Understanding Metastatic Breast Cancer
- A new study has found a significant rise in women diagnosed with late-stage breast cancer under the age of 40. This news reminds us of “Street Outlaws” star Lizzy Musi, who passed away at age 33 from stage 4 triple-negative breast cancer.
- The study, published in this week in the peer-reviewed journal Radiology Society of North America, concluded that distant-stage breast cancer incidence rates across the U.S., of women between the ages of 20 and 39 rose by nearly 3 percent between 2004 and 2021.
- Metastatic breast cancer, also called “stage four” breast cancer, occurs when the cancer has spread, or metastasized, beyond the breasts to other parts of the body. It most commonly spreads to the bones, liver and lungs, but it may also spread to the brain or other organs.
- While treatment for metastatic breast cancer is not curative, it can improve your quality of life. You and your doctor will work together to develop a treatment plan that’s right for you.
- For help finding a clinical trial that’s right for you, try our easy-to-use Clinical Trial Finder.
The study, published in this week in the peer-reviewed journal Radiology Society of North America, concluded that distant-stage breast cancer incidence rates across the U.S., of women between the ages of 20 and 39 rose by nearly 3 percent between 2004 and 2021.
Read MoreFormer president of the American College of Radiology and study co-author Debra L. Monticciolo, MD, said in a statement following the study’s release, “It’s important to understand that these women presented with distant (metastatic or Stage 4) breast cancer at the time of diagnosis.
“Women with this diagnosis have a much lower survival rate and are much harder to treat.”
Dr. Monticciolo continued, “It’s been previously reported that metastatic breast cancer at initial presentation has increased significantly for women under 40, but until now, no clear trend in older women has been reported.”
The study’s lead author R. Edward Hendrick, PhD, clinical professor, department of radiology at the University of Colorado Anschutz School of Medicine, also stated, “The significant increase in metastatic disease at diagnosis among all U.S. women and across all age groups is an alarming new finding.
“This finding is even more remarkable given the likely undercounting of advanced disease in 2020 due to the COVID-19 pandemic.”
It’s important to understand that although advances in breast cancer treatment has shown major improvement among survival rates in woman fighting breast cancer, American Cancer Society says that the five-year relative survival rate for metastatic breast cancer across the U.S. is only 31 percent in women and 20 percent in men.
This low percentage reminds us of how the world lost an incredible race car driver, known for her time on Discovery Channel’s “Street Outlaws: No Prep Kings,” shortly after one year of her stage 4 triple-negative breast cancer diagnosis.
The type of breast cancer she fought is one of the most aggressive types of the disease.
Meanwhile, an earlier study, which looked into more than 200,000 women in the SEER database, who received a breast cancer diagnosis between 1988 and 2003, found that women under the age of 40 were at a 39 percent high risk of dying than women older than 40.
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Remembering Lizzy Musi
Musi, who passed away on June 27, 2024 from metastatic breast cancer, was a regular on the Discovery Channel reality TV show “Street Outlaws: No Prep Kings,” a show which showcases the world of street racing.
In the spring of 2023, she revealed to fans that she was diagnosed with triple-negative stage 4 breast cancer. Stage 4 or metastatic breast cancer means the cancer has spread beyond the breast to other parts of the body.
Triple-negative is an aggressive form of cancer and is considered among the hardest types of breast cancer to treat, according to SurvivorNet experts. However, good treatment options still exist for women impacted. The main treatments are chemotherapy, immunotherapy, and participation in clinical trials.
Being diagnosed with triple-negative breast cancer means the outside of a woman’s cancer cells don’t have the receptors that are commonly found in breast cancer. These are estrogen, progesterone, and HER2 receptors. Chemotherapy is the most important way triple-negative breast cancer is treated.
A statement announcing her passing, which was shared by her dad on Facebook, read, “Surrounded by her Family, in the comfort of her own home, Lizzy was called to heaven at 11:25pm tonight.
“Thank you for all the prayers and support throughout her battle, At this time, the family would like to have time to process, grief and make arrangements in peace. we will give an update as soon as we have information to share.”
Music passed away shortly after a year of her diagnosis, which she announced on social media on April 23, 2023, writing, “Hey Everyone, I haven’t been able to have much time to post due to an unexpected life change.
“A few days ago I have been Diagnosed with Triple Negative Stage 4 Breast Cancer that has moved to my lymph nodes to my liver.
(Click link in my bio, then click YouTube) on me sharing my story and spreading awareness to others. Story is too long to type. I have a rough journey ahead of me. I appreciate everyone’s messages and calls.”
Metastatic Breast Cancer and How It’s Treated
Breast cancer spreads through the bloodstream or lymphatic system. The blood carries cancer cells to different body parts, where they grow as new tumors.
Once breast cancer spreads, the cells may continue to grow slowly or stop growing and stay at equilibrium.
“Metastatic breast cancer is a treatable disease,” explains Dr. Kenneth D. Miller, medical oncologist at the Alvin & Lois Lapidus Cancer Institute at Sinai Hospital of Baltimore.
“Fortunately, we have so many new treatments for women with recurrent breast cancer and for many women who look at this as a chronic disease that they can live with often for many years.”
When Breast Cancer Spreads to the Bones
Breast cancer is sometimes classified as either local, regional, or distant.
- Local: Cancer is located in the breast and has not spread
- Regional: Cancer spreads from the breast to nearby lymph nodes
- Distant: Cancer spreads to distant parts of the body, including bones, liver, lungs, and/or brain
Treatment for metastatic breast cancer focuses on decreasing the spread of cancer cells, as well as relieving symptoms and improving quality of life.
Women with HER2-positive breast cancer, meaning they have high levels of a protein called HER2 on the surface of their cancer cells, targeted treatments are available. The drugs trastuzumab (Herceptin) and pertuzumab (Perjeta) have transformed the outlook for some women with late-stage breast cancers. These therapies, which are often combined with chemo, are very effective at controlling breast cancer once it has spread.
Another notable treatment is for triple-negative breast cancer. This has historically been one of the most aggressive and most challenging to treat forms of the disease because it lacks any of the main drivers of breast cancer, the estrogen receptor, the progesterone receptor, and the HER2 receptor, and it doesn’t respond to treatments that target these receptors.
Now, in addition to chemotherapy, immunotherapy has been approved to treat triple-negative breast cancer.
The Outlook for Immunotherapy Treatment
Breast cancer that has spread to the bone – such was the case with Anderson’s mom – the cancer is often hormone receptor-positive, according to SurvivorNet experts. Women may think when this happens, they need aggressive chemotherapy. However, in most instances of hormone receptor-positive metastatic breast cancer to the bone, the first line of attack is hormone therapy.
Hormone therapies are often combined with other medications to improve their efficacy. For example, CD4/CD6 inhibitors are a type of oral medication that is sometimes combined with hormonal therapies to help shrink breast cancers.
Chemo Plus Immunotherapy for Metastatic Triple-Negative Breast Cancer
The Importance of Breast Cancer Screening
Screening for breast cancer is normally done through a mammogram, which looks for lumps in the breast tissue and signs of cancer.
While there is some disagreement about the exact age a woman should start getting mammograms, doctors generally agree it should happen in their 40s.
The American Cancer Society (ACS) suggests women should begin annual mammogram screenings for breast cancer at age 45 if they are at average risk for breast cancer.
However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) now says that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives
WATCH: Mammograms are still the best tool for detecting breast cancer.
The ACS also advises:
- Women aged 40-44 have the option to start screening with a mammogram every year
- Women aged 55 and older can switch to a mammogram every other year
- Women aged 55 and older could also choose to continue yearly mammograms
For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase risk of breast cancer such as a BRCA gene mutation or a medical history including chest radiation therapy before the age of 30.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Don’t delay speaking with your doctor to make sure you are staying on top of your breast health.
Contributing: SurvivorNet Staff
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