How Long Can You Live with Metastatic Breast Cancer?

How Long Can You Live with Metastatic Breast Cancer?

Let’s face it: A metastatic breast cancer diagnosis is scary. Unlike breast cancer, which has a very high survival rate—an average of 90% over five years—metastatic breast cancer isn’t curable.

But technology, treatments, and therapies are constantly improving, experts say, which means a metastatic breast cancer diagnosis is not an automatic death sentence.

“The most important thing to do in the face of a metastatic breast cancer diagnosis is to not lose hope,” says Karen Hendershott, M.D., fellowship-trained breast surgical oncologist at Arizona Oncology. “While we can’t currently cure metastatic breast cancer, we can treat it.” 

Here’s what you need to know about life expectancy after a metastatic breast cancer diagnosis.

What is metastatic breast cancer, anyway?

Metastatic breast cancer, or stage IV breast cancer, is cancer that originated in the breast, but now, the cancer cells have spread beyond the breasts and lymph nodes to other parts of the body—most commonly, to the bones, lungs, liver, or brain.

Women who are diagnosed with metastatic breast cancer have typically recovered from breast cancer only to develop new symptoms years later, such as bone pain, shortness of breath, unexpected weight loss, or persistent fatigue, which signal the cancer cells have spread, says Danae Hamouda, M.D., associate professor of medicine and fellowship program director of hematology and oncology at The University of Toledo. “It is less common for women to be diagnosed with metastatic breast cancer without a prior history of a breast cancer diagnosis,” she says, adding that approximately one in 20 women receive an initial diagnosis of metastatic disease.

But not everyone who gets breast cancer later develops metastatic breast cancer. It’s estimated that somewhere between 3 and 30% of women who are diagnosed with—and cured of—breast cancer will later be diagnosed with metastatic breast cancer, according to Hamouda.

The type of breast cancer with which a woman is initially diagnosed is also a factor. For example, women who are diagnosed with hormone-sensitive breast cancer generally have a lower risk of metastatic breast cancer, but they can develop it “decades after their initial diagnosis,” says Hendershott. Women with hormone-incentive breast cancers have a higher risk of it spreading and becoming a metastatic disease. But in these cases, “the chance of becoming metastatic tends to peak within the first few years,” and is very unlikely after five years, Hendershott says.

Your life expectancy after a metastatic breast cancer diagnosis

“Once breast cancer has spread beyond the ‘local’ area and is metastatic, it is treatable but no longer considered curable,” says Hendershott. Eventually, treatments will fail. Metastatic breast cancer typically spreads microscopically to numerous areas, of the body, mutating in ways “that eventually allow them to escape the medications used to treat them,” Hendershott explains.

While the average survival rate of a breast cancer diagnosis is 90% over five years, that statistic tumbles for metastatic breast cancer, dipping to just 29% in the same time period, the most recent data shows. (Here’s what that means: A woman with metastatic breast cancer is 29% as likely to be alive in five years as a woman who does not have metastatic breast cancer.)

Many women with metastatic breast cancer will live only a handful of years, says Hendershott. But about one-third will live at least five years after their diagnosis. And “there are people who have been living with stage IV breast cancer for more than 15 years,” she says.

But survival rates are hardly cut-and-dry: How long a woman lives after a metastatic breast cancer diagnosis depends on a variety of factors, including her age at diagnosis, whether she has existing or underlying medical conditions, the type of breast cancer she has, where it has spread in her body, and the amount of cancer throughout her body, according to Hamouda.

“While getting diagnosed with metastatic breast cancer means you will almost certainly eventually die of breast cancer, the timing is unclear,” Hendershott says.

Once a woman is diagnosed with metastatic breast cancer, her medical team will work with her to gather information, discuss treatment options and create an initial treatment plan, Hamouda says. “At this time point, the prognosis is still quite variable from patient to patient,” she says. “But in general, an oncologist can discuss the average and best- and worst-case scenarios. With each subsequent visit—and with monitoring for response to treatment, which is monitored through blood work and imaging, such as CT or PET scans—an individual’s prognosis can become clearer.”

Recent advances in therapies and cancer research have also led to higher survival rates for women with hormone-receptor-positive breast cancer as well as more aggressive types of breast cancer, such as triple-negative and HER2-positive metastatic breast cancers, both Hamouda and Hendershott add.  

The most recent data on survival rates after metastasis—collected by the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program, or SEER—goes only through 2018, which means it may not have captured some of those more recent treatments’ successes.

What you can (and should) do when you have metastatic breast cancer

While metastatic cancer isn’t curable, it can be treated. And those cancer treatments—which include everything from oral medications to IV chemotherapy, hormone therapy, immunotherapy, radiation, and palliative care—can help extend and improve a patient’s quality of life after diagnosis.

“There is no one experience with metastatic breast cancer,” says Hendershott. “Because each person’s [metastatic breast] cancer is different, treatment will be individualized as well.” 

But there are some standard starting points, she says: For example, most breast cancer patients are given oral medications initially. Like with other breast cancers, chemotherapy may be used to treat metastatic breast cancer, especially in breast cancer patients with hormone-receptor-negative cancers. And health care providers often battle hormone-receptor-positive breast cancer—such as estrogen receptor-positive or progesterone-receptor-positive cancers — with hormone therapy.

Some women may undergo surgery “to remove areas of metastatic disease that are causing symptoms, or to stabilize bones that may be weakened by tumor deposits,” Hendershott says.

Unlike early-stage breast cancer, which is treated until it is no longer detected in the body, advanced breast cancer “requires ongoing treatments to try to control the disease for as long as possible, while helping manage side effects from the cancer or treatments,” Hamouda says.

Lifestyle changes can also affect a woman’s prognosis and improve her quality of life. “The things that are good for us before a metastatic breast cancer diagnosis are good for us after one,” Hendershott says. That includes regular exercise or activity, eating a healthy diet of whole foods and vegetables, and activities that reduce stress and nausea, such as acupuncture and massage.

And lastly, relying on a supportive community can make a big difference. Family and friends can help women navigate the management of metastatic breast cancer, Hamouda says, from serving as travel companions to making meals and lending a listening, empathetic ear. A local, community support group “who are going through this experience” too can also help, says Hendershott. “Connect with others who can help point you to resources, doctors, and programs focused on your type of breast cancer and alert you to various clinical trials,” she recommends.

Jillian Kramer is a journalist who writes about health, wellness, science, and adventure. She taps into a broad network of doctors, scientists, and medical experts to write in-depth service articles for leading publications, including Glamour, The New York Times, Scientific American, Travel + Leisure, EatingWell, and Food & Wine.\

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Originally Appeared on Glamour