Metastatic Breast Cancer: Symptoms and Modern Treatments

Metastatic breast cancer (MBC) is breast cancer that has spread to other parts of the body, such as the bones, liver, lungs, or brain. Early detection of symptoms is crucial for timely diagnosis and treatment, which can help manage the disease and improve quality of life. This article outlines the common signs of MBC and the treatment options available.

Symptoms of Metastatic Breast Cancer

Symptoms depend on the affected area. Key signs include:

• Bone Pain: Persistent pain in the back, hips, or legs may indicate bone metastasis.
• Shortness of Breath: Lung involvement can lead to breathing difficulties or a persistent cough.
• Abdominal Pain or Swelling: Liver metastasis may cause abdominal discomfort, swelling, nausea, or appetite loss.
• Headache or Neurological Changes: Brain involvement can result in headaches, vision issues, memory problems, or seizures.
• Fatigue: A common symptom caused by the cancer or ongoing treatments.
• Swelling in Feet or Legs: Peripheral edema, often mild, may result from cancer or treatments like chemotherapy or immunotherapy (source: National Cancer Institute).

Persistent symptoms warrant a doctor’s consultation for effective management.

The Reality of Metastatic Breast Cancer

MBC affects a significant portion of breast cancer patients. Between 2001 and 2021, approximately 260,379 (5.6%) of the 4,652,885 new breast cancer cases in U.S. women were metastatic at diagnosis. The incidence increased from 5.8 to 7.9 cases per 100,000 women during this period (source: CDC). In the U.S., 1 in 8 women will be diagnosed with breast cancer, and 1 in 3 of these cases may develop metastases. Disparities exist, with African American women facing a 40% higher mortality rate than white women (source: Metavivor).

Treatment Options for Metastatic Breast Cancer

While MBC is incurable, treatments can alleviate symptoms and slow progression. Common medications include:

1. Ibrance (Palbociclib): A CDK4/6 inhibitor used with hormone therapy for HR+, HER2-negative MBC. It slows cancer cell growth by blocking cell division enzymes.

• Pros: Targets specific cancer types, improving progression-free survival.
• Cons: May cause fatigue and reduced white blood cell counts, increasing infection risk.

2. Verzenio (Abemaciclib): Another CDK4/6 inhibitor, used alone or with hormone therapy for HR+, HER2-negative MBC.

• Pros: Effective in slowing disease progression.
• Cons: Side effects include diarrhea, fatigue, and low white blood cell counts.

3. Kisqali (Ribociclib): A CDK4/6 inhibitor for HR+, HER2-negative MBC, often paired with hormone therapy.

• Pros: Extends progression-free survival and enhances quality of life.
• Cons: May cause nausea, elevated liver enzymes, and fatigue, requiring regular monitoring.

4. Nerlynx (Neratinib): A tyrosine kinase inhibitor for HER2-positive MBC, targeting the HER2 protein to inhibit cancer growth.

• Pros: Offers targeted treatment, improving outcomes when combined with other therapies.
• Cons: Side effects include diarrhea and fatigue, necessitating supportive care.

Conclusion

Metastatic breast cancer is a chronic condition with unique challenges. Early symptom recognition and consultation with healthcare professionals can improve quality of life and allow for personalized treatment plans. By understanding available treatments, patients can actively manage their disease and maintain their health.