Stage IV Breast Cancer

Stage 4 breast cancer, or advanced breast cancer, has metastasized to other tissue including bone tissue, lung tissue, or the liver. When breast cancer has overwhelmed the body?s natural defenses and spread this far by the time the cancer is first diagnosed, the 5-year survival rate drops to 16%-20% in the United States (American Cancer Society).

Over the years since the original publication describing high-dose chemotherapy for the treatment of stage IV breast cancer, thousands of women have been treated. All of the more recent publications demonstrate that the complete remission rate for high-dose chemotherapy as initial treatment for stave IV breast cancer is 40%-60%, the mortality from therapy has decreased to 1%-5% and the number of patients alive without evidence of cancer recurrence is 15%-25% 4-5 years from treatment. The results from two clinical trials comparing high-dose to lower dose chemotherapy have also been published.

In one clinical trial published in 1997, women in complete remission after induction chemotherapy were treated with high-dose chemotherapy or no further treatment. At 5 years from diagnosis, 24% of the women treated with immediate high-dose chemotherapy survived without disease recurrence, compared to only 8% of the women who did not receive further treatment.

The 3-year survival rates were 38% for those receiving the standard chemotherapy, and 32% for those receiving the high-dose chemotherapy. Twelve percent of those in the standard-dose group had no progression of disease, compared with only 6% in the high-dose group. Furthermore, there were more side effects in the high-dose therapy group, including one treatment-related death.

Early detection is clearly the most important factor in breast cancer survival rates. Breast cancer detected at Stage 1 while it is still localized to the breast has a survival rate of 98%-100%, while metastasized breast cancer first detected at Stage 4 drops down to 16%-20%.

Early detection procedures must include monthly self-examinations done at the same time each month. From age 20-40, healthy women should have clinical breast exams performed by their health care providers every three years. After age 40, the breast exams should be annually and should include a mammogram or similar procedure.

North American white women have the highest rates of breast cancer in the world, but the 5-year survival rate for all stages (Stage 1, Stage 2, Stage 3, and Stage 4) combined is 88% for the U.S. A recent study found European countries have lower 5-year breast cancer survival rates, with England at 77.8% and Ireland at 76.2% (Lancet Oncology).