Metastatic Breast Cancer

Question 1

Define metastatic breast cancer.

Answer 1

Breast cancer is considered metastatic breast cancer (MBC) if the disease has spread beyond the breast and ipsilateral lymph nodes (axillary, internal mammary, infra- and supraclavicular).

Question 2

Explain the aetiology/risk factors of metastatic breast cancer.

Answer 2

Female sex
Age >50 years
Family history of breast and/or ovarian cancer
BRCA1 and BRCA2

Question 3

Summarise the epidemiology of metastatic breast cancer.

Answer 3

The breast is the most common site of cancer in women worldwide, accounting for approximately 24% of female cancers, with highest rates in North America, Western and Northern Europe, and Australia. MBC diagnosed at initial presentation or following treatment for loco-regionally-confined breast cancer, occurs in approximately 40% of breast cancer patients.

Question 4

Recognise the presenting symptoms of metastatic breast cancer. Recognise the signs of metastatic breast cancer on physical examination.

Answer 4

Bone pain
Pleural effusion
Palpable mass after treatment of the primary tumour
Shortness of breath
Anorexia
Weight loss

Question 5

Identify appropriate investigations for metastatic breast cancer and interpret the results.

Answer 5

FBC
LFTs
Calcium
CXR
CT (of chest and abdomen)
Bone scan