Metastatic carcinoma of the breast (stage IV)

Metastatic carcinoma of the breast (stage IV)

Treatment of metastatic cancer is aimed at palliating symp toms, improving quality of life, preventing potential disabling complications and attempting to prolong life. Endocrine therapy for hormone receptor-positive disease is preferred for patients with bony metastasis and limited visceral metastasis . Systemic chemotherapy is preferred for patients with hormone receptor-negative cancers, hormone-refractory metastases and patients with visceral crisis. Oral low-dose metronomic chemotherapy has cytostatic and antiangiogenic e ff ects and may help in improving quality of life. Patients with bony metastasis should receive palliative radiotherapy to lesions in weight-bearing areas (e.g. vertebra, femur) and to painful bony deposits, along with bisphospho nates . Symptomatic pleural e ff usions are palliated by inter costal chest drainage and pleurodesis. Surgical resection of Frederick Pei Li , 1940–2015, Dana–Farber Cancer Institute, Boston, MA, USA, and Washington, DC, USA, in 1969 identified four families with increased susceptibility to cancer. This led to the discovery of mutation in the tumour suppressor gene p53 . Cowden syndrome was named after Rachel Cowden, in whom the features were first recognised. Jan Peutz , 1886–1957, Dutch physician, documented the eponymous condition. Harold Joseph Jeghers , 1904–1990, Boston, MA, USA, recognised the eponymous syndrome. - tasis in patients with good performance status and favourable tumour biology .