What is metastatic breast cancer
Metastatic breast cancer (also called advanced breast cancer or stage 4 breast cancer) means that breast cancer cells have spread beyond the breast and nearby lymph nodes to other parts of the body. The most common places are bones, liver, lungs, and brain.
Unlike early breast cancer, metastatic breast cancer cannot usually be cured. However, it can be treated and managed, sometimes for many years.
How it’s diagnosed and staged
Metastatic breast cancer may be diagnosed in two ways:
De novo metastatic: Diagnosed as metastatic from the start, with no prior early breast cancer diagnosis.
Recurrence: Cancer that was previously treated as early breast cancer has come back and spread to other parts of the body.
Your doctor will use scans and tests to understand where the cancer has spread and how to best treat it.
Cancer subtypes and why they matter
Breast cancer is not one disease. Your cancer’s subtype affects which treatments will work best for you.
The main subtypes are:
HR+ (Hormone Receptor Positive) - Cancer cells grow in response to hormones like estrogen or progesterone. Most common subtype.
HER2+ (HER2 Positive) - Cancer cells have high levels of HER2 protein. Specific targeted treatments are available.
Triple Negative (TNBC) - Cancer cells don’t have hormone receptors or HER2. Requires different treatment approach.
Triple Positive - Cancer has both hormone receptors and HER2.
Understanding your subtype helps your medical team choose the right treatment for you.
Common scans and tests explained
You’ll likely have several types of scans and tests:
Imaging scans:
- CT scan - Takes detailed X-ray pictures from different angles
- PET scan - Shows where cancer cells are active in your body
- Bone scan - Checks if cancer has spread to bones
- MRI - Uses magnets to create detailed images, especially for brain or liver
- X-ray - Quick images, often used for lungs or bones
Biopsy - Taking a small sample of tissue to test the cancer cells directly.
Blood tests - Check your overall health and some markers that indicate how the cancer is responding to treatment.
Genomic testing and personalised medicine
Genomic testing looks at the DNA of your cancer cells to find specific mutations or changes. This information can:
- Identify targeted treatments that may work specifically for your cancer
- Predict how your cancer might behave
- Help match you with clinical trials
- Guide treatment decisions
Ask your doctor if genomic testing (also called molecular profiling or tumor sequencing) is right for you.
Typical care pathway (timeline overview)
While everyone’s journey is different, here’s a general timeline of what to expect:
- Diagnosis (Weeks 1-2) - Scans, biopsies, and tests to confirm diagnosis and understand your cancer
- Treatment planning (Weeks 2-4) - Meeting with your oncology team, discussing options, deciding on first treatment
- Starting treatment (Week 4+) - Beginning your treatment plan
- Ongoing monitoring (Every 2-3 months) - Regular scans and tests to see how treatment is working
- Treatment adjustments - Changing treatments if needed, trying new options, managing side effects
Throughout this pathway, you’ll have access to support services, symptom management, and wellbeing resources.