Definition of Stage IV Breast Cancer
Patients diagnosed with Stage IV or metastatic breast cancers have disease that has spread from the affected breast to one or more distant sites in the body. Historically, metastatic breast cancer has been considered incurable; the goal of treatment has been to provide relief from symptoms and prolong the duration and quality of life. However, there have been some important advances resulting in the addition of many more treatment options for managing this disease. These include the now widespread use of taxane chemotherapy, the development of targeted therapies, and the development of more active hormonal therapy drugs.
By 1997, these patients had been observed over 10 years and the original 14% remain alive without a relapse of their cancer and appear cured of their disease. It is important to understand that because over 50% of patients with stage IV breast cancer relapse, it is not useful to compare the response rate to chemotherapy, the average duration of survival or time to relapse. When evaluating treatment strategies in stage IV breast cancer, patients should compare the percent of patients alive with or without relapse 3-5 years from treatment to determine whether a treatment is truly superior.
In one clinical trial published in 1997, women in complete remission after induction chemotherapy were treated with high-dose chemotherapy or no further treatment. At 5 years from diagnosis, 24% of the women treated with immediate high-dose chemotherapy survived without disease recurrence, compared to only 8% of the women who did not receive further treatment.
Since this is the most deadly category of breast cancer, it is important to work closely with all the health care providers. New treatments are being developed all the time, and second, or even third opinions may give the patient more information about newly discovered successful solutions.
Additional clinical trials directly comparing conventional chemotherapy treatments to high-dose chemotherapy treatments are currently ongoing to help determine which patients may benefit most from high-dose chemotherapy treatment.
The main reason patients with breast cancer fail treatment is relapse. Relapse of breast cancer occurs because the high-dose chemotherapy is either unable to kill all the cancer cells in the patient and/or because cancer cells “contaminating” the stem cells are infused back into the patient. The majority of relapses occur because all the cancer cells were not destroyed by the high-dose chemotherapy treatment. However, some relapses may be due to infusion of breast cancer contaminated stem cells. Doctors are performing clinical trials designed to improve the treatment of breast cancer with high-dose chemotherapy that include the following approaches alone or in combination:
Monoclonal antibodies are a treatment that can locate cancer cells and kill them directly without harming normal cells. Herceptin (trastuzumab) is the first monoclonal antibody approved by the Food and Drug Administration for the treatment of breast cancer. Herceptin recognizes a protein on the cancer cell surface of 1 in 3 patients with breast cancer. In order to be treated with Herceptin your doctor must test the breast cancer cells for the protein that Herceptin recognizes. This protein is called Her 2-neu. Herceptin or other monoclonal antibodies are not substitutes for other cancer treatments but have the advantage of being administered during or after high-dose chemotherapy and killing cancer cells by a different method than chemotherapy with the goal of improving the total treatment. Clinical trials are currently being performed to determine whether monoclonal antibodies administered during or after high-dose chemotherapy can improve survival or cure rates.
Inflammatory breast cancer is a rare cancer that happens in a very small percentage of women. It is an aggressive type of locally advanced cancer. In general, women with inflammatory breast cancer are diagnosed at a younger age. In extremely...
Cancer Treamtment – Chemotherapy, an option for Breast Cancer.Many experts are in agreement that for most breast cancer instances, chemotherapy might not always be the best choice for treatment. For the women the treatment is right for, chemotherapy can provide them with long term and effective results....
Lobular Breast CancerAbout 1 in 10 breast cancers diagnosed (10%) are invasive lobular carcinoma. This means that the cancer is growing in the cells that line the lobules of the breast. Invasive lobular cancer can develop in women of any age. But...
Metastatic Breast Cancer SymptomsThe stage of breast cancer when cancer cells do not remain in the original cancer site and spread out to other parts of the body is called metastatic breast cancer. This is the stage when the cancer is fully advanced....
Breast Cancer TreatmentThe diagnosis of breast cancer is overwhelming. After the initial phase of diagnosis comes the discussion of your breast cancer treatment type. This decision should involve more than just your physician. Choosing the most appropriate breast cancer treatment type is...