When Cancer Spreads: What to Know About Metastatic Breast Cancer

Mar. 15, 2025

Photo:Getty

Getty

If you’ve been diagnosed with early-stage breast cancer, you may be grappling with the idea that the cancer can get worse. Experts say that 20 to 30 percent of people with an early diagnosis eventually graduate to Stage IV, known as Metastatic Breast Cancer (MBC), at some point.

1. It’s always terminal.

People often assume that being diagnosed with MBC automatically means they will die. That’s not necessarily true.

“We have so many better treatments for breast cancer nowadays—even for more aggressive types of breast cancer,” said surgeon Anne Peled, MD, co-director of the Breast Care Center of Excellence at Sutter Health California Pacific Medical Center, in San Francisco. “I’ve had several patients who are alive and doing well many years after finding out that their cancer was metastatic.”

Chemotherapy isn’t the only treatment option for MBC, either, she pointed out; in some cases, hormone-blocking therapy or immunotherapy is indicated.

2. It can be cured.

Unlike early-stage breast cancer, MBC can’t really be cured. But it can be managed as a chronic condition, with treatments that focus on controlling the spread, alleviating symptoms, and improving patients’ quality of life. It’s true that people living with MBC will be in treatment for the rest of their lives. That being said, there are many cases where patients who’ve undergone treatment for breast cancer no longer have any visible signs of the disease, so it is “treatable.” There are a variety of regimens and clinical trials out there, and many approaches can be tried.

3. It’s inevitable.

Most people with early-stage breast cancer do not develop MBC, according to experts at Johns Hopkins Medicine, in Baltimore.

“In general, when breast cancer is diagnosed at a more advanced stage, there is an increased risk of it coming back as metastatic cancer in the future, as compared to earlier stages,” said Dr. Peled. As a breast cancer survivor, she knows what it’s like to fear potential metastasis. “While I know rationally that the risk for me is low, I still start worrying every time I have a new symptom, like persistent back pain.” If it doesn’t go away in a few weeks, she gets it checked out—and recommends that anyone with similar anxieties consult with their oncologist, too.

Stock image of a mother with cancer.Getty

4. It’s your fault.

This idea preoccupies some patients with MBC, said Dr. Bea: “They think that if they had caught it earlier, they [might] not have been diagnosed. The truth is that metastatic breast cancer can still occur, even if normal screening recommendations have been followed.”

Mammograms and ultrasounds can improve breast cancer outcomes, but they can’t eliminate a cancer that has already metastasized. Factors like tumor subtype and genetic factors often play a larger role in determining metastatic potential. You can develop MBC even if you’ve been diagnosed and followed all treatment guidelines perfectly.

“Catching breast cancer at its earliest stage is important, but the biology of the tumor is perhaps even more important,” Dr. Bea explained. “Tumor biology often dictates how cancer cells act and determines what their metastatic potential is.”

5. You need to keep a positive attitude.

Maintaining a good attitude helps when fighting cancer, but it isn’t everything. You also need comprehensive treatment and support.

Too often, patients living with breast cancer will avoid discussing new symptoms with their oncologists because they’re afraid of an MBC diagnosis, and a shorter life expectancy. That’s a bad idea.

If you’re feeling scared, reach out to breast cancer support groups, networks, and online communities, urged Dr. Peled. Speaking to others who’ve been there can lessen your fear. Valuable resources includeMETAvivor, a site that offers support and education to those dealing with Stage IV breast cancer, andThe Breasties, an organization that provides community for those with breast and gynecologic cancers.

Medical Review

source: people.com