Metastatic Breast Cancer

The Weiser Family Center for Breast Cancer is dedicated to providing compassionate, cutting-edge care for individuals affected by breast cancer. We enhance lives through early detection, personalized treatment, and survivorship support, while advancing research, education, and advocacy. Our unwavering commitment is to make a meaningful difference, improving breast cancer outcomes for all.

If you're a patient interested in making an appointment, please call 734-647-8902.  Healthcare providers looking to refer a patient, please contact M-LINE: 800-962-3555.

For those with questions, please contact our Cancer AnswerLine at 800-865-1125.

If breast cancer spreads to other parts of the body, it may not cause any symptoms. If there are symptoms, what they are often depends on where the cancer has spread:

• Bone Metastasis: Pain, fractures, elevated calcium levels leading to confusion or muscle weakness.
• Liver Metastasis: Abdominal pain or swelling, jaundice, elevated liver enzymes.
• Lung Metastasis: Shortness of breath, chronic cough, pleural effusion (fluid around lungs).
• Brain Metastasis: Headaches, seizures, vision changes, neurological deficits.

The following is used to diagnose metastatic breast cancer:

• Imaging Tests: CT scans, PET scans, bone scans, MRIs, and x-rays to identify the extent and specific locations of metastasis.
• Blood Tests: To assess overall health and organ function (e.g., liver function tests, calcium levels).
• Biopsy: A biopsy of a metastatic site is performed to confirm diagnosis and evaluate cancer characteristics.

Treatment for metastatic breast cancer focuses on controlling the disease, alleviating symptoms, and maintaining quality of life. Treatment plans are individualized based on cancer subtype, previous treatments, and the patient's overall health.

Systemic Therapies

• Hormonal Therapy: For hormone receptor-positive cancers. Medications like tamoxifen, aromatase inhibitors (letrozole, anastrozole), and fulvestrant are commonly used.
• Chemotherapy: Various chemotherapy agents are used, either as single drugs or in combination regimens, to target rapidly dividing cancer cells.
• Targeted Therapy: Drugs that specifically target molecular changes in cancer cells:
  • HER2-Positive: Trastuzumab (Herceptin), pertuzumab, ado-trastuzumab emtansine (Kadcyla), and others.
  • CDK4/6 Inhibitors: Palbociclib, ribociclib, abemaciclib for certain hormone receptor-positive cancers.
  • PARP Inhibitors: Olaparib, talazoparib for patients with BRCA mutations.
• Immunotherapy: Pembrolizumab or atezolizumab for select patients, often combined with chemotherapy for triple-negative breast cancer.

Learn more about systemic therapies.
 

Localized Treatments

• Radiation Therapy: To alleviate pain and control symptoms in specific areas like bones or brain.
• Surgery: Less common but may be used to relieve symptoms or manage specific complications.

Bone-Strengthening Agents

Bisphosphonates (e.g., zoledronic acid) or denosumab can be used to prevent fractures and bone pain in cases of bone metastasis.

Palliative Care

• Symptom Management: Focus on alleviating symptoms such as pain, nausea, fatigue, and emotional distress.
• Multidisciplinary Approach: Includes oncologists, palliative care specialists, pain management experts, mental health professionals, and social workers.

Learn more about U-M Health's Palliative Care Program.

Clinical Trials

• Opportunities for New Treatments: Participation in clinical trials offers access to cutting-edge therapies and contributes to medical research.
• Consultation with Oncology Team: Discuss potential eligibility and appropriateness of clinical trials based on individual health status and treatment history.

Learn more about clinical trials.

View a list of open breast cancer trials.

Psychosocial and Emotional Support

• Mental Health Services: Counseling or therapy to cope with the emotional and psychological impact of a metastatic cancer diagnosis.
• Support Groups: Connecting with others facing similar challenges can provide emotional support and practical advice.
• Family and Caregiver Support: Education and support for caregivers and family members are crucial for comprehensive care.

Learn more about Rogel Cancer Center's Patient & Family Support Services.

Prognosis

Metastatic breast cancer is a challenging diagnosis that requires a comprehensive, individualized approach to treatment and care. Advances in medical treatments and supportive care have improved the ability to manage the disease and maintain quality of life.

Prognosis depends on numerous factors, including cancer subtype, extent of metastasis, response to treatment, and overall health.

Many patients live for years with metastatic breast cancer, managing it as a chronic condition with ongoing treatment.

The psychosocial impacts of breast cancer are profound and multifaceted, necessitating a comprehensive approach to care that addresses emotional, psychological, and social needs. At the Weiser Family Center for Breast Cancer, we understand by leveraging a range of support services and resources, breast cancer patients can better cope with their diagnosis, treatment, and post-treatment phases, enhancing their overall quality of life.

Further reading:

• Tumor Receptors & Breast Cancer
• Aromatase Inhibitors Musculoskeletal Symptoms (AIMSS)
• Breast Cancer & Sexual Health
• Breast Cancer & Young Women
• Breast Cancer & Older Adults
• Psychosocial Support for Breast Cancer

• Lumpectomy & Axillary Surgery: A Patient Care Guide for Before and After Surgery

• Lumpectomy & Sentinel Lymph Node Biopsy: A Patient Care Guide for Before and After Surgery

• Mastectomy: A Patient Care Guide for Before and After Surgery

• Mastectomy & Axillary Surgery: A Patient Care Guide for Before and After Surgery

• Axillary Surgery: A Patient Care Guide for Before and After Surgery

Related services offered by U-M Health:

• Weiser Family Center for Breast Cancer Peer Mentoring Program
• Lymphedema Screening and Early Detection Program
• Support Services