Advances in treatments add years of life for those with metastatic breast cancer

While Oct. 13 is nationally recognized as Metastatic Breast Cancer Awareness Day, those living with this cancer are battling every day.

One in eight American women has chance of developing breast cancer. About 30% of breast cancers eventually metastasize – the spread to elsewhere in the body.

Dr. Carey Anders with the Duke Cancer Institute said breast cancer can spread to the bone, lung, liver and brain.

“The incidents of breast cancer spreading to the brain among patients who already have metastatic breast cancer can differ based on the type of breast cancer they have,” said Anders. “We tend to see that more in patients that have metastatic HER2-positive or metastatic triple-negative breast cancer.”

One of Anders’ patients, Elizabeth Levene, learned her cancer had metastasized in 2018.

The news came two years after her initial cancer diagnosis. Levene first went through chemo, radiation and surgery to remove a lump in her left breast.

“I ended up in the hospital a lot from dehydration,” she recalled.

Almost as soon as Levene finished treatment, the Durham resident learned she would need to do the process over again to remove another cancerous lump from her right breast.

“It was a little bit of a different chemo but the same overall process,” she said. “After the second time I was diagnosed, I really thought I was truly free of cancer.”

That’s when the mother of two learned her cancer had metastasized and she had tumors in her brain.

“That was when I felt like all my possibilities were gone,” Levene said.

Her doctors determined SRS radiation was the best course of action. The process used small gamma rays to focus radiation on tumors in specific areas of Levene’s brain rather than treating the entire organ.

Levene said the targeted radiation got rid of the cancer but the effects caused her to need three brain surgeries.

It has been a year since her last round of SRS radiation but her brain swelling still causes mobility issues. She has had to relearn how to complete daily tasks without complete control of her once-dominant right arm.

“I don’t have any coordination [in my right arm] and my balance is a little bit off,” she said. “If I try to point at anything or if I try to turn a top or something, I have to use my left hand."

Levene said she ended up having to leave her job with a nonprofit. “I couldn’t look at a computer screen, and I can’t type,” she explained.

To help regain strength in her right shoulder and arm, Levene now regularly sees a physical therapist.

Another part of her treatment plan includes antibody infusion therapy.

"Just like antibodies that we make against a virus or other foreign antibodies, it actually targets HER2 on the cancer cell and then it delivers chemotherapy directly to the cancer cell,” Anders explained.

Breast cancer has a high five-year survival rate – 90%. However, once it metastasizes to the brain, life expectancy is often measured in months.

Anders said every case is different and treatment plans vary. In some cases, like Levene’s, infusion therapies have been known to give patients more time.

2024 marks six years since Levene first learned she had metastatic breast cancer. She said each year has been a gift, and she’s thankful for every moment she has with her husband and children.

“I didn’t think I would get to see them leave elementary school, and now I’m still here and my son is going into high school,” Levene said while looking at her children’s school photos.

Her doctor says Levene’s perseverance serves as motivation for other patients learning of a new diagnosis.

“I met several new patients yesterday in Eli’s scenario, and it is so inspiring to be able to say to them, you know we have patients living years after their diagnosis of brain metastasis,” said Anders.