Hormone receptor-positive metastatic breast cancer

In metastaticinfo-icon breast cancer, or stageinfo-icon IV disease, the cancer cells have traveled from the breast and nearby lymphinfo-icon nodes and formed tumors in tissues or organs far away from the breast. Metastatic breast cancer can be:

  • Hormone receptorinfo-icon-positive
  • HER2-positive
  • Both hormone receptor-positive and HER2-positive
  • Triple-negative

If you are diagnosed with metastatic hormone receptor-positive breast cancer, it means the stage IV breast cancerinfo-icon is hormoneinfo-icon-sensitive and can be treated with hormonal therapyinfo-icon. You can find more information on how metastatic breast cancer is diagnosed on our pages about Metastatic Breast Cancer and Testing.

If you had early-stage hormone receptor-positive breast cancer, the metastasisinfo-icon is likely to be hormone receptor-positive as well. Your medical oncologistinfo-icon may recommend you have a biopsyinfo-icon of any abnormalinfo-icon finding from an imaginginfo-icon test. The biopsy helps to:

  • Diagnose the cancer
  • Confirm the cancer is metastatic
  • Check the receptorinfo-icon status to make sure it did not change from your original diagnosisinfo-icon

Treatments for Hormone Receptor-Positive Breast Cancer

Treatment for metastaticinfo-icon breast cancer has two goals. The first is to keep the cancer under control for as long as possible. The second is to maintain your quality of lifeinfo-icon, or overall enjoyment of life.

Treatments for HR-positive metastatic breast cancer may include:

Surgery is rarely done for metastatic breast cancer, but there are several reasons your doctor may recommend it. If other treatments keep the cancer from growing for some time, for example, your doctor might remove the primary, or original, tumorinfo-icon and in rare cases a metastatic legion from the lung or liver. Or, if you have pain or bleeding, your surgeoninfo-icon might remove the original tumor to help ease your symptoms.

In hormoneinfo-icon-sensitive breast cancers, hormonal therapy can work as well as or even better than chemotherapy. There are several types of hormonal therapy for metastatic HR-positive disease, and you may be switched from one to another over time if one medicineinfo-icon stops working against the cancer:

Aromatase inhibitors increase the risk for bone thinning and osteoporosisinfo-icon, which can lead to bone breaks. Your doctor will monitor you and may recommend bone-strengthening medicine, if needed.

SERDs, or selective estrogen receptor downregulators, stop activity of estrogeninfo-icon on cancer cells, keeping them from growing. They are approved only for use in metastatic disease. They are used when the cancer no longer responds to other hormonal therapies. One common SERD is:

  • Fulvestrantinfo-icon (Faslodexinfo-icon). Fulvestrant is injected into a muscle every 4 weeks. Hot flashes, mild nauseainfo-icon and fatigueinfo-icon are the major side effects.
  • Megestrolinfo-icon acetate (Megace) is a human-made form of the hormone progesteroneinfo-icon that counteracts some of the negative effects of estrogen. It is used when the cancer stops responding to other hormonal treatments. Megestrol, available as a pill or as liquid, is usually taken once a day, but it can also be taken in smaller doses at regular times during the day. One side effectinfo-icon is weight gain, so your doctor may prescribe megestrol if you have loss of appetite and weight loss. Megestrol also has a small risk of blood clots.

You may also consider taking part in a clinical trial, a study that looks at how well new medical approaches work in people. Clinicalinfo-icon trials offer access to new treatments that are not otherwise available and may prove to work better than standard treatments. Taking part in a clinical trialinfo-icon also helps researchers develop better treatments for those diagnosed in the future. 

November 22, 2019
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