Metastatic Breast Cancer

If your Inflammatory Breast Cancer has progressed (traveled to an organ outside of the primary breast) to metastatic breast cancer, we provide specific resources and support to help you manage this stage of the disease. Learn about the latest treatments, clinical trials, and strategies for living well with MBC. Our goal is to support you in maintaining the best possible quality of life and staying informed about new developments in care.

What is MBC?

Stage IV breast cancer, also known as metastatic breast cancer (MBC), occurs when cancer has spread to distant parts of the body. Common sites include the brain, bones, lungs, and liver. Approximately 6% of female breast cancer patients are initially diagnosed with MBC (“de novo metastatic breast cancer”), and nearly 30% of women with early-stage breast cancer will develop MBC over time.

    Symptoms of Metastatic Breast Cancer

    Many IBC patients worry about what MBC symptoms look like. The symptoms of MBC vary depending on the affected organs:

    Bone:

    • Sudden onset of new pain
    • Commonly affected areas: ribs, spine, pelvis, long bones

    Lungs:

    • Pain or discomfort in the lungs
    • Shortness of breath
    • Persistent cough

    Brain:

    • Headache
    • Changes in speech or vision
    • Memory problems

    Liver:

    • Pain or discomfort in the midsection
    • Fatigue and weakness
    • Weight loss or poor appetite
      Changing Prognosis

      While there is still no cure for MBC, recent treatments have improved survival and quality of life. More patients achieve long-term survival. Studies have shown that the number of women living with MBC is growing, with improvements in median and 5-year relative survival, especially among younger women.

      Treatment of Metastatic Breast Cancer

      Advances in systemic treatments have significantly improved outcomes for MBC patients. Treatment decisions are based on tumor biology and clinical factors, and biopsies of suspected lesions are evaluated for molecular markers like ER (estrogen receptor), PR (progesterone receptor), and HER2. Germline testing for BRCA1 and BRCA2 mutations is also recommended.

      Treatment of metastatic disease is palliative, aiming to prolong life and improve quality of life. Recommendations are often grouped by molecular markers present.

      HR+ HER2-Negative Breast Cancer:

      • Endocrine therapy is usually preferred over chemotherapy. Tamoxifen and aromatase inhibitors are commonly used, with CDK4/6 inhibitors (palbociclib, ribociclib, abemaciclib) enhancing the efficacy of endocrine therapies. Alpelisib is an option for those with PIK3CA mutations.

      HR- HER2-Negative (Triple-Negative) Breast Cancer:

      • Chemotherapy is the primary treatment. Atezolizumab can be added to first-line taxane-based chemotherapy for patients with triple-negative advanced breast cancer.

      HR- HER2-Positive Breast Cancer:

      • HER2-targeted therapies (trastuzumab, pertuzumab, ado-trastuzumab emtansine, lapatinib) have revolutionized treatment.

      Germline BRCA Mutation:

      • PARP inhibitors (olaparib, talazoparib) are effective for patients with BRCA mutations.

      Bone-Modifying Therapy:

      • Treatments like pamidronate, clodronate, zoledronate, and denosumab reduce skeletal morbidity in patients with bone metastases.