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Metastatic breast cancer presents differently than breast cancer

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Posted at 8:25 AM, Oct 14, 2019

Metastatic breast cancer kills an average of 116 people a day and 40,000 people a year.

The advanced, or metastatic form, of the disease means the cancer has spread through the blood and created secondary tumors in the bones, liver, lung or brain.

“About 1 in 8 women will develop breast cancer in the course of their lifetime, and that is about an average risk of women developing breast cancer in the United States -- about 13 percent in their lifetime,” said Thomas-Spann Clinic at Corpus Christi Medical Center oncology/hematology specialist Dr. Aftab Mahmood.

Once the breast cancer metastasizes to different parts of the body, the symptoms can vary depending on the location of the cancer.

“So the symptoms can be liver failure, fracture of the bone that is related to the cancer," Mahmood said. "It can spread to the lungs and present shortness of breath, coughing up blood, or sometimes it can present with brain metastases disease, symptoms of stroke, or headaches, or double vision."

Being diagnosed with metastatic breast cancer can happen to anyone, at any time. What starts out as Stage I breast cancer can eventually become Stage IV metastatic breast cancer.

“So most of the time the breast cancer, like I mentioned, it is diagnosed when it is localized so it is diagnosed when screening mammograms," Mahmood said. "About 15 percent of the time, mammograms will miss the diagnosis or miss the breast cancer, and that is diagnosed by the patient presenting with a lump in their breast."

Treatment for metastatic breast cancer has two main goals: to control the cancer for as long as possible, with the highest quality of life possible.

“Most of the breast cancer are estrogen receptor-positive; the treatment is directed towards removing the estrogen from the body or keeping the breast from producing estrogen," he said. "So it is based on medications that will keep the body from producing estrogen and a combination of some targeted therapy as well."

Keep in mind that metastatic disease is not the end. Many people continue to live long, productive lives with breast cancer in this stage.

“Just to give you an idea, the average survival for somebody diagnosed with metastatic breast cancer is about 3 years, and that time frame keeps getting longer and longer with the newer therapy that’s become available,” Mahmood said.

The symptoms of metastatic breast cancer can be very different depending on the location of the cancer:

• constant back, bone, or joint pain

• difficulty urinating (either incontinence or not being able to go); this can be a sign that the nerves in your back are being pinched by a cancer

• numbness or weakness anywhere in your body

• a constant dry cough

• difficulty breathing

• shortness of breath

• chest pain

• loss of appetite

• abdominal bloating, pain, or tenderness

• constant nausea, vomiting, or weight loss

• jaundice (a yellow tinge to the skin and whites of your eyes)

• severe headaches

• vision problems (blurry vision, double vision, loss of vision)

• seizures

• loss of balance

• confusion

Tests to diagnose metastatic breast cancer:

• blood tests (including tumor markers in some patients)

• whole-body bone scan, with or without X-rays of specific bones

• MRI of the spine or brain

• CT scan of the chest, abdomen, pelvis, and/or brain

• PET scan

• X-ray or ultrasound of the abdomen or chest

• bronchoscopy, if you have a constant cough or trouble breathing

• biopsy of any suspicious area

• a "tap," removal of fluid from the area with symptoms to check for cancer cells; a pleural tap removes fluid between the lung and chest wall, and a spinal tap removes fluid from around the spinal cord