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).
By 1997, these patients had been observed over 10 years and the original 14% remain alive without a relapse of their cancer and appear cured of their disease. It is important to understand that because over 50% of patients with stage IV breast cancer relapse, it is not useful to compare the response rate to chemotherapy, the average duration of survival or time to relapse. When evaluating treatment strategies in stage IV breast cancer, patients should compare the percent of patients alive with or without relapse 3-5 years from treatment to determine whether a treatment is truly superior.
In one clinical trial published in 1997, women in complete remission after induction chemotherapy were treated with high-dose chemotherapy or no further treatment. At 5 years from diagnosis, 24% of the women treated with immediate high-dose chemotherapy survived without disease recurrence, compared to only 8% of the women who did not receive further treatment.
Since this is the most deadly category of breast cancer, it is important to work closely with all the health care providers. New treatments are being developed all the time, and second, or even third opinions may give the patient more information about newly discovered successful solutions.
High-dose chemotherapy and autologous stem cell transplant treatment for previously untreated stage IV breast cancer appears safe; however, the benefit of this treatment approach is currently unknown. It is known that many factors may influence an individual patient’s potential outcome if treated with high-dose chemotherapy. Patients without prior treatment, those with small amounts of cancer, and those whose cancer responds to conventional chemotherapy all do better.
One strategy to improve outcomes is to increase the effectiveness of induction therapy so that patients have significant reduction in the number of malignant cells in the body before high-dose chemotherapy.
Since more treatment kills more cancer cells, increasing the intensity of treatment delivered to the cancer cells by utilizing high doses of anti-cancer therapies or by delivering multiple cycles of high-dose therapy is one strategy to improve cure rates. While increasing the intensity of treatment may kill more cancer cells, this approach may also damage normal cells and increase the toxicity or side effects of therapy.