As a public health initiative, breast cancer awareness has been generally successful. Patients, families, physicians, and advocates have worked diligently to make the disease better understood and synonymous with strength, survivorship and scientific breakthrough. With improved screening efforts and increasing numbers of available therapies, breast cancer is often discovered and treated in early-stage; as a result, a steady increase has occurred over the past 30 years in survival rates for breast tumors found and treated early.

Unfortunately, there is less familiarity with late-stage breast cancer, also called advanced or metastatic disease. The term ‘advanced’ is sometimes broadly applied to refer to locally advanced or metastatic disease. Locally advanced disease may include disease that has spread to the skin or chest wall, but not to distant body sites. Metastatic means that the cancer has spread beyond the breast to other places in the body, including internal organs like the bone, brain, lung, liver or others. Today about 150,000 to 250,000 women (and some men) in the U.S. are living with metastatic breast cancer.

Currently no cure exists for metastatic breast cancer but that doesn’t mean that people shouldn’t be hopeful. The focus for patients with metastatic breast cancer shifts from cure to keeping the cancer under control as long as possible while maintaining quality of life. Metastatic breast cancer care is comprised of complex medical management and decision-making. Creating awareness around this important topic can help women with metastatic disease feel less isolated and more visible to those around them, who may be able to offer vital support and encouragement.

A Need For Better Understanding
A survey of over 2,000 adult Americans found a lack of awareness of accurate information about metastatic breast cancer among the general public. More than 60% of respondents said they know little to nothing about metastatic breast cancer.

Many also had misinformation about advanced disease. For example, 72% believed that breast cancer in the advanced stages is curable. However, the truth is that metastatic disease is not curable with currently available therapies. The median survival after a diagnosis of metastatic breast cancer is approximately 3 years. This means about half of women diagnosed with metastatic breast cancer will live longer and half will live shorter than 3 years. Survival may be longer or shorter depending on a number of factors.

Another result of the survey was that 50% of respondents believed that breast cancer progresses because patients either did not take the right medicines for early stage breast cancer or did not follow the right preventative measures. Unfortunately, no matter what measures are taken, 1 in 3 women with early breast cancer will later develop metastatic disease. Although we understand many factors that may place a woman at higher risk of recurrence, we cannot necessarily predict in which patients cancer will recur or when.

Raising awareness and providing reliable information about metastatic breast cancer is important, as it will afford needed support and education for those currently affected, their families, friends and co-workers, as well as those who may become affected in the future.

What You Can Do
If you have metastatic breast cancer, let your healthcare team know how you want to participate in your own care. Here are some things to consider when speaking with your doctor:

• How much do you want to participate in the decision-making process when it comes to treatment?
• What and how much do you want to know about your prognosis?
• Are you comfortable having discussions about the goals of your care and end-of-life planning early on?
• Should you bring a family member or friend for support during your doctor visits?
• Have your concerns been heard and questions answered?
• Did you share your current experience on therapy and your goals of therapy with your healthcare team?

Taking an active role in your treatment can help you feel empowered in managing your disease and living your life to its fullest potential.

Show Your Support
If you know someone with metastatic breast cancer in your community or workplace, offer your support. Celebrate National Metastatic Breast Cancer Day on October 13th and be part of the hope that will drive research and public health agendas to help raise awareness for metastatic breast cancer.

For more information on the survey, you can download a PDF fact sheet on metastatic breast cancer here.

Julia Perkins Smith, MD is a Senior Medical Director, and is the Breast Cancer Team Lead in Pfizer Oncology Medical Affairs.  

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