Diagnosis and Treatment of Metastatic Breast Cancer

In general, women experience a lot of pain and illness, but they typically don’t talk about it with others. Most women who experience moderate to severe chest pain do not feel comfortable telling anybody about it. They frequently try to suppress a variety of physical symptoms, believing that they are the typical signs of stress brought on by their work. Avoiding these signs and symptoms could result in ignoring the warning indications of a large tumour forming in the body. One of the prominent forms of tumours is one that leads to breast cancer.

Breast Cancer is an abnormal cell growth that builds up and forms a lump in the breasts and is brought on by hormonal, lifestyle, environmental, and hereditary factors. People’s malignancies frequently spread from one body region to another. Metastasis is basically the process of cancer spreading and this happens when the cancer cells break away from the original tumour in the breast and travel to other body parts through the lymphatic system. Also, breast cancer can relapse in a different body part, months and years following the original diagnosis and treatment, known as metastatic recurrence. Not just women, men too may get diagnosed with metastatic breast cancer, although rarely. In women it starts from the milk ducts but could spread to lymph nodes and various other body parts when not detected at an early stage. When this happens the breast cancer is referred to as metastatic breast cancer or stage IV breast cancer

Finding the signs of metastatic breast cancer and diagnosing it

The symptoms of metastatic breast cancer may vary from person to person depending on which body part it has spread to. Some of the most common signs of metastatic breast cancer include back, bone, or joint pain that does not go away, difficulty urinating (either incontinence or not being able to go), numbness or weakness anywhere in the body, a constant dry cough, shortness of breath or difficulty breathing, chest pain, loss of appetite, abdominal bloating, pain, or tenderness constant nausea, vomiting, or weight loss, jaundice (a yellow tinge to the skin and whites of your eyes), severe headaches, vision problems (blurry vision, double vision, loss of vision), seizures, loss of balance and confusion.

The following tests are recommended to those experiencing any of the above signs for metastasis breast cancer diagnosis.

● Blood tests including tumour markers in some patients

● Whole-body bone scan with or without X-rays of specific bones

● MRI (magnetic resonance imaging) of the spine or brain

● CT (computed tomography) scan of the chest, abdomen, pelvis, or brain PET (positron emission tomography) scan

● X-ray ultrasound of the abdomen or chest bronchoscopy

● Pleural tap, also called a thoracentesis that removes fluid between the lung and chest wall, a spinal tap that removes fluid from around the spinal cord, and a tap of fluid in the abdomen (called a paracentesis) that removes fluid in the abdominal cavity can be used to check cancer cells from the areas where the signs have shown.

Also, a biopsy could be done to confirm if the cancer has certain characteristics like HER2 status and hormone receptor status that could influence the treating options.

Treating metastatic breast cancer

Various approaches could be used for treating metastatic breast cancer and every treatment is customised to the unique condition. The first step of the treatment for metastatic breast cancer is systemic medication for treating cancer throughout the whole body. These include chemotherapy, hormonal therapy, targeted therapies, and immunotherapy. In certain specific cases local treatments targeting a specific body part like a surgery or radiation is recommended. Treatment techniques depend on three things – the body part where the cancer has spread, the characteristics of the cancer and history of cancer.

Living with metastatic breast cancer

Metastatic cancer doesn’t mean it is the end of life. Hence, one must plan to live with it. It is essential to find ways to manage one’s feelings, seek support from a group, family or friends and continue working following the diagnosis. The three most vital things to be kept in mind include:

● Managing symptoms so that things are comfortable

● Finding the support that hospice care can offer

● Organising one’s finances

Finding the appropriate care and support can make lives of those with metastatic breast cancer convenient. One must pay adequate attention in seeking help for emotional support too as metastatic cancer may have an adverse impact on one’s psychology.

 

BY: Dr. Tanay Shah, Consultant- Surgical Oncology (Breast Cancer Specialist), HCG Cancer Centre Ahmedabad