Stage IV Breast Cancer Treatment Options

So the treatment of stage IV breast cancer is complicated and has changed a lot over the course of even the last few years. Most patients with stage IV disease-- disease that's spread beyond the breast or surrounding lymph nodes-- won't be curable. It'll be treatable, and sometimes treatable for years or even decades, but probably not curable. And so each treatment decision has to be made with an understanding of, what are the patient's goals? What are their other limitations? How is this treatment going to impact their quality of life?

For different types and subtypes of breast cancer, there are different treatment options. Chemotherapy is one of the things that we use, chemo or drugs that classically travel through the bloodstream and kill rapidly dividing cells. So that includes cancer cells, but it also includes other cells. So chemotherapy is not without its side effects. But can be really beneficial for the patients who have aggressive stage IV cancer and require it.

We also have a growing number of targeted therapies for metastatic breast cancer, which has been really exciting, because more targeted therapies allow us to treat the breast cancer a little bit more focused with fewer side effects, because we're killing off cancer cells as opposed to normal cells. And immunotherapy, treatments that kind of harness the patient's own immune system to fight the cancer more effectively, is another kind of class of drugs that is also starting to make its way now into the breast cancer space.

Maintaining quality of life with stage IV cancer is a really important question. So I think, for doctors, it's very important to have honest conversations with patients about what in their life is most important to them and what do they feel like the cancer is limiting them from doing so that we can then help them figure out how to manage that.