Metastatic breast cancer. What was that again? We’re guessing that would be your reaction when you hear the lesser known term for advanced breast cancer. It is horrifying enough to know about breast cancer and to hear about a tongue-twister name of an advanced disease is not any easier. But what really is metastatic breast cancer? Let’s call it mBC to simplify our conversation.
mBC is commonly known as advanced breast cancer or stage 4 – this means that the cancer has already spread in different parts of the body’s organs.1 Typically, a patient who was earlier diagnosed with breast cancer has a 20-30% chance of eventually developing mBC.2
This article will not attempt to explain the medical reason behind mBC but would rather touch on the common myths surrounding breast cancer and the advanced stage. Sometimes, cultural sensitivities play a role in how patients and their families view mBC and these give rise to myths and common beliefs about the disease3.
So let’s have a look at some of the myths surrounding breast cancer and mBC and attempt to debunk them:
- MYTH:
Breast cancer is contagious
FACT:
The risk of breast cancer is related not to contagion but to factors such as increasing age4 and other clinical factors such as the presence or absence of specific hormonal receptors (HR) and human epidermal growth factor 2 (Her2).5
- MYTH:
Breast cancer is caused by the evil eye or black magic
FACT:
Despite what people say, breast cancer is rapidly increasing6 not because of “superstitious spells” but documented research has shown multiple reasons including changes in women’s age at first birth and higher adoption of a sedentary lifestyle.7
- MYTH:
Under wired bras or other bras can cause breast cancer
FACT:
There is no scientific evidence that supports a link between wearing an underwire bra or any other bra and a risk for breast cancer.8
- MYTH:
If your mother has breast cancer you will have it as well
FACT:
While it is true that if you have a family member with cancer you are at a higher risk, most women with breast cancer had no family history.9 In fact, only about 10% of women with breast cancer had a family member or history of breast cancer.10
- MYTH:
If you are diagnosed with mBC, it means you have approximately two years to live
FACT:
Although mBC is the most advanced stage of breast cancer, many women can and do live with mBC for multiple years.11
- MYTH:
If you have preventive double mastectomies, mBC will not occur
FACT:
Even if breast cancer is diagnosed and treated at an early stage, it may still develop into mBC- at times even 5 to 15 years after initial diagnosis.12
- MYTH:
Breast cancer does not spread and remains within the breast
FACT:
mBC is when the breast cancer has spread to other parts of the body such as the bones, liver, brain and lungs.13 Bone metastasis is the most common site of cancer-related pain.14
- MYTH:
If you are young, you cannot get mBC
FACT:
Women in the MENA region get breast cancer almost 10 years earlier than women in Europe and the US, with 50% of cases in women younger than 50 years.15
- MYTH:
There are high levels of awareness surrounding mBC
FACT:
The general public’s understanding of BC most often relates to the earlier stages and not the advanced, causing significant misconceptions about what mBC is. This is primarily because women with mBC have been largely absent and forgotten in the public discourse on BC.16
- MYTH:
mBC is a highly-funded and supported cause with multiple care services available
FACT:
Even though mBC is responsible for 21% of female cancer deaths, 17 palliative care services are poorly developed.18 Moreover, many countries lack the capacity to deliver a multidisciplinary approach needed by mBC patients.19
- MYTH:
mBC affects only the physical well-being of women and men
FACT:
The clinical burden of mBC has a huge impact on the quality of life of most patients20. Furthermore, the diagnosis of mBC also highly affects the psychological and emotional state of women and their families.21
Among the above myths live many others, and it is up to us to educate ourselves and build awareness around mBC to further support loved ones living with the most advanced stage of BC. Would you take up the challenge and help people know about mBC?
References:
- Metastatic Breast Cancer Network. Metastatic breast cancer awareness. 13 things everyone should know about metastatic breast cancer. 2014.
- O’Shaughnessy I. Extending Survival with chemotherapy in metastatic breast cancer. The Oncologist 2005; 10:20-29.
- Taha H, Al-Qutob R, Nystrom L, Wahlstrom R, Berggren V. “Voices of fear and safety” Women’s ambivalence towards breast cancer and breast health: a qualitative study from Jordan. BMC Women’s Health 2012; 12:12.
- Ferlay J, at al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013. Lyon, France, International Agency for Research on Cance. 22-8-0014.
- Onitilo AA, Engel JM, Greenlee RT, Mukesh BN. Breast Cancer subtypes based on ER/PR and Her2 expression: comparison of clinic pathologic features and survival. Clinical Medicine and Research 2009; 7:4-13
- Znoar A, et al. Cancer incidence and mortality patterns in South Eastern Europe in the last decade: gaps persist compared with the rest of Europe. Eur J Cancer 2013; 49:1683-1691
- Ibid.
- Chen L, Malone KE, Li CI. Bra wearing not associated with breast cancer risk: a population-based case-control study. Cancer Epidemiol Biomarkers Prev. 23(10):2181-5, 2014.
- National Breast Cancer. Breast Cancer Myths. Sourced from National Cancer Institute. 2016
- Ibid.
- Ferlay J, at al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013. Lyon, France, International Agency for Research on Cancer. 22-8-0014.
- Metastatic Breast Cancer Network. Metastatic breast cancer awareness. 13 things everyone should know about metastatic breast cancer. 2014.
- Ibid.
- National Cancer Institute. Metastatic Cancer Fact Sheet. 2015.
- Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 2006; 12:6243s-6249s.
- Abulkhair O, et al. Modification and implementation of NCCN guidelines on breast cancer in the Middle East and North Africa region. J Natl Compr Canc Netw 2010; 8:S8-S15.
- Cardoso F. Metastatic breast cancer patients: the forgotten heroes! The Breast 2009; 18:271-272.
- Ferlay J, at al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013. Lyon, France, International Agency for Research on Cance. 22-8-0014.
- Silbermann M. Palliative cancer care in Middle Eastern countries: accomplishments and challenges. Ann Oncol 2012; 23:15-28.
- Abulkhair O, et al. Modification and implementation of NCCN guidelines on breast cancer in the Middle East and North Africa region. J Natl Compr Canc Netw 2010; 8: S8-S15
- Mayer M. Living with Breast Cancer: a global patient survey. Community Oncology 2010; 7(9):406-412.
