Stage 4 breast cancer treatment in Germany

Doctors in developed countries successfully treat breast cancer at all its stages, including the advanced one. This is confirmed by statistics: a third of women live more than 5 years after the development of distant metastases. Moreover, these are indicators of patients who started their treatment 7-10 years ago. During this time, new drugs and techniques have appeared, so the results of therapy are constantly improving. You can undergo your stage 4 breast cancer treatment in Germany to benefit from all the achievements of modern medicine.

Principles of treatment

At stage 4, breast cancer treatment is mainly systemic, that is, one that is aimed at reducing or destroying all tumor foci in the body at once, regardless of their size, location, number, whether they are detected or not. Doctors use drugs that enter the bloodstream, spread throughout the body, and act on all cancer cells at the same time. These drugs are administered intravenously or taken orally in the form of pills or capsules.

Treatment is continued as long as it works and does not cause any severe side effects. If one or the other happens, the therapy regimen will be changed. There are many effective drugs for breast cancer treatment, so even at stage 4, the disease can be controlled for a long time.

Methods of systemic therapy

The types of drugs used for stage 4 breast cancer depend on the presence of hormone receptors (estrogen and progesterone), HER2 status, and gene mutations.

Hormone receptor-positive tumors. In the presence of hormone receptors, doctors use antiestrogen or aromatase inhibitors. Concomitantly, targeted therapy with CDK4/6 inhibitors or PI3K inhibitors is often provided.

Hormone receptor-negative cancer. Chemotherapy is considered the main treatment method. 

HER2-positive tumors. The first-line therapy is usually a combination of chemotherapy and HER2 inhibitors. If this treatment regimen no longer works, doctors switch to other treatment options: kinase inhibitors, other HER2 inhibitors, and, in Germany, antibody-drug conjugates can also be used. These are molecules that target HER2 proteins to which chemotherapy drugs are attached. As a result, drugs are delivered directly to cancer cells, which increases their effectiveness.

HER2-negative cancer in women with a BRCA gene mutation. This type of cancer can be treated with PARP inhibitors. Chemotherapy and hormone therapy can often be used as well.

HER2-negative breast cancer with a mutation in the PIK3CA gene. The PIK3CA gene mutation is detected in every third woman with stage 4 hormone receptor-positive cancer. A biopsy followed by laboratory diagnostics is required for detecting this mutation. If the mutation is present, doctors prescribe PIK3CA inhibitors.

Triple-negative breast cancer. Doctors often use immunotherapy. Before it is administered, cells are checked for the presence of the PD-L1 protein. This is found in 20% of women. In addition, a high level of genetic cell instability can be detected, and these cancers can also be treated with immunotherapy. Doctors prescribe immune checkpoint inhibitors. These reduce the ability of the tumor to evade the immune response. If immunotherapy does not work or cannot be provided, triple-negative breast cancer can be treated with chemotherapy or antibody-drug conjugates.

Local treatment

Local treatment for stage 4 cancer can be provided if one tumor has become larger than the rest, and this has to be removed or destroyed to save a woman from symptoms and complications. Here are some examples of local treatment:

• Sanitation mastectomy involves mammary gland removal
• Irradiation of metastases in the brain, bones, and spine
• Hepatic artery chemoembolization blocks the blood vessels supplying the tumor with microspheres containing chemotherapy drugs

You are welcome to use the Booking Health service to undergo your stage 4 breast cancer treatment abroad. Our website offers the best clinics in Germany. You can find the cost of treatment and make your appointment at favorable prices. The Booking Health specialists will take care of the organization of your trip.