Metastatic Breast Cancer: Myths

Metastatic Breast Cancer: Myths

MYTH  No. 1

If breast cancer has spread outside of my breast and outside of my lymph nodes, there are no other treatment options.

False. Breast cancer spreading outside of the breast and underarm lymph nodes to another organ system (Stage IV or metastatic breast cancer) does not mean there are no other treatment options.  Examples of other organ systems include lung, liver, brain, and bone. Technically, metastatic breast cancer (MBC) does not allow for removal of all breast cancer cells in the body (meaning, it is not curable), but there are often treatment options (meaning it is treatable).  Life expectancy for patient with MBC is shorter than patients without MBC, but there are many who will for years live with a diagnosis of MBC.

MYTH No. 2

My doctor should be able to tell me my exact life expectancy.

While there is data available suggesting survival ranges per stage, it can be difficult to accurately predict life expectancy for an individual patient . Staging breast cancer takes several factors into account, with each patient having a unique breast cancer, amount of breast cancer in their body and individual health history. For example, a patient with an estrogen receptor positive breast cancer typically has a more favorable outcome than a patient whose cancer is estrogen receptor negative. But if that patient with an estrogen positive breast cancer is a tobacco smoker and has a history of heart disease, standard cancer staging may overestimate her survival.  This is why doctors may give survival ranges or why doctors may not provide exact numbers.

MYTH No. 3

Surgery of the affected breast is never an option for patients with MBC.

False.  Over recent years, more data has emerged regarding the role of surgery and MBC.  It is not currently clear which patients definitely benefit.  At present, most patients with MBC are not felt to be appropriate candidates for surgery.  However, breast specialists agree there is a role in selected patients.  Generally speaking, patients who have stable  MBC (ie., no progression over a prolonged period of time) that is isolated to certain a organ with a small volume of breast cancer may be a candidate. Ultimately, the individual patient’s team of doctors have to consider if there is an opportunity for benefit before offering surgery.

MYTH No. 4

Surgery on organs affected by breast cancer spread is not possible because MBC is not curable.

False. Patients with MBC sometimes experience symptoms from breast cancer located in other organ systems (examples: lung, liver, bone).  Some of these symptoms can adversely affect quality of life.  Although MBC cannot be cured, there are sometimes options for improving quality of life and occasionally prolonging life in certain patients with MBC.  Surgery to remove an area of metastatic breast cancer may be an option depending on a patient’s individual circumstances. If you are a patient with MBC, it is always OK to ask your healthcare team if you are a candidate for surgery to remove a metastasis.

Myth No. 5

Once a patient has MBC that patient no longer needs to see their breast cancer health care team if they have new problems or concerns.

False. Any new symptoms arising in a patient with MBC should be reported to the breast cancer health care team. The problem could be unrelated to MBC and may be potentially treatable, such as a patient with MBC who has gallstones. If the problem is related to MBC, this can be addressed to improve quality of life.  Quality of life is of critical importance for patients regardless of stage of breast cancer and is especially important for  MBC patients. For MBC patients, palliative care services, which are are designed to improve quality of life for patients and family members, may be helpful.