Metastatic Breast Cancer

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Metastatic, or advanced, breast cancer is a lifelong disease requiring active management. If you have metastatic breast cancer, our team is here for you every step of the way. Our treatment goal is to control the cancer and help you maintain a good quality of life.

At Penn Medicine Lancaster General Health, we offer the advanced imaging, innovative treatment and compassionate support you need to successfully manage metastatic breast cancer.

What Is Metastatic Breast Cancer?

All types of breast cancer begin in the breast tissue. If the cancerous cells spread (metastasize) beyond the breast, we call it metastatic breast cancer, or stage IV breast cancer. This happens when breast cancer cells travel through the bloodstream or lymphatic system.

If breast cancer is not detected before it spreads, metastatic breast cancer may be your first breast cancer diagnosis. In other cases, breast cancer may resurface elsewhere in your body months or years after an initial diagnosis. About 30 percent of early-stage breast cancers return as metastatic disease.

Breast cancer most commonly spreads to the bones, lymph nodes, lungs, liver and brain. In more than half of metastatic breast cancers, the cells spread to bones first. No matter where a metastatic tumor is found, it contains breast cancer cells and is considered breast cancer.

Signs of Stage IV Breast Cancer

Symptoms of metastatic breast cancer depend on where the cancer is discovered. Common locations and symptoms include:

Bone: Symptoms can include a severe new bone pain that gradually becomes constant. Bony metastases can also cause fractures.
Brain: Signs can include headaches, nausea, facial numbness and changes in speech, vision or balance.
Liver: Liver metastases rarely produce symptoms. When they occur, symptoms can include pain in the right side of the abdomen, weakness, poor appetite and yellowing of the eyes and skin.
Lungs: Signs of lung metastases include lung pain, shortness of breath and persistent cough.

Metastatic Breast Cancer: The Penn Medicine Lancaster General Health Advantage

We understand that managing metastatic breast cancer requires comprehensive care. We offer all the support and treatment you’ll need to live with advanced breast cancer. You can expect:

Team approach to care: Our multidisciplinary team of breast cancer specialists works together to determine the best course of treatment. We assess your response to that treatment and modify whenever needed.
Leaders in targeted therapy: We offer liquid biopsies and test every patient with metastatic disease for sensitivity to immunotherapy and targeted treatment. We use this information to provide the most effective treatment.
Access to innovative treatment: Our care is based on Penn Medicine research specific to metastatic breast cancer. We provide access to leading-edge treatments through clinical trials offered in Lancaster and Philadelphia.
High-quality care close to home: Metastatic breast cancer requires a lifetime of care. We make world-class care convenient at the Ann B. Barshinger Cancer Institute in Lancaster. Learn more about our breast cancer care locations.

Our Approach to Treatment for Metastatic Breast Cancer

To provide effective treatment and support, we first need to understand the spread of the cancer. We use advanced imaging technology to identify the location of the cancer, see where it has spread and determine how well treatment is working. Imaging for metastatic breast cancer includes:

Bone scan, which looks inside bones in search of metastasized
CT scans, which look inside bones and soft tissues in search of metastasized cancer
MRI (magnetic resonance imaging), to get a full-body scan and measure tumor size
PET/CT (positron emission tomography/computed tomography), which are typically used together to detect the spread of breast cancer and measure the size of tumors
X-ray, to look for cancer that spread from the breast to the lungs

We understand that metastatic breast cancer is a disease you will actively manage for the rest of your life. We want to control the cancer and help you maintain a good quality of life. Our patient-centered treatment for stage IV breast cancer includes:

Systemic and Targeted Therapy

Systemic therapy (drugs that work throughout the body) is the primary treatment used for metastatic breast cancer. The types of medication used depends on whether a cancer is hormone receptor-positive or HER2-positive (human epidermal growth factor receptor 2). Systemic therapy for advanced breast cancer can include:

Chemotherapy, which uses either oral or intravenous (IV) drugs to attack cancer cells
Targeted therapy, for cancer that is hormone-positive, HER2-positive and/or for patients with a BRCA gene mutation
Hormone therapy, (also called endocrine therapy) if breast cancer is hormone-positive

Immunotherapy

Immunotherapy (biologic therapy) is a type of treatment that helps your immune system attack cancer cells. We use liquid biopsy, which examines the DNA in your blood to see whether immunotherapy will be effective for you.

Immunotherapy for breast cancer is a new and promising approach that may benefit advanced cancer with characteristics including:

Triple negative status
Higher levels of PD-L1 protein in the immune cells around the breast tumor

Clinical Trials

We offer promising studies for patients with metastatic breast cancer. In addition to clinical trials offered in Lancaster, you’ll also have access to other Penn Medicine breast cancer clinical trials held in Philadelphia.

Participating in a trial may give you access to innovative treatments and imaging studies. Your care team identifies trials that are appropriate for you. Learn more about breast cancer research and clinical trials at Penn Medicine Lancaster General Health.

Relieving the Symptoms of Advanced Breast Cancer

Metastatic breast cancer may cause pain and discomfort. Treatments such as radiation therapy and surgery help us prevent or minimize more serious symptoms and complications of metastatic breast cancer. Our comprehensive cancer support services help with treatment side effects and non-medical issues.