Treatment options for metastatic breast cancer

Treatment for metastatic breast cancer does not follow a simple formula. Everyone’s cancer is different. Cancer cells can be found in different parts of the body and people can respond differently to the same treatments.

Treatment aims to:

• stop the cancer from growing or slow its growth as much as possible, to lengthen survival
• control pain, discomfort and other symptoms to improve quality of life.

Usually, treatment is ongoing from the time of diagnosis, but you may be able to have a break at times.

What your team may consider

Treatments may be used one at a time or in combination. Some treatments may relieve symptoms quickly. Other treatments may take longer and some may not work at all. If one type of treatment doesn’t work for you, there are usually others to try.

Treatment options may include:

• radiotherapy
• chemotherapy
• targeted therapy
• hormone-blocking therapy
• immunotherapy
• treatments to control symptoms, such as surgery for a broken bone
• other supports to improve quality of life, such as palliative care.

Surgery is a less common treatment. It may be used in specific situations, such as:

• preventing/treating a bone fracture
• reducing fluid around the lungs (‘pleurodesis’)
• removing a cancer from the brain
• to improve mobility or nerve pain problems with spinal metastases
• bypass or stent procedures to treat blockages

Your specialists will discuss surgery if they think it is an appropriate treatment. They will also consider factors such as your general health and the risk versus benefit of any procedure.

Choosing the right treatment for you

After your diagnosis, you don’t usually have to make a decision about treatment right away.

You may want to take time to:

• gather information
• find out what treatments are available
• explore clinical trial options
• speak with family and friends.

You might also want to think about what is going on in your life that might influence your decisions.

Reading about the different treatments can help you understand your options and prepare questions to ask your doctors.

The choice of treatment depends on:

• the subtype of breast cancer (such as hormone receptor status or HER2 status)
• where in the body the metastases are located, for example in the bone, liver, lung, brain, skin or abdomen
• any breast cancer treatments you have had before
• your symptoms
• your age
• whether you have any other health issues
• your individual preferences for treatment, needs and priorities.

Your needs and priorities are important. To ensure you have quality of life, you may still want to enjoy hobbies, take care of family, socialise and work.

You and your team need to find a balance between the goals of treatment and the side effects.

This is why each person has a tailored treatment plan. You may find that other people are having different treatments from you; this is nothing to worry about.

The role of your treating team

You will have a whole team involved in your treatment. It’s important for them to regularly assess your progress and help you manage side effects.

Find out who is normally part of your team. Read Your metastatic treatment and care team.

To understand the scans and tests that may happen during treatment, read Monitoring metastatic breast cancer.

Approaches to treatment and care can vary from doctor to doctor. If you are concerned or have questions, ask a member of your team why they have recommended one treatment over another for you.

It’s okay to ask for a second opinion to help you feel more comfortable in your decisions.

Emerging treatments

Research is looking into why cancers become resistant to treatments and stop working, and how we can overcome this. Research is also testing new drugs every day which target genetic mutations such as: 

• BRCA1/2
• AKT1
• ERBB2
• ESR1
• PALB2
• PIK3CA

Ask your medical oncologist about any trials or schemes that may be appropriate for you.

For more information, read:

• Ways to access new breast cancer drugs
• Clinical trials

Resources

• Video: Just diagnosed with metastatic breast cancer, what’s next?
• Video: New and emerging treatments for metastatic breast cancer
• Podcast: In conversation with Kala and Emily: Living with metastatic breast cancer
• HER2-positive metastatic breast cancer booklet – includes treatment recommendations for HER2-positive metastatic breast cancer.
• Hormone receptor positive metastatic breast cancer booklet – includes treatment recommendations for hormone receptor positive metastatic breast cancer.
• Triple negative metastatic breast cancer booklet – information about the treatment recommendations for triple negative metastatic breast cancer.
• Virtual conference: Thriving Together – Living Longer, Living Stronger (2021)
• Virtual conference: Treatments for Breast Cancer – Options and Considerations (2021)
• Podcast: Communicating with your health professionals
• Influencing best practice in metastatic breast cancer – Cancer Australia Statement on 10 key appropriate and inappropriate metastatic breast cancer practices to ensure that patients receive consistent breast cancer care.