometimes with
good quality and quantity of life.
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Do normal things, continue to work,
go to Bar Mitzvahs and weddings and
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live their lives.
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Patients are living, sometimes without
evidence disease, for many years,
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more and more.
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We're seeing more and more of that.
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Breast cancer: facts and figures 2019-2020. Atlanta, GA: American Cancer Society. (Accessed on January 10, 2021 at https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2019-2020.pdf)
What is metastatic breast cancer? National Breast Cancer Foundation. (Accessed on January 10, 2021 at http://www.nationalbreastcancer.org/metastatic-breast-cancer.)