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NCCN Guidelines for Patients



Breast Cancer – Metastatic (STAGE IV), Version 2.2017


Treatment guide


Part 3 is a guide to treatment for

metastatic breast cancer. Cancer

treatments are briefly described, and

treatment options based on cancer

features are listed. Part 3 also includes a

guide to checking treatment results.


Treatment of metastatic breast cancer includes

treatment of the cancer and support for you. Read

this section to learn how metastatic breast cancer

is treated. Some details about clinical trials are

provided. This section also describes supportive


Systemic therapy

Metastatic breast cancer is unlikely to be cured.

However, long-term cancer control is often achieved

with systemic therapy. Systemic therapy affects all

cancer in the body. Medical oncologists are cancer

doctors trained to use systemic therapy.

Systemic therapy consists of many types. Endocrine

therapy stops cancer growth caused by hormones.

Targeted therapy affects other molecules that

are key to cancer growth. It differs from classic

chemotherapy, which affects a wider range of cells.

Chemotherapy, or “chemo,” includes drugs that

disrupt the life cycle of cancer cells. Keep reading

this chapter to learn more about these treatments.

Surgery and radiation therapy are local treatments.

They treat cancer in one spot. These treatments

may be an option for symptom relief. It is unknown

if surgery helps to prolong life. There is ongoing

research on how surgery can help treat stage IV

cancers. The best time to conduct surgery is also

being studied.

The treatment approach for metastatic cancer is to

use one treatment after another. A treatment change

occurs if the treatment stops working or there are

too many side effects. This approach is followed

until there are no more options or you become too

sick. This allows long-term cancer control for many


Your doctor will plan your treatment based on many

factors. One key factor is the hormone receptor

status of the cancer. As explained on page 18, breast

cancers may be either hormone receptor–positive or

negative. Treatment options grouped by hormone-

receptor status are listed later in this chapter.

I could focus on the lifetime of

treatments or I could focus on my

life in-between treatments. That’s

my struggle.