Recognizing and Managing Metastatic Breast Cancer

Metastatic breast cancer (MBC) occurs when breast cancer spreads to other parts of the body, such as the bones, liver, lungs, or brain.

Identifying the symptoms early is crucial for timely diagnosis and treatment, which can help manage the condition and enhance quality of life. This article outlines the common signs of MBC and the treatment options available.

The symptoms of MBC depend on the affected area. Key symptoms include:

• Bone Pain: Persistent pain in the back, hips, or legs may suggest bone involvement.

• Shortness of Breath: Lung metastases can cause breathing difficulties or a chronic cough.

• Abdominal Discomfort: Liver metastases may lead to abdominal pain, swelling, nausea, or loss of appetite.

• Neurological Symptoms: Brain involvement can result in headaches, vision issues, memory problems, or seizures.

• Fatigue: A common symptom due to the cancer's impact on the body and ongoing treatments.

• Swelling: Peripheral edema, particularly in the feet or legs, can be caused by the cancer or its treatments.

If these symptoms persist, consulting a healthcare provider is essential for effective management.

MBC is more common than many realize. Between 2001 and 2021, about 5.6% of new breast cancer cases in the U.S. were metastatic at diagnosis. The incidence rose from 5.8 to 7.9 cases per 100,000 women during this period. Additionally, about one-third of breast cancer cases eventually metastasize, with African American women facing a 40% higher mortality rate compared to white women.

While MBC is incurable, several treatments can alleviate symptoms and slow progression:

• Ibrance (Palbociclib): A CDK4/6 inhibitor used with hormone therapy for HR+, HER2-negative MBC. It can improve progression-free survival but may cause fatigue and lower white blood cell counts.

• Verzenio (Abemaciclib): Another CDK4/6 inhibitor effective for HR+, HER2-negative MBC. Side effects include diarrhea and fatigue.

• Kisqali (Ribociclib): Used with hormone therapy, it can extend progression-free survival but may cause nausea and elevated liver enzymes.

• Nerlynx (Neratinib): A tyrosine kinase inhibitor for HER2-positive MBC. It may improve outcomes but can lead to diarrhea and fatigue.

MBC is a complex condition, but early symptom recognition and tailored treatments can significantly improve quality of life. Understanding the available options empowers patients to actively manage their health.