Introduction
Metastases are daughter tumours of a primary tumour that can be found in practically any tissue of the body, even very far away from the actual tumour. As with all types of cancer, breast cancer can also be divided into different ways of spreading, through which the original tumour can spread. Firstly, there is lymphogenic metastasis, i.e. spreading via the body’s lymphatic system. This form is particularly pronounced in breast cancer. There is also haematogenic metastasis, i.e. the spread of tumour cells via the blood, which leads to so-called distant metastases.
What influence do metastases have on life expectancy?
Life expectancy in breast cancer is strongly dependent on many factors and thus also on metastasis. In general, it can be said that every cancer disease has a very different course and even advanced stages must be considered and assessed individually. Statistically, life expectancy decreases at a higher stage of the disease, also due to the presence of metastases.
Cancer therapy initially involves exact diagnostics, the so-called “staging”, by which the size of the tumor in the breast, as well as metastases in surrounding lymph nodes or in distant organs are detected. The interplay of these criteria results in a tumor stage that has a different prognosis. Today, many breast cancers can be cured and even after five years, about 9 out of 10 patients still survive.
With the presence of metastases, this number can statistically drop to 1 in 4 patients in five years. It is equally relevant whether the metastasis is located in the neighbouring lymph node or in the brain, bone or lung. The latter have a particularly negative influence on life expectancy.
For general cancer treatment, the lymph nodes in the armpit can be removed in addition to the tumor in the breast. These are in many cases the first to be affected by metastases. Chemotherapy and radiation are also primarily directed against small, undetected metastases. Chemotherapy is effective throughout the body, whereas radiation only affects the irradiated organ area. Radiation is usually directed at the primary tumour or individual organ metastases.
What influence does a metastasis have on a chance of recovery?
The chance of recovery from breast cancer also decreases statistically with the presence of metastases. Nowadays, however, many people affected by breast cancer can be cured. This is mainly due to modern chemotherapy, surgery and radiation therapy.
The therapy of advanced breast cancer consists of these three pillars. Today, an operation is performed to preserve the breast if possible. The diagnosis and treatment of the nearby lymph nodes has also improved significantly, so that the removal of all lymph nodes, with sometimes severe side effects, is often no longer necessary today.
In cancer treatment, it can never be ruled out that there are no small, undetected metastases in the drainage area of the carcinoma, which can grow weeks or months after the operation. For this reason, even if there are no metastases, in many cases chemotherapy is used to attack undetected cancer cells throughout the body. In principle, the chance of recovery is reduced if metastases are present.
Especially in the case of metastases in distant organs, the therapy and the associated prognosis often change. Metastases in bone, brain, lung and liver are the most common regions of metastatic disease in breast cancer. From a certain level of metastasis in the body, a cure is no longer realistic and cannot be sought by doctors. In the case of metastases in many different organs, it must be considered together with the patient whether a complete therapy with the intention of healing is sensible and should still be carried out.
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