Treatments for Metastatic Breast Cancer
Metastatic breast cancer (also called stage IV or advanced breast cancer) is not a specific type of breast cancer. It’s the most advanced stage of breast cancer.
Metastatic breast cancer is breast cancer that has spread beyond the breast and nearby lymph nodes to other parts of the body (most often the bones, lungs, liver or brain).
Metastatic breast cancer treatment
As hard as it is to hear, metastatic breast cancer cannot be cured today. Unlike breast cancer that remains in the breast or nearby lymph nodes, medical treatments can’t get rid of all the cancer that’s spread to other parts of the body.
However, metastatic breast cancer can be treated. Treatment focuses on extending life and maintaining quality of life.
Your treatment plan is guided by many factors, including:
- The biology of the tumor (characteristics of the cancer cells)
- Where the cancer has spread
- Your symptoms
- Past breast cancer treatments
- Your overall health, age, menopausal status and other medical issues
- Personal goals and preferences
It’s always OK to get a second opinion at any time during your treatment.
Learn about factors related to the biology of the tumor that affect treatment options.
Learn about emerging areas in treatment.
Learn more about getting a second opinion.
Susan G. Komen®‘s Metastatic Breast Cancer (MBC) Impact Series |
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Susan G. Komen’s free MBC Impact Series provides people living with metastatic breast cancer and their loved ones a safe, space to gather information related to MBC and discover practical resources to help make decisions for improved physical and emotional health. To learn more and register visit www.komen.org/mbcseries. |
The biology of the tumor
Many tests will be done on a sample of the metastatic tumor (from a biopsy of the metastases). The results of these tests give information on the biology of the tumor that help guide treatment.
Which tumors are tested? |
What does the tumor test determine? |
How do the test results guide treatment? |
All tumors |
Hormone receptor status (estrogen and progesterone receptor status) |
If the cancer is hormone receptor-positive, the first treatment is usually hormone therapy, often with a CDK4/6 inhibitor. |
All tumors |
HER2 status |
If the cancer is HER2-positive, HER2-targeted therapies, such as trastuzumab (Herceptin), are included in the treatment plan. |
Tumors that are both hormone receptor-positive and HER2-negative |
Whether the tumor has a PIK3CA gene mutation |
If the tumor has a PIK3CA gene mutation, the cancer may be treated with the PI3 kinase inhibitor alpelisib (Piqray), in combination with the hormone therapy fulvestrant. |
Triple negative breast cancers (tumors that are both hormone receptor-negative and HER2-negative) |
PD-L1 status |
If the cancer is PD-L1-positive, the first treatment may be the immunotherapy drug pembrolizumab (Keytruda) in combination with chemotherapy. |
Adapted from National Comprehensive Cancer Network (NCCN), 2022 [4] |
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The NCCN has an animated video on these tumor tests.
Drug therapies for metastatic breast cancer
Many different drug therapies can be used to treat metastatic breast cancer. To learn about drug therapies that may be part of your treatment plan, click on any class of drugs or drug name below.
Class of drugs |
Drug (brand name) in alphabetical order by class of drugs |
Paclitaxel, albumin bound, also called nab-paclitaxel (Abraxane) | |
Genetic testing for inherited gene mutations
The National Comprehensive Cancer Network (NCCN) recommends everyone diagnosed with metastatic breast cancer get genetic testing for BRCA1 and BRCA2 (BRCA1/2) inherited gene mutations [4]. If you have a mutation in one of these genes, a PARP inhibitor may be included in your treatment plan.
Learn more about BRCA1/2 inherited gene mutations.
Learn more about genetic testing to guide treatment.
The NCCN has an animated video on genetic testing to guide metastatic breast cancer treatment.
Treatment guidelines for metastatic breast cancer
Although the exact treatment for metastatic breast cancer varies from person to person, guidelines help ensure high-quality care. These guidelines are based on the latest research and agreement among experts.
The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.
In addition, the National Cancer Institute (NCI) has treatment overviews.
The Centers for Disease Control and Prevention (CDC) recommends people with cancer and their caregivers get the seasonal flu shot. |
Find more information from the CDC about the seasonal flu.
Find information about COVID-19 and breast cancer.
Clinical trials
Clinical trials offer the chance to try new treatments and possibly benefit from them.
Consider joining a clinical trial when your oncologist is considering changing treatments, before starting a new treatment or when there are limited treatment options.
Susan G. Komen® Breast Care Helpline |
If you or a loved one needs information or resources about clinical trials, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877- 465- 6636) or email clinicaltrialinfo@komen.org. The helpline offers breast cancer clinical trial education and support, such as:
Se habla español. |
Metastatic Trial Search |
The Metastatic Trial Search is a web-based clinical trial matching tool that can help you find clinical trials that fit your needs. |
Learn more about clinical trials for people with metastatic breast cancer.
You are not alone
Many women and men have been where you are today. It’s estimated there were more than 168,000 women living with metastatic breast cancer in the U.S. in 2020 (most recent estimate) [1].
It may be helpful to talk with others. You might consider a cancer support group. Or you may prefer to meet with a counselor in a one-on-one setting. Your health care provider may be able to help you find a local support group or counselor.
Learn more about support groups, counseling and other types of support for people with metastatic breast cancer.
Learn about social support for loved ones.
SUSAN G. KOMEN® SUPPORT RESOURCES |
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Financial assistance
Costs related to metastatic breast cancer care can quickly become a financial burden. Dealing with finances and insurance can be overwhelming.
Learn more about insurance plans and prescription drug assistance programs.
Learn more about other financial assistance programs.
Komen Financial Assistance Program |
Susan G. Komen® created the Komen Financial Assistance Program to help those struggling with the costs of breast cancer treatment by providing financial assistance to eligible individuals. Funding is available for eligible individuals undergoing breast cancer treatment at any stage or living with metastatic breast cancer (stage IV). To learn more about this program and other helpful resources, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org. Se habla español. |
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date.
Updated 05/16/23
