Stage 4 – Metastatic Breast Cancer

Also called advanced, secondary breast cancer or stage 4 cancer, metastatic breast cancer tumours have moved beyond the primary site of the breast. The most common places that secondary breast cancer spreads to include the bones, liver, lung and brain, however the cancer may not spread to all these places.

Many women diagnosed with metastatic breast cancer might have been diagnosed with breast cancer before, and it can lie dormant for many years since their initial stage 1 to 3 diagnosis and treatment. However, for some, a diagnosis of secondary breast cancer may be their first diagnosis of cancer.

A study published in the Medical Journal of Australia in 2012 tells us that one in 20 women diagnosed with disease confined to the breast, and one in six women whose breast cancer has reached adjacent soft tissue or lymph nodes at diagnosis, will eventually progress to metastatic disease.


Although metastatic breast cancer has spread to another part of the body, it is considered and treated as breast cancer. For example, breast cancer that has spread to the bones is still breast cancer (not bone cancer) and is treated with breast cancer drugs, rather than treatments for a cancer that began in the bones. That said, advanced breast cancer is considered incurable and the aim of treatments is to control the growth and spread of the cancer, to relieve symptoms, reduce pain, improve or maintain quality of life, and help patients live longer.

Treatment options can include surgery, radiation, chemotherapy, hormonal therapy and/ or targeted therapy, depending on the location, subtype of the cancer and patient’s condition. If the cancer is hormone receptor-positive, the first treatment is hormone therapy. If the cancer is HER2-positive, patients may be prescribed anti-HER2 drugs such as trastuzumab (Herceptin). Chemotherapy, surgery and/ or radiation therapy can be used to shrink or slow the growth of tumours or to ease symptoms.

Research is helping

  • Liquid biopsies: Tumour cells release circulating DNA (ctDNA) into the blood, making a liquid biopsy, or blood sample, a cost-effective and less invasive diagnostic and prognostic tool for determining if cancer has moved beyond the primary site and is spreading to other parts of the body through the blood. A universal biomarker for determining cancer relapse or spread has not yet been discovered, however Professor Kirill Alexandrov from Institute for Molecular Bioscience, University of Queensland is working towards a simple blood test that breast cancer survivors could do at home. Read more here.
  • Nanotechnology: Nanotechnology is being researched for targeted drug delivery, where cancer-detecting nanoparticles are loaded with anticancer drugs that bind to and destroy tumours with minimal damage to healthy tissue and organs. They use less medication and could potentially include time-release doses. It’s an exciting area of research but is still very much in the developmental stage. Read about NBCF-funded Professor Phil Darcy from the Peter MacCallum Cancer Centre who is designing new nanotechnologies that will engage to immune system to eradicate cancer cells. Read more here.

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