Breast cancer: metastases
In about three out of 100 breast cancer patients, the tumor has already formed daughter cell metastases in other parts of the body at the time of diagnosis. In the long term, every fourth patient develops metastatic breast cancer.
So far the statistics. In individual cases, it depends on several factors, how likely to develop breast cancer metastases in the course of the disease. A role plays, for example, how far advanced the tumor is at the first treatment. The biological properties of the cancer also influence the risk of breast cancer metastases.
In general, the risk of daughter relapses in breast cancer is highest in the early years of the disease. But there are also patients who do not develop metastases many years later.
How and where do breast cancer metastases develop?
From the main tumor in the chest, cancer cells can detach and be swept up with the flow of blood or lymph to other parts of the body, where they can settle and form new tumors. Most commonly, breast cancer metastases occur in the bones, liver and lungs. But sometimes they are also found in other organs like the brain .
Bone metastases: If the breast cancer forms bone metastases, then it is preferred in the spine , but sometimes in other bones such as femoral and humeral bones, pelvis, ribs, sternum or skullcap. Bone pain and broken bones that can not otherwise be explained indicate such breast cancer metastases in the skeleton. They can detect bone metastases by X-ray examination, computed tomography (CT) and magnetic resonance imaging (MRI). Bone scintigraphy shows how extensive bone involvement is.
Liver metastases : Breast cancer metastases in the liver often do not cause discomfort for a long time. Sometimes they trigger nonspecific symptoms such as bloating and other digestive problems, poor appetite and weight loss . If liver metastases are suspected, the doctor will examine the abdomen with ultrasound. If the findings are unclear, a computed tomography or a magnetic resonance tomography continues to help.
Pulmonary metastases : When coughing and dyspnea occur in advanced breast cancer without any explanation (such as respiratory tract infection), breast cancer metastases in the lungs may be behind it. This suspicion can be clarified by the doctor x-rays the chest of the patient in two levels (chest X-ray).
Brain metastases : Sometimes breast cancer metastasizes to the brain. Depending on the affected brain region different symptoms result. These may be headache, cognitive disorders, consciousness or speech disorders or convulsions. Brain metastases can be detected by computed tomography or magnetic resonance tomography.
For more detailed clarification and treatment planning for breast cancer metastases further investigations are necessary. Blood analyzes, for example, can give indications of conspicuous tumor markers and other disease-related changes. If possible, a tissue sample of the metastases is also taken and analyzed more precisely in the laboratory. Sometimes, metastases have different biological properties than the original breast cancer. So it may be that the primary tumor (breast tumor) increases hormone dependent, the metastases but not. An (anti) hormone therapy then acts only against the tumor in the chest, but does nothing against the metastases.
Treatment of breast cancer metastases
The treatment of breast cancer metastases is planned individually for each patient. In addition, it is checked by the doctors again and again and adapted as needed. First and foremost, the affected women are treated systemically – ie with drugs that act throughout the body and act against scattered cancer cells. These may be anti-hormonal drugs (anti-hormone therapy) or cytostatics (chemotherapy). Sometimes, targeted drugs (such as HER2 antibodies) are also used against metastases.
In addition, other medications may be useful. For example, women with bone metastases often also receive bisphosphonates. These agents can cause less damage to the bone tissue through metastasis. The bone is thus more stable and less prone to breakage.
In some patients, systemic therapy may be supplemented with local or regional treatment of breast cancer metastases. For example, some metastases may be surgically removed or irradiated.
Breast cancer metastases can be painful for those affected. That’s why proper pain therapy is part of the treatment plan. It mainly includes painkillers – the type and dosage are adjusted by the doctor individually to the patient. In addition, pain can often be relieved with non-drug procedures. These can be, for example, cold or heat applications (baths, packs, etc.) as well as relaxation methods such as autogenic training .
Breast cancer metastases: life expectancy and prognosis
If women are diagnosed with “metastatic breast cancer,” that’s a big shock . Because the cancer usually can not be completely cured or brought to a standstill. However, this statistical empirical value does not say anything about the chances of recovery of a single patient! Even though breast cancer has metastasized, some women still survive decades of proper treatment, while in others the condition is rapidly worsening despite therapy.