Menu: MBC Treatment
Treatment for Metastatic Breast Cancer in Young Women
There is no single way to treat metastatic breast cancer (MBC). There are many options, and even the leading experts may not treat the same breast cancer in the same way. It is important to be comfortable speaking with your healthcare providers and asking them the questions you need answered.
Goals of Metastatic Breast Cancer Treatment
Treatments for MBC aim to shrink or stabilize the tumors and to prevent new tumors by killing cancer cells that are circulating in the body. Treatments are generally dictated by the location of the known metastasis (where the cancer has spread) and the type of breast cancer. What is appropriate treatment for someone else may not be the best for you. Your doctor may order regular scans or tests to see if your treatment is working. Closely monitoring and changing treatments when necessary may stabilize the disease for a long period of time.
Types of MBC Treatment
Treatments for MBC may be similar to treatments for an initial or local diagnosis of breast cancer such as surgery, chemotherapy, radiation and hormonal therapy. In general, metastatic disease will be treated with one therapy after another, pursuing each one as long as it remains effective. If one course of therapy stops working, your doctor will use another one. MBC treatments are often referred to as “first-line,” “second-line,” “third-line,” etc.
Treatment Decision Factors
If possible, your metastases will be biopsied to determine their characteristics. These characteristics, in combination with the location of the metastases, will determine treatment. Our Metastatic Navigator has more details on the treatment options and drugs available.
The location of your metastases may determine the treatment options available to you.
- Bone mets: The most common type of breast cancer metastases, they can cause pain, fractures and calcium in the blood. You may receive a bone targeted therapy to alleviate these issues and slow tumor growth. Radiation may also be used to lessen pain.
- Liver mets: The goal is to remove liver metastases if possible through surgery, radiofrequency ablation or cryosurgery. If inoperable, treatment will be given depending on the type of breast cancer.
- Lung mets: These may be removed by surgery. If surgery is not possible, treatment will be given depending on the type of breast cancer.
- Brain mets: The number and location of brain metastases guides treatment decisions. If there are relatively few tumors or a large tumor impacting surrounding tissue, surgery or stereotactic radiosurgery (such as Gamma Knife) may be used. Whole brain radiation may be recommended in patients with multiple brain metastases, especially if they are large.
Your treatment options will also depend on the characteristics or type of MBC you have. For example:
- ER/PR+ Disease: First line therapy is endocrine (hormonal) therapy, which will be used as long as possible. Chemotherapy is typically used only when endocrine therapy fails. New drugs recently approved and in clinical trials are CDK (cyclin dependent kinase) inhibitors.
- HER2+ Disease: All therapies will involve the use of anti-HER2 treatment including Herceptin (trastuzumab), Tykerb (lapatinib) and Perjeta (pertuzumab). A recent innovation, Kadcyla (ado-trastuzumab), which links anti-HER2 therapy to a chemotherapy that is not released until it reaches the cancer cell, has been FDA-approved.
- Triple Negative: Typical treatments involve chemotherapy, with multiple single agents and combinations available (although combinations are used more rarely). Carriers of BRCA 1/2 mutations may receive platinum-based chemotherapies and PARP inhibitors through clinical trials.
Palliative care, given to improve a patient’s quality of life, is for patients at any stage of their cancer journey, but can be particularly beneficial for women with MBC. The goal of palliative care is to manage distressing side effects of a disease or its treatment. Healthcare providers who specialize in this type of care have extensive training in the management of symptoms such as pain, neuropathy, nausea, diarrhea and constipation. They are also skilled at helping patients with psychological, social and spiritual problems related to a disease.
For more information on palliative care, watch our video about the research and benefit of introducing care early in the cancer journey.
For more information about treatment for metastatic breast cancer, check out these audio files from past YSC conferences:
Connect with Others
Find women who know what it’s like to face breast cancer at a young age. The YSC community makes it easy to find and connect with other young survivors and co-survivors.