What does the diagnosis of metastatic breast cancer mean for me?
Even if you were treated for breast cancer before, some breast cancers may come back. Anyone who has had breast cancer can possibly have a recurrence or relapse at any time3.
Metastatic breast cancer is different from earlier stages of breast cancer – it is a chronic and incurable cancer1. Treatment will slow the growth of the cancer and it may even stop it for a while1.
What tests do I need to confirm my diagnosis and check my progress?
The first thing your oncologist will want to do is to find out as much as possible about your cancer – what type of metastatic breast cancer it is and where it has spread in the body1,2. This will help your oncologist determine the best treatment plan for you.
The types of tests you might have include4:
Laboratory tests – these are tests of the blood, urine or other body fluids.
Imaging procedures – there are a variety of different imaging procedures that can help detect the location and size of tumors. Examples include CT scans and MRI scans.
Biopsy – this is when a sample of tissue is taken from your tumor to test for genetic markers on the tumor cells.
Which tests are performed may vary from one person to another – depending on your signs and symptoms, whether you’ve had breast cancer before and what the usual practice (protocol) is in the hospital where you are being seen5.
The tests and scans used to diagnose your breast cancer may be repeated throughout your treatment at regular check-ups. They can help determine if your treatment is effective and the tumor has shrunk (remission) or stopped growing (stable disease), or if your treatment has to be changed because the tumor is growing again (progression)3,5.
What are the different types of metastatic breast cancer?
The presence (or absence) of particular genetic markers on your breast cancer cells will define which types of breast cancer you have. The two main types of markers are human epidermal growth factor receptor 2 (HER2) and hormone receptors (HR). The two hormone receptors that are important in breast cancer are estrogen receptors (ER) and progesterone receptors (PR)6.
Knowing which combination of these markers you have will help your oncologist select the treatments that will be best for you.
There are four main types of metastatic breast cancer6:
HR-positive, HER2-negative
This is the most common form of breast cancer found in approximately two-thirds of patients7.
HR-negative, HER2-positive
When breast cancer cells make too much HER2 protein, they grow faster than normal cells, and faster than other cancer cells. This is called HER2-positive breast cancer6.
HR-positive, HER2-positive
This is cancer that has both HER2 and hormone receptors6.
HR-negative, HER2-negative (also called triple-negative)
This cancer does not have HER2 or the receptors for the hormones estrogen and progesterone6.
Even if you had early breast cancer that was tested, your oncologist may want to re-test your cancer cells for HER2 and hormone receptor status since these can often change when your breast cancer recurs3.