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How Siteman approaches metastatic breast cancer treatment

Washington University School of Medicine
Seeking new treatments for metastatic breast cancer, researchers have designed nanoparticles (shown in magenta) that carry... Seeking new treatments for metastatic breast cancer, researchers have designed nanoparticles (shown in magenta) that carry chemotherapy and are targeted directly to tumors that have spread to bone. The strategy, developed in mouse studies at Washington University School of Medicine in St. Louis, lets chemotherapy penetrate the protective environment of bone and minimizes toxic side effects.

Finding out you have metastatic breast cancer (also known as advanced or stage IV breast cancer) can be very scary. While there is no cure, treatment can slow the cancer, extend the patient’s life and improve quality of life.

What is metastatic breast cancer?

Metastatic breast cancer refers to cancer that originated in the breast and has spread to another part of the body. First, cancer cells break away from the original tumor in the breast. Then, they travel through the bloodstream or lymphatic system to other parts of the body. When breast cancer spreads, it most commonly does so to the liver, brain, bones, lymph nodes or lungs.

Which breast cancers are most likely to metastasize?

All breast cancers have the potential to metastasize. However, human epidermal growth factor receptor 2 (HER2)-positive and triple-negative breast cancers are more aggressive. For this reason, these types of breast cancer are more likely to spread than others.

Afraid of your metastatic breast cancer diagnosis? You’re not alone.

If you or a loved one has recently been diagnosed with metastatic breast cancer, you may be feeling a great deal of fear. Common fears of stage IV breast cancer patients include:

  • Fear of cancer progression
  • Making treatment decisions
  • Worry about loved ones
  • Uncertainty about the future
  • Financial pressures
  • Dying

Your fears and concerns are surely valid. Still, it is important to remember that many metastatic breast cancer patients continue to live full and meaningful lives. Siteman breast cancer specialists are here to provide you with only the most exceptional care to give you the best possible chances for a positive outcome.

Risk factors for metastatic breast cancer

Although all breast cancers have the potential to spread, there are certain factors that increase the chances of that happening. These include:

  • Previous breast cancer diagnosis
  • Type of cancer (HER2-positive or triple-negative)

Metastatic breast cancer survival rates

Breast cancer is the second leading cause of cancer death in women, with metastatic breast cancer causing the vast majority of those deaths. According to the American Cancer Society (ACS), the five-year survival rate for women with metastatic breast cancer is 28 percent. For men with metastatic breast cancer, that rate is 22 percent.

While these statistics may seem daunting, keep in mind that metastatic breast cancer is treatable at any stage. What’s more, treatments are continuously improving and have proven to help metastatic breast cancer patients live longer and more fulfilling lives.

Bone metastasis and pain management

Breast cancer can spread to any area of the body. However, breast cancer most often metastasizes in the bones. Bone metastases affect more than half of women who develop stage IV breast cancer. The most common sites of bone metastasis are the ribs, spine, pelvis and long bones in the arms and legs.

Patients with bone metastases are at risk of bone fractures, spinal cord compression and bone pain. This pain tends to be constant. It may get worse with physical activity and usually doesn’t go way with rest. As a result, sleeping can be difficult.

The good news is that there are drugs that can reduce these symptoms by strengthening and protecting your bones. There are many benefits to these drugs for those suffering from bone metastasis. These include:

  • Reduced pain due to bone metastasis
  • Lower risk of bone fractures
  • Reduced need for surgery to repair bone fractures
  • Reduced need for radiation to treat bone pain
  • Blocked progression of bone metastasis

The Siteman approach to metastatic breast cancer

With expert physicians, skilled support staff and the latest technology, we ensure that our metastatic breast cancer patients receive the comprehensive care they need. In addition to clinical care, our researchers are making strides in developing ways to use the body’s immune system to fight breast cancer, including vaccines.

Siteman conducts more clinical trials than any other cancer center in the region. Several new drugs have emerged from our clinical studies that have had a promising impact on metastatic breast cancer. Meanwhile, more and more innovative breast cancer drugs continue to be developed.

Metastatic breast cancer treatment options

Washington University breast cancer specialists at Siteman offer the following treatment options for all types of metastatic breast cancer.

  • Chemotherapy: to destroy as many cancer cells as possible
  • Radiation therapy: to relieve or control pain in a specific area
  • Hormone therapy: to shrink or slow the growth of hormone receptor-positive metastatic breast cancer
  • Targeted therapy: to target specific characteristics of cancer cells, such as proteins that foster cancer cell growth
  • Surgery: to prevent broken bones or cell blockages in the liver

The type of treatment you receive will depend on the type of breast cancer that you have.

Hormone therapy for metastatic breast cancer

Hormone therapy differs based on the hormone receptor (HR) status and the human epidermal growth factor receptor 2 (HER2) status of your cancer. For example:

HR-positive – If you have estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+) breast cancer, hormone therapy will likely be the first treatment you’ll receive. Hormone therapy drugs lower estrogen levels or block estrogen receptors. Hormone receptor-positive cancers tend to grow more slowly than hormone receptor-negative cancers.

HR-negative – This type of breast cancer doesn’t have any hormone receptors. For this reason, the cancer won’t be affected by treatments intended to block hormones in the body. Instead of hormone therapy, chemotherapy is the main treatment for hormone receptor-negative breast cancers.

HER2-positive – This type of breast cancer involves an overabundance of HER2, a protein that promotes the growth of cancer cells. Treatment for HER2-positive breast cancers involves a combination of chemotherapy and drugs that target the HER2 proteins. These drugs block the HER2 receptors from receiving growth signals in order to slow or stop the growth of the cancer. HER2-positive cancers tend to be more aggressive than HER2-negative cancers.

HER2-negative – This type of breast cancer involves cancer cells that have a small amount or none of the HER2 protein. HER2-negative cancer cells may grow more slowly and are less likely to come back or spread than HER2-positive cancer cells. If your cancer is HER2-negative and hormone receptor-positive, hormone therapy will likely be the first treatment you’ll receive.

Siteman advances in metastatic breast cancer treatment

Washington University experts at Siteman continue to pave the way for innovative breast cancer treatments through cutting-edge research. Some of our groundbreaking studies include:

Low-dose estrogen studyResearch conducted at Washington University in 2009 revealed that raising estrogen levels may benefit women whose metastatic breast cancer no longer responds to standard anti-estrogen treatment. In 30% of study participants, their tumors either shrank or stopped growing.

Nanoparticles chemotherapy study – In 2018, our researchers discovered that when chemotherapy agents are exposed to radiation emitted by visible light, the drugs produce reactive particles that are toxic to cells. In contrast to traditional light therapy, this technique can target and attack cancer cells deep inside the body.

Breast cancer vaccine study – Washington University surgeon William Gillanders, MD, has led the development of personalized breast cancer vaccines. In this study, the research team took a small tissue sample from a patient’s tumor. Then, they used it to develop a personalized vaccine based on the tumor’s unique genetic information.

Our metastatic breast cancer specialists

The breast cancer specialist team at Siteman comprises outstanding Washington University medical oncologists, radiation oncologists, surgeons, radiologists, geneticists, psychologists and others. The diverse expertise of our specialists allows them to create individualized treatment plans for all metastatic breast cancer patients.

Success among Siteman metastatic breast cancer patients

Debbie Davis was only 34 when she was diagnosed with stage I breast cancer in 1993. She had no family history of cancer. While Debbie was terrified of her diagnosis and the uncertainty that came with it, she quickly transformed that fear into determination. She made the decision not to let her breast cancer stop her from living a fulfilling life. She maintained this mindset even after being diagnosed with metastatic breast cancer seven years later.

Throughout her decades-long cancer journey, Debbie has continuously received the most exceptional care and support from physicians at Siteman. Her treatment has included chemotherapy, radiation therapy and clinical trials. The expertise, dedication and compassion of Washington University breast cancer specialists at Siteman have allowed Debbie to take charge of her life and to be an incredible inspiration to other breast cancer patients.

Debbie’s cancer journey is just one of Siteman’s many breast cancer success stories.

Patient support

In addition to providing unmatched clinical care, Siteman provides compassionate support to help patients cope with the emotional and physical tolls of cancer treatment.

  • Nurses: specially trained to help patients cope with symptoms, treatment and side effects
  • Nurse navigators: clinically trained to provide guidance and answer questions at any point
  • Registered dietitians: provide guidance about nutrition and meals or snacks that will be good for you as you go through treatment
  • Psychologists: provide free mental health care for you and your family members
  • Palliative care specialists: provide support to help you manage pain and other side effects of your treatment

You’ve been diagnosed with metastatic breast cancer. Now what?

If you’ve been diagnosed with metastatic breast cancer, you may be experiencing a wave of emotions including fear, anger and sadness. Siteman providers are here to support you every step of the way throughout your cancer journey. With our exceptional physicians, psychology services and survivorship care, we are committed to caring for your body, mind and wellness, even after treatment ends.

If you are experiencing symptoms that may indicate your breast cancer has spread, or if you have received a stage IV breast cancer diagnosis and would like a second opinion from a breast cancer specialist at Siteman, please call 800-600-3606.