Recurrent or Metastatic Breast Cancer

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If you have entered this section of our web site, you are facing a diagnosis of breast cancer that has spread to other parts of the body or is locally advanced. Like many other women dealing with this diagnosis, you may be afraid and concerned facing new treatments and the prospect that a cure is unlikely.

You are not alone.

We talk to hundreds of women facing this difficult diagnosis, and who are coping with their fears and concerns. Each of our counselors has talked with hundreds of survivors of advanced cancer — women who are living with cancer, despite its daily presence in their lives.

What we have learned from so many women who are living with advanced breast cancer is:

  • How they face each day
  • Making medical decisions
  • Giving and getting support from families and friends
  • How the experience of living with cancer has changed their lives

As you know, life as a patient with cancer is difficult, and some of the material in this section may bring up your fears and other feelings. You may want to discuss your feelings with your family or friends, or those in your support group. Please know that you can also call the 24-hour Y-ME National Breast Cancer Hotlines at to talk with a counselor any time of the day or night.

The National Coalition for Cancer Survivorship defines a cancer survivor as someone who has been diagnosed with cancer and is living today.

YOU ARE A SURVIVOR.

Treatments

Metastases.In the case of metastases, treatment options are also determined from a specific set of considerations related to your individual case. Depending on the type and extent of the metastases, systemic therapies are usually indicated. Chemotherapy and hormonal therapy can be effective in controlling breast cancer metastases. (Regardless of where the cancer is now, it is still breast cancer that has spread to other parts of the body.) Radiation therapy for metastasis to the bone or brain can be very effective. Radiation therapy and radiotherapeutics are often helpful for bone pain.

While bone metastases can be difficult to live with, there are many treatment options available for alleviating pain and treating the cancer itself. These treatments include:

  • Aredia/pamidronate: This is a treatment that is not chemotherapy or hormone therapy (it is a drug in the family of biphosphonates), which can be taken in addition to those treatments. Aredia can relieve bone pain from metastases, and in some cases may actually rebuild bone where cancer has destroyed it. Aredia may also prevent further bone lesions from occurring in other areas of the body. There are two kinds of bone mets, osteolytic and osteoblastic – most women with bone mets have osteolytic lesions and this is what Aredia targets.
  • Chemotherapy: Various types of chemotherapy are given to treat bone metastases as well as bone pain. Choices in chemotherapy drugs are usually determined by the drugs the patient has previously been given (the doctor would want to try something new), and the potential for side effects (such as low white blood cell count). In addition, an important factor can also be the administration schedule required–if you have to choose between a treatment that would require a visit to your oncologist once a week versus once every three weeks, you might prefer going to the doctor less often (all other considerations being equal).
  • Radiation therapy: Many women receive adjuvant radiation therapy at the site of their bone metastases to relieve pain. The relief generated by radiation tends not to last as long, but can be effective for some people.
    Hormone therapy: This is a treatment option that is offered to women whose cancer is estrogen dependent. While it may not seem the most aggressive approach, hormone therapy is a very effective treatment for bone metastases. Many women who are ER+ and have bone mets are given an aromatase inhibitor, like Arimidex or Femara, which can stabilize and even fight the disease in the bone.
  • Metastron: This treatment is a radiopharmaceutical, which cannot be taken while on chemotherapy. Metastron targets osteoblastic lesions, and can be taken in addition to pamidronate. Metastron is administered by certified nuclear medicine technologists in the nuclear medicine department at your treatment facility. It is injected into a vein in your arm — it is possible for one injection to alleviate bone pain for weeks or months. For the first few days after your injection, you will have to take some precautions due to the level of radioactive drug in your system. After this precautionary time period, you can resume your normal activities without concern.
  • Quadramet: This treatment is also a radiopharmaceutical, which is administered by a certified nuclear medicine technologist. Quadramet alleviates bone pain, and targets osteoblastic lesions. An injection of Quadramet can relieve bone pain for weeks or months; it requires the same treatment administration and precautions as other radiopharmaceutical drugs for bone metastases.

Chest wall, scar-line or local recurrence after a lumpectomy

Generally speaking, the typical treatment plan for a recurrence of breast cancer involves a mastectomy or a local resection, possible radiation and chemotherapy. A recurrence to the scar-line or chest wall after a mastectomy is usually treated with radiation and/or systemic therapies.

Our informational booklet for metastatic breast cancer patients, I Still Buy Green Bananas (PDF file), is available to answer more of your questions in detail.

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