How is metastatic breast cancer treated?

Treatment of metastatic breast cancer is highly personalized. It depends not only on the cancer but also on the importance a person places on his or her own potential benefits and harms of specific treatments.

Some treatments have side effects that can lower quality of life. There is also the possibility a particular treatment may not offer much benefit for a particular patient.

So, patients must balance whether the possible benefits of a treatment outweigh the impact it can have on quality of life. This balance can shift over time.

Together with their oncologists, people with metastatic breast cancer can find the balance of treatment and quality of life that is best at each stage of care.

Treatment plans are guided by many factors, including:

  • Characteristics of the cancer cells (such as estrogen receptor status and HER2 status)
  • Where the cancer has spread
  • Symptoms
  • Past breast cancer treatments
  • Person’s goals
  • Person’s strength or physical condition

The most common treatments for metastatic breast cancer include:

  • Hormone therapy for estrogen receptor-positive (ER-positive) cancers
  • Anti-HER2 targeted therapies for HER2-positive cancers
  • Chemotherapy for all cancers, regardless of type

For people with metastatic breast cancer that has spread to the bones, additional drugs are used to improve bone strength and prevent fractures.

Radiation therapy can be used to treat some areas in the body where the cancer has spread and is causing symptoms or pain. For example, radiation therapy may be used to ease the pain of cancer that has spread to the bones.

Surgery is not commonly used for metastatic breast cancer as it has not been shown to improve survival [4].

What about joining a clinical trial?

Like all aspects of cancer care, the decision to join a clinical trial is a very personal one.

Clinical trials can provide an opportunity to try new treatments and possibly benefit from them. They also allow people to contribute to the science of breast cancer treatment that will benefit others for years to come.

But, they may have some downsides as well. For example, clinical trials have restrictions on who can enroll, and they often require travel to a study location.

Some clinical trials compare a new treatment to the standard of care. So, not everyone in the trial will get the new treatment. However, even those who don’t get the new treatment will get the standard treatment, just as if they did not join the trial.

Patients with metastatic breast cancer should talk with their oncologists about a clinical trial when a current treatment stops working and the oncologist recommends changing treatment.