With approximately 61,000 new cases in 2023, breast cancer is the most common female cancer in France. If early detection is generally a guarantee of cure, it happens that the disease spreads to other organs: we then speak of metastatic breast cancer.
What is metastatic breast cancer and what are the causes?
THE metastatic breast cancer is a form of advanced cancer in which tumor cells have spread to other parts of the body. “It happens, in fact, that the cancer cells resulting from the initial tumor in the breast spread to other organs such as the bones, the liver, the lungs or less frequently the brain and the skin.explains Dr. Barbara Pistilli. These are metastases. »
And added: “At present, it is not yet clear why certain organs are more affected than others by these metastases. Many laboratories are working on the subject, without having clear answers. This could be linked to vascularization or a microenvironment more favorable to the proliferation of tumor cells. It’s very complex.“
Certain types of breast cancer, notably triple negative breast cancer, are more likely to metastasize.
What are the symptoms ?
THE metastatic breast cancer can manifest itself with certain specific symptoms such as:
- bone pain, fixed, persistent for several days. “This pain is different from migratory osteoarticular pain which regularly changes location and is linked to the side effects of hormone therapy.“, specifies the oncologist.
- shortness of breath, a dry cough that does not go away or pain in the rib cage;
- yellowing of the skin and whites of the eyes, alteration of liver function tests.
How is the diagnosis made?
In the majority of patients, the discovery of metastases occurs following the appearance of certain symptoms or abnormalities during the surveillance consultation. “There are two types of scenarios: most often, metastases are detected following the appearance of symptoms, blood test abnormalities or during clinical examination in patients who have completed their treatment or are under hormonal therapyconfides the specialist. More rarely, metastases are discovered during the initial diagnosis of breast cancer, particularly during the extension assessment via a scanner, a bone scan or a PET-Scan. Nearly 10% of breast cancers are immediately metastatic.“
When metastatic breast cancer is discovered, biopsies are performed to ensure that the metastases are indeed linked to the initial cancer and that the disease has not changed its histological characteristics. “This helps guide the choice of treatment“, says Dr. Barbara Pistilli.
What are the treatment options?
The management of metastatic breast cancer depends on the specific characteristics of the disease. Thus, the treatment of metastatic breast cancer of the HER2 + type is mainly based on targeted therapy aimed at anti-HER2 while the flagship treatment of HR+ and HER2- breast cancer – i.e. – say when tumor cells express hormone receptors for estradiol or progesterone but do not express the HER2 receptor – is hormone therapy. Finally, the main treatment for metastatic triple negative breast cancer is based on the use of chemotherapy which often combines several molecules.
Metastatic breast cancer: what is the prognosis?
Although it cannot be cured, metastatic breast cancer can nevertheless be controlled using various treatments aimed at extending – sometimes significantly – the life expectancy of patients while preserving their quality of life. “Today we have at our disposal several different lines of therapy that improve the prognosis of patients, especially those affected by hormone-sensitive or HER2+ cancer, confirms the oncologist. These treatments, which are taken orally (in the form of tablets) or administered intravenously, make it possible to control the disease in the long term by avoiding or slowing its progression and containing the symptoms. “. And to conclude: “On the other hand, we do not talk about remission in metastatic breast cancer. From the moment metastases are detected, we enter into the logic of a chronic disease. Even though it is possible that the tumor disappears and is no longer visible on the scan, patients will have to continue their treatment. for life, despite the disappearance of all signs of the disease.“
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