Living With Metastatic Breast Cancer: 5 Things to Know

Kate M. O'Rourke

Disclosures

August 15, 2019

As a result of more effective and varied treatments, patients with metastatic breast cancer (MBC) are living longer, particularly those with the HER2-positive subtype.[1,2] With this expanding longevity, clinicians are increasingly challenged in managing quality of life and survivorship issues, including psychosocial matters, in this patient population.[2] Patients with MBC and their families have complex needs that should be addressed to minimize severe distress and deterioration in quality of life. Optimizing the quality of life and well-being of patients requires the full engagement of an interdisciplinary approach to palliative and supportive care, with an emphasis on the assessment of current and anticipated needs.[2,3] Here are five things to know about living with MBC.

1. Varied Treatment Options Are Increasing

Patients with MBC are living longer, with an increasing number of varied treatment options, including targeted therapy and immunotherapy, and a growing number of opportunities to participate in clinical trials.[1,4,5,6,7,8] Aggressive subtypes of MBC, such as triple-negative breast cancer, may lead to death within a few months or years, whereas patients with hormone receptor-positive and HER2-overexpressed MBC will have a prolonged course of illness.[3] Approximately 10% of patients with newly diagnosed breast cancer have metastatic disease, and of these, approximately one fifth will survive for 5 years.[9] In a single-institution review of 168 patients with HER2-positive MBC, 7% of patients with newly diagnosed MBC survived more than 10 years.[10] Patients with triple-negative disease have improved outcomes from immunotherapies, including pembrolizumab and atezolizumab.[4,5,6,7,11] Patients with HER2-overexpressed MBC benefit from targeted therapies and some immunotherapies.[1,10,12] Combination hormonal therapy can improve survival in patients with hormone receptor-positive disease.[13]

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