Stage IV breast cancer is the final stage of breast cancer. A person is said to have stage IV breast cancer when the primary cancer, originating in the breast, spreads (metastasizes) to a site in the body distinct from the breasts. The liver, lungs and bones are common sites for breast cancer metastases. Stage IV breast cancer is not a curable illness. However, treatments exist to improve quality of life and increase longevity for those diagnosed with stage IV breast cancer.
Stage IV Breast Cancer
Stage IV breast cancer is invasive. The cancer, which originates in the ducts, tissue or glands, of the breast, extends beyond the breast and the lymph nodes near the breast. The primary cancer cells have moved through the body to a secondary area, and cancer cells have developed in this secondary area in the body. Some women are diagnosed with an earlier stage of breast cancer, and the breast cancer becomes stage IV after earlier treatment fails to stop the growth of the cancer. Other women are metastatic at presentation, which means the breast cancer has already spread into lymph nodes near the breast when the woman is first diagnosed with breast cancer.
Treatment
Once breast cancer reaches stage IV, it is not curable. Treatments are systemic and designed to maximize the patient's quality of life, minimize symptoms of metastases and extend survival. New drugs have proven successful at minimizing the pain and increasing the longevity of breast cancer patients. Treatments may include hormone therapy, chemotherapy, surgery, radiation or a combination of these treatments.
Trastuzumab
Trastuzumab is prescribed for women with HER2-Positive Stage IV breast cancer. It is given intravenously, through an IV in a vein in the arm or hand. Its purpose is to extend quality of life, and it is usually given with chemotherapy and possibly hormone therapies or in conjunction with other treatments. Potential side effects include nausea, vomiting or diarrhea, cough or fever, lightheadedness and headaches. Weakness, pain at the site of the tumor or skin inflammation are also possible.
Bevacizumab
Bevacizumab is a relatively new treatment designed to slow the progression of metastatic stage IV breast cancer. It works by blocking the blood vessels in tumors necessary for tumor growth and slows the growth of the cancer. It is most successful when combined with chemotherapy, especially Taxol.
Radiation and Surgery
In certain cases, surgery or radiation may be used to treat small areas of local metastases. For example, surgery and radiation may be used to treat a patch of cancer cells on the bone or liver in order to present a bone fracture or liver blockage. Surgery and radiation can also eliminate secondary cancer cells from small areas in order to minimize pain. Generally, this does not provide a lasting cure, as the cancer cells will return to the area of metastases or metastasize to other areas.
Treating Symptoms of Metastases
In addition to attempting to slow the growth of cancer tells, treatment for stage IV breast cancer involves pain management and the treatment of the symptoms of the metastatic cancer. Bisphosphonates are used to treat pain from bone metastases, and external beam radiation therapy has also proven effective at treating metastatic bone pain. Opiote-based or NSAIDs (non-steroidal pain relievers) have also been prescribed to deal with pain associated with metastatic stage IV breast cancer.
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