Monitoring Metastatic Breast Cancer
Metastatic breast cancer (also called stage IV or advanced 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 can respond to many different drug therapies. This means the drugs can shrink the tumors.
However, over time, the tumors can become resistant (stop responding) to your current drug therapy.
How is metastatic breast cancer monitored?
If you have metastatic breast cancer, you’ll be monitored (checked) regularly to see if the cancer is responding to treatment. This is called “restaging.”
Tests may include a physical exam, blood tests and/or imaging tests (such as an X-ray, CT scan, PET scan, bone scan or MRI).
These tests help show whether or not your current treatment is working. If it’s no longer working, your oncologist will change your treatment or discuss other options. This can be a difficult time. You may want to seek support from your health care team and loved ones.
Learn more about changing drug therapies.
Ashley Fernandez, living with metastatic breast cancer
“Allow yourself to feel whatever it is you’re feeling but remember there are lots of different options, there are clinical trials, there’s always something out there. Talk to your medical team and do your research.”
Changing drug therapies
Some metastatic breast cancer cells need specific proteins or cell pathways to grow. Drugs that target the proteins or pathways can slow or stop the growth of these cancer cells for a period of time.
You can think of the proteins as traffic signs and the pathways as roads. Breast cancer cells must pass through the signs to continue along the road.
If the cancer cell hits a roadblock, such as a drug that targets the protein, the cancer cell can’t continue down that pathway. This slows or stops the growth of the cancer.
At some point however, the cancer cell finds a detour around the roadblock and uses another pathway to continue to grow.
Metastatic breast cancers often develop resistance to drugs, so it’s common to change therapies multiple times.
You usually start a drug therapy and then see whether:
- It controls the growth of the cancer
- The side effects can be managed
If the treatment is working at the time of restaging (and the side effects are manageable), the treatment is usually continued.
If the treatment is no longer working or if you’re having a lot of side effects, your oncologist may switch you to a different drug. Your oncologist may also change the dose or schedule of the treatment to reduce side effects.
Blood tests for tumor markers
In some cases, blood tests for tumor markers (sometimes called liquid biopsies) may be used to help monitor metastatic breast cancer to see if the cancer is responding to treatment.
For example, you may have blood tests for cancer antigen 15-3 (CA15-3) or cancer antigen 27.29 (CA27.29) [4]. These tests are similar. Health care providers usually check one, but not both of these blood tests.
Whether the tumor marker test score rises or falls over time may give some information on tumor response to a drug or tumor spread.
Tumor marker tests are not helpful in every case though. Some people with rising tumor marker levels don’t have tumor growth, and some people with tumor growth have normal or unchanged tumor marker levels. Small changes in tumor marker levels are not usually of major clinical importance.
Health care providers don’t make treatment decisions based on tumor marker testing alone. They may combine findings from a tumor marker test with information on symptoms and findings from imaging tests (such as bone scans). This combined information can help your health care providers understand if a treatment is working well for your cancer.
Talk with your health care provider about whether it may be helpful to have tumor marker testing.
Scan anxiety (scanxiety)
It’s normal to feel anxious before scans or other tests that check if the cancer is responding to treatment. Your loved ones may feel this way too. Some call this scan anxiety or scanxiety.
Many hospitals now make tests results available for you to read online before you meet your health care provider. You may want to read the tests results before you meet with your provider or you may prefer to wait until you can review the results together. Remember, test results may contain descriptions that can be hard to understand and how the findings affect your treatment may not be clear.
If it helps, talk to a friend or family member, or bring them with you to the appointment.
It’s also normal to feel anxious while you wait for your results. Try to do something to take your mind off the wait. For example, stay busy and do things you enjoy. Or talk with your family and friends.
You can also talk with your health care provider about ways to cope with stress before scans or while you’re waiting for results.
Learn more about ways to cope with stress, such as mindfulness meditation.
Watch our MBC Impact Series, Ask Your Quality of Life Questions.
Susan G. Komen® Patient Care Center |
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Do you need help with a metastatic breast cancer diagnosis? We’re here for you. The Komen Patient Care Center is your trusted, go-to source for timely, accurate breast health and breast cancer information, services and resources. Our navigators offer free, personalized support to patients, caregivers and family members, including education, emotional support, financial assistance, help accessing care and more. Get connected to a Komen navigator by contacting the Breast Care Helpline at 1-877-465-6636 or email helpline@komen.org to get started. All calls are answered Monday through Thursday, 9 a.m to 7 p.m. ET and Friday, 9 a.m. to 6 p.m. ET. Se habla español. |
Clinical trials
Clinical trials offer the chance to try new treatments and possibly benefit from them.
Many clinical trials are available. Some are available as the first treatment for metastatic breast cancer. Others are for treatments later in the disease course. Consider joining a clinical trial when you’re newly diagnosed, when your oncologist is considering changing treatments or when there are limited treatment options.
Susan G. Komen® Patient Care Center |
If you or a loved one needs information or resources about clinical trials, the Patient Care Center can help. Contact the Komen Breast Care Helpline at 1-877-465-6636 or email clinicaltrialinfo@komen.org. 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. You can also register to receive Trial Alerts. |
Learn more about clinical trials for people with metastatic breast cancer.
Susan G. Komen® Metastatic Breast Cancer Support Resources |
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Updated 03/22/24
