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Stage IV breast cancer prognosis
Prognosis means the likely outcome or course of a disease.
- Medical Review: Generosa Grana, MD, FACP
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Prognosis means the likely outcome or course of a disease. If you’ve been diagnosed with stage IV metastatic breast cancer, you may have already learned that the cancer is not curable, but it is treatable.
Having stage IV breast cancer means being in treatment for life. It’s completely understandable to want to know how long that really is.
“The diagnosis of metastatic breast cancer is devastating and overwhelming,” says Douglas Yee, MD, breast cancer oncologist at University of Minnesota. “The first question that frequently comes to the forefront is, ‘How long am I going to live?’”
Predicting how long a person might live after a stage IV metastatic breast cancer diagnosis depends on many factors, including:
- Your age and your health before cancer
- Where the cancer cells traveled
- How much cancer there is
- The cancer’s unique characteristics
- If the metastasis is a recurrence of an early-stage breast cancer, how much time passed between early breast cancer treatment and metastasis
- How well the cancer responds to treatment
You may hear statistics about prognosis and survival from your doctor or other people, or you may see them online. Remember that these statistics are based on a broad population and do not predict your individual situation. “As each person is different, each tumor is also different,” Dr. Yee says. “Therefore, the course of metastatic breast cancer, and its treatment, is also different.”
On this page, we’ll talk about factors that impact a metastatic breast cancer prognosis and share some statistics on life expectancy. Not everyone finds this kind of information helpful. If instead you’d like to read more about treatment advances, or stories of others living with metastatic breast cancer, we recommend our page on metastatic breast cancer treatments and our blog.
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Understanding statistics and your diagnosis
Collecting statistics on survival is helpful for cancer researchers and may help you to understand your diagnosis. But a statistic cannot tell what will happen in your case. Statistics do not reflect the individual experiences of the many people who were included, and they cannot predict the course of a cancer diagnosis.
Statistics such as 5-year survival rates are averages of thousands of different cases from around the country. While these statistics seek to represent important pieces of information, they cannot reflect everything about you or your diagnosis.
“It is important to understand the subtype of breast cancer, as well as the clinical features and certain molecular aspects of the tumor,” says Dr. Yee. “There are questions to be considered, such as: Where has it spread? How long has it been since the last adjuvant therapy?”
Statistics are also limited by time. They may be based on data from several years ago about cases that were diagnosed years before that. It takes time for the data to be collected, sorted, and calculated. Statistics like these likely don’t capture the effect of new treatments or approaches that have improved care.
As you try to understand breast cancer statistics, remember these limitations. “Taken together, they make it almost impossible to precisely predict any individual’s prognosis, and a discussion of ‘What is possible?’, ‘What have you seen?’, and ‘What are our goals?’ is a good place to start a conversation with your doctor,” Yee says.
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How many people have metastatic breast cancer?
In 2020, the National Cancer Institute reported that there were 168,000 women living with metastatic breast cancer in the U.S. Still, it’s important to know that there can sometimes be different incidence numbers.
Numbers of first-time breast cancer diagnoses (all stages) are regularly tracked. However, logistical and funding challenges can make it difficult to count cases of metastatic breast cancer that are recurrences of early-stage breast cancers — and these cases make up a large portion of metastatic breast cancer cases.
What we do know is that recurrences of past early-stage breast cancers make up the largest portion of metastatic breast cancer cases in the United States. In developing countries, that picture is very different, with more people experiencing metastatic breast cancer as a first-ever breast cancer diagnosis (de novo metastatic breast cancer).
It isn’t always easy to make sense of conflicting numbers. For example:
- According to 2017 research, three-fourths (75%) of U.S. women living with metastatic breast cancer were first diagnosed with early-stage breast cancer. This suggests that one-fourth (25%) of them had de novo metastatic breast cancer (metastatic breast cancer as their first diagnosis).
- However, data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, collected from 2015-2021, reports that only 6% of U.S. women are diagnosed with de novo metastatic breast cancer.
This can make it difficult to know exactly how many cases of metastatic breast cancer are recurrences of an early-stage breast cancer.
In addition, there is no estimated number of men living with metastatic breast cancer. Still, men tend to be diagnosed at higher stages. The American Cancer Society estimates that 530 U.S. men will die of breast cancer in 2026.
We also don’t know exactly how long people live between an early breast cancer diagnosis and a metastatic recurrence. This, too, varies based on a person’s age at diagnosis, the cancer stage, the cancer’s biomarkers, and the types of treatment received.
Researchers are trying to learn more to answer these questions. In the meantime, it’s important to talk with your doctor about your own individual situation and what that means for you.
People are living longer with metastatic disease now than ever before. This is because of ongoing research to produce new, more effective types of treatment — creating more options for controlling the cancer, its symptoms, and treatment side effects.
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Survival rates for metastatic breast cancer
Survival statistics help researchers understand how breast cancer impacts large groups of people. They also set a baseline for researchers looking at whether people are living longer or better with this disease.
Remember that the numbers in this section may not represent your own experience. It takes time to track and record survival rates, so the statistics you read don’t reflect survival with the newest treatment options.
The National Cancer Institute (NCI) and the North American Association of Central Cancer Registries (NAACCR) gather information on people in the U.S. diagnosed with breast cancer on an ongoing basis. The information is made widely available through the Surveillance, Epidemiology, and End Results (SEER) database of the NCI.
Breast cancer survival rates are reported as 5-year relative survival rates. These are calculated by comparing how likely people with breast cancer are to be alive 5 years after diagnosis to similar people without cancer. You can read a more in-depth explanation of 5-year survival on our Life expectancy page.
Survival rates for metastatic, or stage IV, breast cancer depend on many things, including gender, age, and hormone and HER2 receptor status.
It’s also important to know that there are many newer, effective medicines that are helping people with metastatic breast cancer live longer. They include:
- CDK 4/6 inhibitors for hormone receptor-positive breast cancers
- Newer anti-HER2 targeted therapies
- Antibody drug conjugates (ADCs)
- Therapies that target genetic mutations such as PIK3ca, PTEN or others
- Immunotherapy
None of these treatment advances are reflected in the 2015-2021 survival data below. Talk with your doctor about your individual situation.
5-year stage IV breast cancer survival rate by gender (2015-2021)
Source: NCI Cancer Statistics Explorer Network
- Women 32.6%
- Men 30.9%
5-year relative stage IV breast cancer survival rate by age (women, all races 2015-2021)
Source: NCI Cancer Statistics Explorer Network
- Ages <50 44.7%
- Ages 50-64 34.1%
- Ages 65+ 25.6%
- All ages 32.6%
Stage IV breast cancer 5-year relative survival rates by subtype
Survival rates for different subtypes of stage IV breast cancer are also highly individual. The information below shows the 5-year relative survival rates by age at stage IV diagnosis for the four most common subtypes of breast cancer.
Every breast cancer case is unique. The numbers presented here are averages calculated from a large group of people over a long period of time. These calculations were made from the latest available data, but this data was gathered before some recent treatment advances became available. They do not reflect your individual experience.
The information below represents data collected from 2015 to 2021 in women of all races.
SEER data tracks stage IV breast cancer survival rates in different ways, including breast cancer subtypes including hormone receptor-positive (HR+), hormone receptor-negative (HR-), HER2-positive (HER+), and HER2-negative (HER2-).
Source: NCI Cancer Statistics Explorer Network
- HR+/HER2- 36.5%
- HR-/HER2+ 40.8%
- HR-/HER2- (triple-negative) 14.9%
- HR+/HER2+ (triple-positive) 46.7%
Stage IV HR+/HER2- breast cancer at diagnosis, 5-year relative survival rates
Source: NCI Cancer Statistics Explorer Network
- All ages 36.5%
- Ages <50 46.3%
- Ages 50-64 36.7%
- Ages 65+ 31.9%
Stage IV HER2+/HR- breast cancer at diagnosis, 5-year relative survival rates
Source: NCI Cancer Statistics Explorer Network
- All ages 40.8%
- Ages <50 53.9%
- Ages 50-64 40.1%
- Ages 65+ 30.0%
Stage IV triple-negative breast cancer at diagnosis, 5-year relative survival rates
Source: NCI Cancer Statistics Explorer Network
- All ages 14.9%
- Ages <50 19.9%
- Ages 50-64 15.9%
- Ages 65+ 10.6%
Stage IV triple-positive breast cancer at diagnosis, 5-year relative survival rates
Source: NCI Cancer Statistics Explorer Network
- All ages 46.7%
- Ages <50 61.0%
- Ages 50-64 47.5%
- Ages 65+ 34.0%
Stage IV breast cancer survival rates are highly individual
Despite the strength of SEER data, metastatic breast cancer statistics can be hard to interpret and report. This is because many cancer registries that give their patient information to SEER only report cases of de novo metastatic breast cancer, meaning the cancer was metastatic at first diagnosis.
We know that some women diagnosed with early-stage disease will have the cancer come back as metastatic disease. These cases of recurrent metastatic breast cancer are usually not accounted for in SEER data. This means more people may be living with, or dying from, metastatic breast cancer than SEER data show.
Each person living with metastatic breast cancer is unique. If you’ve been diagnosed with metastatic breast cancer and are concerned about prognosis, have an honest conversation with your doctor about your individual situation.
Your doctor will have a better sense of your prognosis based on how the cancer is responding to the selected treatments recommended for you. Some people get to a point of experiencing no evidence of disease (NED) for long and sustained periods of time. This means there are no signs or symptoms of cancer. Other people live with long periods of controlled disease. And some cancers are controlled for shorter periods if the cancer becomes resistant to treatment.
Over time, you and your doctor will have ongoing discussions about your treatment plan, what’s important to you, and ways to help you have the best quality of life possible—for as long as possible.
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Get support
Learning you have metastatic breast cancer is tough enough. Reading about metastatic breast cancer prognosis can make it even more overwhelming, even if the information helps you in the long-term. You are not alone. We’re here for you every step of the way.
- Get support in person, online, by phone, or in print through our programs and resources.
- Connect with a trained volunteer for emotional support, guidance, and hope on the Breast Cancer Helpline.
- Read personal stories from other diagnosed with metastatic breast cancer.
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About this page
About LBBC
Reviewed and updated: April 8, 2026
Reviewed by: Generosa Grana, MD, FACP
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Living Beyond Breast Cancer is a national nonprofit organization that seeks to create a world that understands there is more than one way to have breast cancer. To fulfill its mission of providing trusted information and a community of support to those impacted by the disease, Living Beyond Breast Cancer offers on-demand emotional, practical, and evidence-based content. For over 30 years, the organization has remained committed to creating a culture of acceptance — where sharing the diversity of the lived experience of breast cancer fosters self-advocacy and hope. For more information, learn more about our programs and services.