Metastatic breast cancer

• Metastatic breast cancer can be treated but not cured. 
• For some people, living with metastatic breast cancer is like living with a chronic (long-term) illness.
• The aim of treatment is to relieve your symptoms and improve your quality of life by slowing the growth of the cancer. 
• Your doctor will be very keen to ensure that any side-effects from your treatment are managed, to allow you live as full a life as possible.  
• If one treatment doesn't work, or if the side-effects are difficult to manage, your doctor will look at other treatment options.

Hormone therapy for metastatic breast cancer

The female hormones oestrogen and progesterone can cause the growth of some breast cancer cells. Changing the level of these hormones in your body can slow down or stop the growth of metastatic breast cancer. 

Hormone therapy is suitable if you have oestrogen-receptor positive or progesterone-receptor positive cancer. 

Hormone therapy is usually used as the first treatment for metastatic breast cancer.

You may have hormone therapy alone or in combination with other treatments.

Read more about hormone therapy for metastatic breast cancer.

Targeted therapies for metastatic breast cancer

These drugs work with your body to fight cancer. Different targeted therapies work in different ways. Those used for breast cancer usually work by stopping the breast cancer cells from dividing and growing.

Read more about targeted therapies for metastatic breast cancer.

Chemotherapy for metastatic breast cancer

Chemotherapy drugs kill cancer cells thereby slowing down and controlling cancer growth. You may be offered chemotherapy:

• If your cancer is growing quickly.
• If the cancer is affecting how your liver or lungs are working.
• If you don’t have positive hormone receptors on your cancer cells or if if you have stopped responding to hormone therapies. 

You may have chemotherapy on its own or together with other treatments. 

Read more about chemotherapy for metastatic breast cancer.

Immunotherapy for metastatic breast cancer

Immunotherapy helps the body’s immune system recognise and attack cancer cells. Immunotherapy may be an option for some types of metastatic cancer. It is often given together with chemotherapy, but it’s not helpful for all cancers. Tests on the tumour sample can show if immunotherapy is likely to be helpful for you.

Read more about immunotherapy for metastatic breast cancer

Radiotherapy for metastatic breast cancer

Radiotherapy uses X-rays to destroy cancer cells. The aim of radiotherapy in metastatic breast cancer is to reduce the size of the cancer in some parts of your body and relieve symptoms such as pain. It is mostly used when the cancer has spread to your bones, lungs or brain.

Read more about radiotherapy for metastatic breast cancer.

Bone-strengthening drugs for metastatic breast cancer 

Bisphosphonates 

Drugs called bisphosphonates are used to treat the effects of metastatic breast cancer in your bones.

Bisphosphonates can slow down or prevent bone damage and may reduce the spread of cancer.

They can relieve bone pain, reduce the risk of fractures and control the level of calcium in your blood if you have a condition called hypercalcaemia. This is when calcium escapres from damaged bone into your bloodstream.

Targeted therapies

A type of targeted therapy called a monoclonal antibody can also be used to prevent fractures and other cancer-related bone problems. An example is denosumab (Xgeva®, Prolia®). Tell your
doctor or dentist immediately if you develop any problems with your
teeth or gums, or swelling, pain, heaviness or numbness of your jaw
while you are taking targeted therapies.

Read more about bone strengthening drugs

Clinical trials

If you take part in a clinical trial, you may get a new drug or combination of drugs instead of standard treatment. Ask your consultant if you are suitable for a clinical trial.

Read more about clinical trials

Surgery for metastatic breast cancer

Surgery is rarely an option for people with metastatic breast cancer. It is not likely to remove all the cancer. Drugs tends to be a better option. Surgery is mainly used to help control your disease and reduce your symptoms. 

You may have surgery to:

• Get a sample of tissue to send to the lab. If metastatic breast cancer is your first diagnosis, you might need surgery to remove a sample of breast tissue (biopsy) to confirm your breast cancer diagnosis. Your surgeon may remove the primary breast cancer if the tumour is small. Your doctor will tell you if surgery to the breast is likely to be helpful in your situation.
• Treat a fracture or replace a damaged joint, if the cancer has spread to your bones.
• Help with lung problems. If the cancer has spread to the lining of the membrane outside your lungs (pleura), or to the lungs themselves, there are different types of surgery to manage the cancer.
• Remove small areas of cancer or drain fluid from your brain, if the cancer has spread there.
• Remove a small cancer in a single area of the liver, if the cancer has spread there.
• Help with cancer that has grown out through your skin, or is pressing on nerves and causing pain or a blocked bowel.

Treatment of symptoms and palliative care

Some symptoms of metastatic breast cancer may need to be treated straight away. For example, bone pain or breathlessness. Treating symptoms is also called palliative care. Read more about side-effects and symptoms.

Palliative care aims to control your symptoms and give you the best quality of life possible. 

Palliative care includes end-of-life care but being offered palliative care does not mena you're at the end of your life. Palliative care may be given at any stage to relieve symptoms such as pain and nausea. The palliative care team - experts in managing the symptoms of advanced cancer - may be involved in your care at many different times. 

Read more about palliative care