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Metastatic Breast Cancer

Metastatic breast cancer (sometimes called advanced or stageStage:
A way of classifying breast cancer that describes how far a cancer has spread. It identifies whether breast cancer is at an early, locally advanced or metastatic stage. The stage of breast cancer can sometimes be represented as a number (e.g. between 0 and 4).
4 breast cancer) is breast cancer that has spread to distant parts of the body, such as the lungs, liver, bones, or brain.

Metastasis can be present when you are first diagnosed with breast cancer. More often, however, metastasis occurs after breast cancer recurrenceRecurrence:
Cancer that returns after treatment.
(when breast cancer comes back). In Canada, about 10% of new breast cancers are metastatic when they are diagnosed, and 30% of women who are first diagnosed with early stage breast cancer will go on to develop metastatic breast cancer.

Learning that you have breast cancer, and that it has metastasized, can be a shock. You may feel scared, angry, sad, in disbelief, or overwhelmed. Although metastatic breast cancer is considered incurable, it is important to know is that there are many treatment options which can control the disease for extended periods of time and allow people to live with a good quality of life, and in many cases for many years. 

In this section you can learn more about how cancer spreads, the signs and symptoms of metastatic breast cancer and how it is diagnosed, the treatments and supports available for someone living with metastatic disease, including participating in clinical trialsClinical trial:
One of the most common types of experimental studies in humans is the clinical trial. Clinical trials are designed to test new ways to prevent, detect, and treat specific diseases.

How does cancer spread?

Cancer cellsCell:
The basic structural and functional unit of all organisms.
spread from their original (primary) location to other parts of the body through a series of steps. There is still more to learn about why this happens in some, but not other, breast cancers.

As cancer cells grow out of control they can invade healthy nearby tissue, including moving through the walls and into nearby blood vessels or lymph vesselsLymph vessels:
Ducts that carry lymph fluid through the lymphatic system.
. Once cancer cells have moved into blood and lymph vessels, they can be carried away from their primary site (the breast tissue in the case of breast cancer) to other parts of the body through the lymphatic systemLymphatic system:
A network of vessels that transports lymph fluid, a clear fluid that comes from your blood and bathes the tissues. It contains water, protein and minerals and white blood cells. The lymph passes through a series of filters, the lymph nodes, before rejoining the bloodstream.
and blood stream. When cancer cells reach tiny blood vessels (called capillaries) in a distant location of the body, they become lodged and stop moving. From here, they can invade and move out of the capillaries and lymphatic vessels and into surrounding tissue, where they can begin to multiply and form new tumoursTumour:
An abnormal mass of tissue that occurs when cells divide more than they should or do not die when they should. Tumours may be benign (not cancer) or malignant (cancer). A tumour is also called a neoplasm.

Most of the time, cancer cells found in a metastatic tumour will generally look and behave the same as the cancer cells in the original (primary) tumour. For example, if the original tumour was hormoneHormone:
A natural substance released into the body by the endocrine glands, such as the thyroid, adrenal gland or ovaries.
Cells have many different proteins on their surface called receptors. Her-2 is one kind of receptor. In normal cells, HER-2 receptors are thought to be involved in cell growth and reproduction. In some breast cancers, there are too many HER-2 receptors and they speed up cancer cell growth.
positive, it is likely that the metastatic tumour will also be. There is growing evidence, however, that in 10-40% of cases, the tumour at the metastatic site may have a different hormone and HER-2HER-2-neu:
Cells have many different proteins on their surface called receptors. HER-2 is a type of naturally occurring receptor. In normal cells, HER-2 receptors are thought to be involved in cell growth and reproduction. In some breast cancers, there are too many HER-2 receptors and they speed up cancer cell growth. HER-2 therapy is used to treat some breast cancers by targeting receptors that stimulate breast cancer growth.
receptor status from the primary tumour.

How likely cancer cells are to metastasize depends on the characteristics of the cancer cell as well as the characteristics of all of the cells and tissues it encounters. Not all cancer cells that successfully reach another location in the body will grow and form a tumour. Metastatic cancer cells can stay inactive at a distant location for many years before they begin to grow again, or may never grow again at all. 


Breastcancer.org. Recurrent and Metastatic Breast Cancer. Accessed February 6, 2014.

Canadian Cancer Society. Metastatic Cancer Overview. Accessed February 7, 2014.

Living Beyond Breast Cancer & Metastatic Breast Cancer Network. Guide for the Newly Diagnosed: Empowering you to make informed decisions and to cope with your emotions after a diagnosis of metastatic breast cancer. Accessed February 7, 2014.

National Breast Cancer Foundation, Inc. Metastatic Breast Cancer. Accessed February 6, 2014.

National Cancer Institute. Metastatic Cancer. Accessed February 6, 2014.

Willow Breast Cancer Support Canada. Metastatic Breast Cancer. Accessed February 20, 2014.