Common Myths About Metastatic Breast Cancer Everyday Health MenuNewslettersSearch Breast Cancer 8 Common Myths About Metastatic Breast Cancer That You Should Stop Believing Feeling confused about your diagnosis? When it comes to metastatic breast cancer — also called stage 4 or advanced breast cancer — it’s not always easy to separate fact from fiction. Let’s take a moment to clear up the myths. By Julia CalifanoMedically Reviewed by Krystal Cascetta, MDReviewed: June 15, 2018Medically ReviewedDon't believe everything you hear about metastatic breast cancer.Jamie Grill/Getty ImagesBeing told you have metastatic, or stage 4, breast cancer is a lot to process. This diagnosis, which is made when breast cancer cells spread to other parts of the body, may leave you feeling surprised, scared, overwhelmed, depressed, or all of the above. Yet many of the fears that immediately come to mind (namely, that a diagnosis of stage 4 breast cancer is a death sentence) are based on outdated, anecdotal, or simply incorrect information. Here, we expose some of the most widespread (and angst-inducing) myths surrounding metastatic breast cancer to help you navigate what can sometimes feel like an emotional and medical minefield. Myth #1 Metastatic Breast Cancer Is Rare Fact: While U.S. registries do not routinely collect or report data on breast cancer progression or recurrence, the National Cancer Institute estimates that more than 150,000 people in the U.S. are currently living with metastatic breast cancer, and that three in four of them were previously diagnosed with an earlier stage of breast cancer. According to the Fred Hutchinson Cancer Research Center in Seattle, 20 to 30 percent of all women diagnosed with early-stage breast cancer go on to develop metastatic disease. Myth #2 You Can' t Treat Metastatic Breast Cancer Fact: Unlike breast cancer that remains in the breast or nearby lymph nodes, with metastatic breast cancer, you can’t get rid of all the cancer that has spread to other organs. But that doesn’t mean it can’t be treated, says Vered Stearns, MD, the codirector of the Breast and Ovarian Cancer Program at the Kimmel Cancer Center at Johns Hopkins in Baltimore. “There are a number of medications that can slow or stop the progression of the disease and extend patients’ lives for many years, possibly even a decade or more,” she says. Your treatment plan will be guided by the biology of the tumor (that is, the characteristics of the cancer cells), your age, where the cancer has spread, and your symptoms. While local therapies, such as surgery and radiation, are sometimes used, metastatic breast cancer is typically treated with systemic medications, such as hormone therapy, chemotherapy, and targeted therapy, according to the American Cancer Society. Myth #3 Metastatic Means I Should Have a Mastectomy Fact: “While it’s natural to want to get rid of the cancer wherever you can, there is no clear evidence that removal of the breast in stage 4 breast cancer patients adds benefit to systemic treatments with medications,” Dr. Stearns notes. That said, every case is different. Your doctor might recommend a lumpectomy or mastectomy if you have a mixed response to treatment, Stearns explains, such as a reduction in tumors throughout the body but growth within the breast, or a very good response throughout the body but still some disease in the breast. Because surgery to remove (and possibly reconstruct) the breast requires halting systemic cancer treatments, it’s a decision that should be made in consultation with your cancer team. Myth #4 My Cancer Spread Because It Wasn t Treated Properly in the First Place Fact: If you had breast cancer in the past and it’s returned as metastatic, it’s natural to question your original treatment. You might be angry at your doctor (or even at yourself) for not beating the disease. But having invasive breast cancer doesn’t mean you or your doctors did anything wrong. “Most people with early breast cancer in Western societies receive the current standard of care, which is a combination of local and systemic therapies,” explains Stearns. “Despite the fact that these are very good treatments, they don’t eliminate all risk.” Even if just one or two cancer cells are missed by radiation, surgery, or chemo, there’s a chance that your cancer could spread and grow a tumor somewhere else months or years later. Some breast cancers (such as those that are HER2-positive or triple negative in that they lack HER2 and hormone receptor expression) are also more aggressive than others and run a higher risk of recurrence no matter how aggressively they were initially treated. Myth #5 Breast Cancer Can Mutate Into Different Kinds of Cancer Throughout the Body Fact: Metastatic breast cancer occurs when cells that originated from the breast tumor travel to and grow in other organs, such as your bones, liver, and lungs. They are still breast cancer cells, however, which means that they require breast cancer treatments. For example, breast cancer that has spread to the bones is still breast cancer, not bone cancer, and is treated as such. In some cases, your doctor may repeat a biopsy in order to make sure the original subtypes (such as your HR and HER2 status) have persisted. “Cancer cells can change or mutate over time, which is what makes them become resistant to treatments,” says Stearns. “However, they always remain breast cancer cells.” Myth #6 My Treatment Will Be the Same as Those of All Other Patients With Metastatic Breast Cancer Fact: “No two breast cancers are alike,” notes Stearns. “As a result, there is no one-size-fits-all approach to treatment.” Your treatment plan and prognosis will depend on a number of factors, including what your tumor looks like under the microscope, whether it’s a new cancer or a recurrence, your age and overall health, and what treatments you’ve used before. Your treatment plan is also likely to change over time as the cancer adapts and builds resistance to medicines. The bottom line is that every person's path will be different. Myth #7 I Should Begin Treatment as Soon as Possible Fact: It’s understandable to feel a sense of urgency after a diagnosis of advanced cancer, but it’s important to take time to learn all you can about the diagnosis and your treatment options. You may also want to consider getting a second opinion and looking into clinical trials before you start treatment. “Waiting a few weeks to sort out your options,” says Stearns, “will not negatively impact your prognosis or the effectiveness of your treatment.” Myth #8 Treatment for Metastatic Breast Cancer Should Be as Aggressive as Possible Fact: It might seem counterintuitive, but treatments for metastatic breast cancer tend to be somewhat less aggressive than treatments for early-stage breast cancers. “With early breast cancer, the treatments are short term and the goal is to eradicate every seed of cancer,” explains Stearns. By contrast, treatment for metastatic breast cancer tends to focus on managing the disease over the long term, limiting side effects, and enabling patients to coexist peacefully with the disease. This usually involves using as few medications as possible, and changing medications when a treatment becomes ineffective. NEWSLETTERS Sign up for our Cancer Care Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. 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