What is metastatic breast cancer?Metastatic breast cancer is breast cancer that has spread to other parts of the body. Breast cancer most commonly spreads to the bones, liver, lungs, and brain. It is still called breast cancer, even after it has spread. Metastatic breast cancer is not curable, but it is treatable.

Many patients continue to live well for a number of months or years with metastatic breast cancer.How can I cope with metastatic breast cancer?A diagnosis of metastatic breast cancer often comes as a shock. People describe a range of emotions such as fear, anger, or sadness that may change day to day or over time. You may have concerns about how this diagnosis will affect many different aspects of your life, such as your relationships, work or career, family and social roles, and finances. You may be worried about suffering or having your life shortened by this disease. It is important to remember that you are not alone.

Key parts of the coping process involve becoming informed about your specific diagnosis and working with your health care team to find professionals who can support you and your family, offer guidance about your treatment options, and identify services to address the needs of your caregivers. Talk openly with your doctors and health care team to express your feelings, preferences, and concerns. They are there to help, and many team members have special skills, experience, and knowledge to support patients and their families.

How is metastatic breast cancer treated?The primary goals of treatment for metastatic breast cancer are to extend or prolong life and to relieve the symptoms caused by the cancer. Treatment aimed at reducing symptoms and improving quality of life is often referred to as palliative or supportive care. It is often given along with treatment to slow or stop the growth of cancer.

Treatment options for women with metastatic breast cancer vary based on several factors, such as whether the tumor is ER-positive, PR-positive, or HER2-positive, where in the body the cancer has spread, the presence of specific symptoms, and previous cancer treatments. For women with ER- and PR-positive cancers, treatment with hormonal therapy is effective and can be used to control breast cancer for an extended period of time.

Other common treatments for metastatic breast cancer include chemotherapy, HER2-targeted therapy, and other types of targeted therapy. Because it is not unusual for metastatic breast cancer to become resistant (stop responding) to these drugs, you may need to change treatments fairly often.

Other possible treatments include radiation therapy or bone-modifying drugs to treat bone metastases and surgery to remove a tumor that is causing discomfort. You may receive additional treatment to make sure you are physically comfortable and free from pain. When making treatment decisions, you may also consider a clinical trial. Talk with your doctor often about all treatment options and the goals of each treatment

“This week, we honor and remember the heroic firefighters and first responders who made the ultimate sacrifice to save and protect our citizens, homes, and communities. n 2017, more than 1.3 million fires killed 3,400 people and injured 14,000 more, while causing an estimated $23 billion in direct property loss. Sadly, the number of fire-related deaths continues to rise, even though the number of fires is falling.”

White House (whitehouse.gov)

In a typical home fire, residents may have as little as one to two minutes to escape safely from the time the smoke alarm sounds. Escape planning and practice can help them make the most of the time they have, giving everyone enough time to get out.

Plan and Practice your Escape ™Fire Prevention Week / October 6-12, 2019 Not every hero wears a cape.Why is it important to have a family escape plan?

Fire is FAST!In less than 30 seconds a small flame can turn into a major fire. It only takes minutes for thick black smoke to fill your home. Fire spreads too quickly and the smoke is too thick. There is only a short time to escape.

Fire is HOT!  Room temperatures in a fire can be 100 degrees at floor level and rise to 600 degrees at eye level. If you inhale this super-hot air, it will scorch your lungs.

Fire is DARK!Fire starts bright, but quickly makes black smoke and complete darkness. If you wake up to a fire you may be blinded, disoriented and unable to find your way around your home.

Fire is DEADLY!Smoke and toxic gases kill more people than flames do. The odorless, colorless fumes can lull you into a deep sleep before the flames reach your door. You may not wake up in time to escape.

“Many germs, such as bacteria, viruses and fungi can cause pneumonia. Understanding the cause of pneumonia is important because pneumonia treatment depends on its cause.”

American Lung Association

“Flu (influenza) is a contagious respiratory illness caused by influenza viruses that can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. … RSV (respiratory syncytial virus) is a common respiratory virus that usually causes mild, cold-like symptoms.”

Cleveland Clinic

“According to the National Cancer Institute, more than 268,600 women in the United States will be diagnosed with breast cancer and nearly 42,000 will die of the disease in 2019.  Breast cancer is the most common type of non-skin cancer in women in the United States.”

First Part of risk factors:

Those that we cannot change:

Gender

Women account for more than 99 percent of all breast cancer cases.

Age

After gender, age is the most influential risk factor for developing breast cancer. Women younger than age 40 account for only 4.7 percent of invasive breast cancer diagnoses and only 3.6 percent of in situ breast cancer diagnoses. Over 70 percent of all breast cancer diagnoses are made in women who are 50 or older.

You may have heard the statistic that one in eight women in the United States will develop breast cancer. This does not mean that a woman of any age has a one-in-eight chance of developing breast cancer. This statistic conveys a woman’s lifetime risk. This means that if a woman lives until age 85, she has a risk of one in eight of developing breast cancer sometime during her lifetime.

Race

After age 40, Caucasian women are more likely to be diagnosed with breast cancer than African-American women. However, African-American women are more likely than white women to die of breast cancer. Women of Asian, Hispanic or American Indian descent are at lower risk than Caucasian or African-American women for developing breast cancer.

Personal History

If a woman has had cancer in one breast, she is at increased risk of developing cancer in the other breast.

Family History

Women with a relative who has had breast cancer are at higher risk of developing breast cancer themselves, particularly if it is a first-degree relative, such as a mother, sister or daughter.

That risk is further increased if a woman has multiple first-degree relatives who have had breast cancer, or if she has a first-degree relative who developed breast cancer at a young age or in both breasts.

Patients with family members who have had breast and/or ovarian cancer may choose to see a qualified genetic counselor from the UCSF Cancer Genetics and Prevention Program at Mount Zion. These counselors are available to evaluate a person’s likelihood of carrying a gene mutation and to discuss the possibility of genetic testing.

Genetic Risk Factors

Women who have certain inherited gene mutations (including BRCA1 and BRCA2) have a significantly increased risk of breast cancer and account for about 5 percent to 10 percent of breast cancer cases. In most women, the normally functioning BRCA1 and BRCA2 genes help to prevent breast cancer by controlling cell growth. However, these genes are no longer able to control cell growth properly unmutated.

Since these genes are passed down from your parents, it is possible to carry a gene mutation from the mother or father’s side of the family. A female who carries either the BRCA1 or BRCA2 gene mutation has up to an 85 percent chance of developing breast cancer by the age of 70. However, in men the BRCA2 gene mutation is reported to increase risk of breast cancer more than the BRCA1 gene mutation. Males who carry the BRCA2 gene mutation have a suggested 6 percent chance of developing breast cancer during a lifetime.

A prevalence of the BRCA1 and BRCA2 gene mutations has been observed in the Ashkenazi Jewish (Jews with European or Central European ancestry) population. Having one or more relatives with breast or ovarian cancer, and being of Ashkenazi Jewish descent, puts a person at greater risk for carrying a BRCA gene mutation.

Radiation

Exposure to high doses of chest radiation, such as for medical therapy for Hodgkin’s lymphoma, particularly during childhood, can greatly increase a woman’s risk of developing breast cancer.

Researchers have found that the age at which radiation was received is inversely related to the acquired risk. Thus, women who received radiation after their menopausal years incurred very little risk.

“1 out of 8 women will develope breast cancer in their lifetime.”

National Breast Cancer Foundation, Inc.