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Making Sense of Cancer Headlines

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Huffington Post article brings attention to metastatic breast cancer


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Barbara Jacoby's Huffington Post piece, "How do breast cancer and metastatic breast cancer differ?" emphasizes the need for more treatment options for patients with advanced breast cancer.


“When breast cancer moves to the brain or bones or lungs or liver, the conception is that you now have brain cancer or bone cancer or lung cancer or liver cancer,” writes Barbara Jacoby in her Huffington Post piece, “How do breast cancer and metastatic breast cancer differ?”

October is National Breast Cancer Awareness month, which aims to increase attention and awareness regarding breast cancer. According to the World Health Organization, “When breast cancer is detected early, and if adequate diagnosis and treatment are available, there is a good change that breast cancer can be cured.”

However, Jacoby brings attention to the fact that patients with metastatic breast cancer feel like “the forgotten ones” that “have not been understood and/or heard by the general population.”  In her essay, she explains how metastatic breast cancer differs from early breast cancer.

What is the difference between early breast cancer and metastatic breast cancer?

Patients with early breast cancer have cancer that stays in the breast or moves to the underarm lymph nodes.

Locally advanced disease is breast cancer that spreads to the chest wall, breast skin or other lymph nodes, like the ones in the breast.

A patient has advanced or metastatic (stage IV) breast cancer when his/her cancer spreads beyond the breast and nearby lymph nodes in the armpit to other organs, such as the lungs, liver, bones, or brain.

Common misconceptions about metastatic breast cancer

Some terms used when talking about metastatic breast cancer can be confusing.  One common misunderstanding is how to talk about breast cancer after it has spread to other organs. Jacoby points this out in her article, explaining that even when breast cancer spreads to the lungs, liver, or brain, it is still breast cancer, or as she notes, “A cancer is identified by its origin and not by a location to which it has advanced.”

Media reports sometime use the terms “metastasis” and “metastatic cancer” to describe breast cancer that has spread to the lymph nodes.  But it is important to remember that metastatic breast cancer has moved beyond the breast and lymph nodes, traveled through the blood stream and/or the lymphatic system to other organs where it continues to grow. Patients who have breast cancer that has progressed to the lymph nodes have cancer that has spread, but it is not metastatic breast cancer.

Although identifying and treating cancer at its earliest stages often prevents it from spreading to other parts of the body, early detection doesn’t guarantee that metastasis won’t occur, or that it hasn’t already occurred at the time of diagnosis. Jacoby notes that some patients are initially diagnosed with metastatic breast cancer.

Finally, Jacoby reminds the reader that not all breast cancers are alike. Just as they differ based on subtype, metastatic breast cancer is different than early breast cancer.

What are the difficulties in treating metastatic breast cancer?

Patients’ response to treatment is extremely variable, according to Jacoby. A patient may respond well to a drug for a month, when it then stops working; another patient may never show a positive response to the same drug. Some patients may have minimal side effects while taking a drug while others may have an extremely difficult time with the same drug.

We need good treatment options for all metastatic breast cancer patients; this can only become a reality with increased funding for research that targets metastatic cancer, as well as targeted therapy based on the type of breast cancer and presence or absence of inherited mutations in genes that increase cancer risk. 

Nonprofits and industry working together

Jacoby’s article spotlights metastatic breast cancer, primarily for the general public.  Another effort with similar focus is The Metastatic Breast Cancer Alliance (MBCA). This coalition of nonprofits, includes FORCE, our XRAYS partners (Living Beyond Breast Cancer, Tigerlily, Triple Step Toward the Cure, and the Young Survival Coalition), and industry partners who formed in 2013 to identify and address issues facing people with metastatic breast cancer. In 2014, MBCA published a landscape analysis identifying the need for more funds to be directed to metastatic breast cancer research.

Highlights of the MBCA findings include:

  • Only 7% of the $15 billion that was invested in breast cancer research from 2000-2013 by major governmental and nonprofit funders from North America and the United Kingdom was dedicated to metastatic breast cancer.
  • Breast cancer research is usually performed on tissue taken from patients with early-stage, primary breast cancer—not from patients with metastatic breast cancer.
  • Not enough funding is allocated toward translational, clinical, or cancer control research for metastatic breast cancer—the majority goes to basic research.
  • Basic research needs to uncover all steps in the metastasis, which will help with the development of new treatments.

The MBCA analysis also identified gaps in the understanding of the epidemiology of metastatic breast cancer, including:

  • an accurate estimate of how many men and women are living with metastatic breast cancer.
  • a better understanding of how many people diagnosed with early-stage breast cancer go on to develop metastatic breast cancer.
  • research on how cancer subtypes (Her2+, ER+/PR+, triple negative) affects outcomes for patients with metastatic breast cancer.
  • the impact of socioeconomic factors on treatment, care, and quality of life.

The landscape analysis also looked at the quality of life for women and men with metastatic breast cancer, availability of support services, and the state of public awareness of metastatic breast cancer.

Clinical trials for people with mutations in BRCA and metastatic breast cancer

FORCE highlights clinical trials of interest to people facing hereditary cancer. Our featured research page and our clinical trial search tool include information on a number of ongoing clinical trials that are recruiting women and men with metastatic breast cancer and BRCA mutations.   

Posted 10/9/16

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References

World Health Organization Breast Cancer Awareness Month

Jacoby, B, “How Do Breast Cancer and Metastatic Breast Cancer Differ?”, Huffington Post, August 29, 2016

Metastatic Breast Cancer Alliance “Changing the Landscape for People Living with Metastatic Breast Cancer,” October 2014 

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