Everything You Should Know About Metastatic Breast Cancer

Metastatic breast cancer (MBC) develops when breast cancer spreads beyond the breast and nearby lymph nodes to distant organs such as the bones, lungs, liver, or brain. Early identification of symptoms is essential for timely diagnosis and initiating effective treatment, which can help control the disease and enhance quality of life. This article highlights the common symptoms associated with MBC and the current treatment approaches.

The symptoms of MBC vary based on which organs are affected. The most frequently reported symptoms include:

• Bone Pain: Continuous pain in areas such as the back, hips, or legs may suggest that the cancer has spread to the bones.

• Shortness of Breath: If the lungs are involved, individuals may experience difficulty breathing or a persistent cough.

• Abdominal Discomfort or Bloating: Metastases in the liver can lead to abdominal pain, swelling, nausea, or decreased appetite.

• Headaches or Neurological Symptoms: Spread to the brain may result in headaches, vision changes, memory loss, or seizures.

• Fatigue: A common complaint among patients, fatigue may stem from the cancer itself or from its treatments.

• Swelling in the Legs or Feet: Mild swelling, or peripheral edema, may be caused by the cancer or side effects of treatments such as chemotherapy or immunotherapy (source: National Cancer Institute).

If these symptoms continue, it is important to seek medical evaluation for appropriate management.

Metastatic breast cancer remains a significant concern among breast cancer diagnoses. From 2001 to 2021, around 260,379 (5.6%) of the 4,652,885 newly diagnosed breast cancer cases in U.S. women were metastatic at initial diagnosis. During that time, the incidence increased from 5.8 to 7.9 per 100,000 women (source: CDC). Statistically, one in eight women in the U.S. will be diagnosed with breast cancer, and one-third of those cases may later develop metastatic disease. Racial disparities persist, with African American women facing a 40% higher death rate compared to white women (source: Metavivor).

Although MBC is not currently curable, various treatments are available to relieve symptoms and slow the progression of the disease. Common treatment options include:

1. Ibrance (Palbociclib): A CDK4/6 inhibitor typically prescribed in combination with hormone therapy for HR-positive, HER2-negative MBC. It works by blocking enzymes involved in cell division to slow cancer growth.

• Advantages: Effectively targets specific breast cancer types, improving progression-free survival.

• Drawbacks: May lead to fatigue and reduced white blood cell counts, increasing susceptibility to infections.

2. Verzenio (Abemaciclib): Another CDK4/6 inhibitor that can be used alone or with hormone therapy for HR-positive, HER2-negative metastatic breast cancer.

• Advantages: Helps to delay disease progression.

• Drawbacks: Side effects may include fatigue, diarrhea, and lowered white blood cell levels.

3. Kisqali (Ribociclib): A CDK4/6 inhibitor used in combination with hormone therapy for HR-positive, HER2-negative MBC.

• Advantages: Extends the duration of progression-free survival and improves quality of life.

• Drawbacks: May cause nausea, elevated liver enzymes, and tiredness, requiring close monitoring.

4. Nerlynx (Neratinib): A tyrosine kinase inhibitor designed for HER2-positive MBC. It targets the HER2 protein to slow or stop cancer growth.

• Advantages: Offers targeted therapy that can improve patient outcomes when combined with other treatments.

• Drawbacks: Common side effects include fatigue and diarrhea, which often require additional supportive care.

Metastatic breast cancer is a long-term condition that presents both physical and emotional challenges. Prompt recognition of symptoms and seeking timely medical advice are essential for effective management and personalized care. By becoming familiar with available treatments, individuals living with MBC can take proactive steps to manage their condition and improve their overall well-being.