Definition of Stage IV Breast Cancer

by: RayLam
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Stage 4 breast cancer, or advanced breast cancer, has metastasized to other tissue including bone tissue, lung tissue, or the liver. When breast cancer has overwhelmed the body?s natural defenses and spread this far by the time the cancer is first diagnosed, the 5-year survival rate drops to 16%-20% in the United States (American Cancer Society).

Up to 5% of white women in the U.S., and up to 9% of black women have advanced breast cancer spread to distant tissue at the time of first diagnosis (SEER). This difference is usually attributed to poverty and lack of health insurance.

In general, women who have advanced breast cancer at the time of diagnosis live approximately 18 months after diagnosis (median survival rate). Those who are still alive five years after their diagnosis of advanced breast cancer can live an additional 3.5 years (median survival rate) according to the American Cancer Society.

This study suggested that there were no differences in survival between the standard-dose and high-dose chemotherapy regimens in women with metastatic breast cancer who had a complete or partial response to initial standard-dose therapy. However, the number of women treated in this trial does not allow the identification of any subsets of women that might benefit more than the overall group from the high-dose regimen.

Early detection is clearly the most important factor in breast cancer survival rates. Breast cancer detected at Stage 1 while it is still localized to the breast has a survival rate of 98%-100%, while metastasized breast cancer first detected at Stage 4 drops down to 16%-20%.

The main reason patients with breast cancer fail treatment is relapse. Relapse of breast cancer occurs because the high-dose chemotherapy is either unable to kill all the cancer cells in the patient and/or because cancer cells "contaminating" the stem cells are infused back into the patient. The majority of relapses occur because all the cancer cells were not destroyed by the high-dose chemotherapy treatment. However, some relapses may be due to infusion of breast cancer contaminated stem cells. Doctors are performing clinical trials designed to improve the treatment of breast cancer with high-dose chemotherapy that include the following approaches alone or in combination:

Monoclonal antibodies are a treatment that can locate cancer cells and kill them directly without harming normal cells. Herceptin (trastuzumab) is the first monoclonal antibody approved by the Food and Drug Administration for the treatment of breast cancer. Herceptin recognizes a protein on the cancer cell surface of 1 in 3 patients with breast cancer. In order to be treated with Herceptin your doctor must test the breast cancer cells for the protein that Herceptin recognizes. This protein is called Her 2-neu. Herceptin or other monoclonal antibodies are not substitutes for other cancer treatments but have the advantage of being administered during or after high-dose chemotherapy and killing cancer cells by a different method than chemotherapy with the goal of improving the total treatment. Clinical trials are currently being performed to determine whether monoclonal antibodies administered during or after high-dose chemotherapy can improve survival or cure rates.

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