NCCN Guidelines for Patients
Breast Cancer – Metastatic (STAGE IV), Version 2.2017
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
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
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