Medical Science: Recent Advances and Applications Vol. 6

Abstract

Metastatic Breast Cancer (MBC) is the leading cause of breast cancer-related death. MBC is a very devastating disease, not curable and associated with poor outcomes. The rate and site of metastasis vary significantly, but it depends mainly on the primary subtype of the tumor, age and stage of the disease. The aim of this study is to review the underlying mechanisms of MBC, evaluate current challenges in its clinical management, and discuss potential future strategies for improving patient outcomes. Metastasis of breast cancer is a multistep process with complex mechanisms. The crosstalk between disseminated tumor cells and microenvironment has been identified as a critical determinant of metastasis. The most common target organs for breast cancer metastasis are bone, lungs, liver and brain along with distant lymph nodes. Bone metastasis is the most frequent metastatic site. The 5-year survival rate is 32.6%.

Most of the patients of MBC are treated with systemic therapy that includes hormone therapy, chemotherapy, targeted therapy, or a combination of these to reduce the tumor burden, relieve the symptoms and improve survival. The focus for MBC patients should be on symptom palliation. Although chemotherapy remains the major treatment, MBC patients need additional supportive care like nutrition; psychology, nursing and palliative care services. Moreover, early detection of metastatic lesions improves the survival rate as well as the quality of life of breast cancer patients. So, there is a dire need for validated biomarkers to identify women at risk of metastasis after diagnosing primary disease. Measurement of circulating tumor DNA may be useful for this purpose. Micro RNAs (miRNAs) are also emerging as promising biomarker for metastasis of breast cancer as it has been observed to link to all stages along the cascade of MBC.