What is Stage 4 Breast Cancer? Here's What You Need to Know About Survival Rates of the Disease
After being diagnosed with breast cancer in 2015—and then announcing she was in remission of the disease in 2017—Shannen Doherty announced Tuesday that she was diagnosed with cancer again, this time with stage 4 breast cancer.
Doherty, 48, shared her diagnosis in a new interview with ABC News, which aired Tuesday on Good Morning America. "It’s going to come out in a matter of days or a week that I’m stage 4. So my cancer came back, and that’s why I’m here," Doherty told Amy Robach. "I don’t think I’ve processed it. It’s a bitter pill to swallow in a lot of ways."
According to Doherty, her stage 4 cancer diagnosis came around the same time her former co-star and friend Luke Perry died, which is at least partially why she kept the news a secret. But she also kept her health news quiet to continue working without judgement. "One of the reasons, along with Luke—that I did '90210' and didn't really tell anybody because I thought, people can look at that other people with stage four can work too. Like, you know, our life doesn't end the minute we get that diagnosis. We still have some living to do," she told ABC News.
Breast cancer in general is a disease with some pretty sobering statistics: According to the Centers for Disease Control and Prevention, it's the most common cancer in women, regardless of race or ethnicity, aside from some types of skin cancer; and it's the cause of death for 41,000 women and 460 men in the US each year. But, like most cancers, breast cancer is also divided into stages 0 to 4—the higher the number, the more the cancer has spread throughout the body, and the worse the prognosis. Here's what you need to know about a stage 4 breast cancer diagnosis—and what the survival rate of a diagnosis like that can typically look like.
What exactly is stage 4 breast cancer?
In the simplest terms, a stage 4 breast cancer diagnosis—which is often referred to as metastatic breast cancer or terminal breast cancer—is the disease in its most serious and life-threatening form, according to the American Cancer Society (ACS).
“Stage 4 breast cancer refers to the spread of breast cancer beyond the area of the breast and surrounding lymph nodes,” Debu Tripathy, MD, professor and chairman of the Department of Breast Medical Oncology, at the University of Texas MD Anderson Cancer Center, tells Health. “The more common sites of spread include the bone, lung, liver and brain.” It's important to note, however, that when breast cancer spreads to another area of the body, like the bones or lungs, it does not become bone or lung cancer—it's still breast cancer, according to the National Cancer Institute (NCI).
Stage 4 breast cancer is an uncommon initial diagnosis—technically called de novo metastatic breast cancer, it's only found in 6 percent of all breast cancer diagnoses. Instead, metastatic breast cancer often emerges months or years after someone has already completed treatment for an initial breast cancer diagnosis in an earlier stage.
How is stage 4 breast cancer treated—and what's the survival rate?
While every stage 4 breast cancer diagnosis is different—which means the methods used to treat it will also differ—this stage of breast cancer is usually treated systemically (aka, via a whole-body approach), since the cancer has already spread to other areas of the body. Systemic treatments usually include options like hormone therapy, chemotherapy, targeted therapy, and immunotherapy, according to the NCI.
Still, those treatments vary depending on a variety of factors, including where the cancer is located, as well as the patient's symptoms, overall health, and previous cancer treatments—and patients are closely monitored throughout treatment for the best outcome. “Patients are generally started on the treatment of best reflex or biology and followed closely using scans, with change in treatments as needed if the current treatment is not resulting and either shrinkage or stability of the breast cancer,” Dr. Tripathy explains.
In addition to more standard systemic treatment options, Dr. Tripathy explains that there are newer technologies being increasingly used—like ones that sequence the DNA of cancerous tumor cells for more specified treatments—as well as various clinical trials designed to offer more options and possibly better outcomes to those dealing with the disease.
Overall though, the main objective of terminal cancer treatment is to extend survival time, while opting for a treatment with the fewest possible side effects to ensure the best and longest quality of life possible—that's primarily because there's no cure for stage 4 breast cancer. Some patients can respond to treatment for many years, or even decades, says Dr. Tripathy, while others with a very aggressive form of the disease may have a survival time of less than one year.
According to the American Cancer Society, the 5-year survival rate for women with metastatic breast cancer that has spread to distant regions of the body is 27%. In comparison, for those with localized breast cancer (meaning the cancer has not spread outside the breast) and regional breast cancer (when cancer has only spread to nearby structures or lymph nodes) the 5-year survival rate is 99 percent and 86 percent respectively.
There is, however, some good news: Women are living longer with metastatic breast cancer than ever before. According to a study conducted by the National Cancer Institute (NCI), published on May 18, 2017 by the journal Cancer Epidemiology, Biomarkers & Prevention, the number of women living with metastatic breast cancer in the United States is not only increasing, but women with the disease are living longer, especially younger women. In fact, the same study found that 11 percent of women under the age of 64 who were diagnosed with stage 4 breast cancer between 2000-2004, lived for 10 years or more.
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter