Stage 4 ER Positive Breast Cancer: 87 Real Stories

Stage IV HR-Positive Invasive Ductal Carcinoma: Samantha's Patient Story

Patient Info: Samantha, Female, Under 40 | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-positive

Metastatic Site: Rib; spine; pelvis

After a mixed response on the radium trial, Samantha changed to anastrozole and abemaciclib. She described the newer hormone-targeted combination as easier to tolerate and working better while remaining in ongoing treatment.

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Breast cancer first discovered after it had already spread to the spinal cord

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: Estrogen receptor-positive; progesterone receptor-negative; HER2 score 0

Metastatic Site: intramedullary spinal cord (D11-D12); bilateral…

Her paraplegia did not improve after spinal radiation, and she died from disease progression 3 months after the breast-cancer diagnosis.

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HER2-positive breast cancer with brain metastases: responding well to T-DXd

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-positive / HER2 IHC 3+

Metastatic Site: brain (left cerebellum, left frontal lobe, medulla)

After 14 months and 19 doses of T-DXd, brain metastases remained controlled with no symptomatic or radiological relapse and no severe T-DXd-related adverse events.

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Metastatic Breast Cancer Returning About 20 Years After Initial Treatment

Patient Info: Anonymized, Female | Stage IV

Biomarkers: ER-positive, PR-negative, HER2-positive

Metastatic Site: bones

About 20 years after her original breast-cancer treatment and sustained remission, bone biopsy confirmed metastatic recurrence; she became too unwell for planned cancer therapy and chose supportive care.

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Metastatic Lobular Breast Cancer First Appearing as Skin Nodules

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: ER-positive, PR-negative, HER2-negative

Metastatic Site: skin

Died 7 months after the diagnosis of cutaneous metastatic breast cancer.

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Breast Cancer Responses During Mistletoe Extract and Intratumoral Influenza Vaccine Treatment

Patient Info: Anonymized, female, 50s | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-negative

Metastatic Site: bone, lungs, pleura

After a mixed radiologic response, she declined further imaging and remained in good condition without clinical evidence of further progression.

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Paclitaxel-Related Macular Edema During Treatment for Metastatic Breast Cancer

Patient Info: Anonymized, Female, 60s | Stage IV

Biomarkers: ER-positive, HER2-negative

Cancer treatment continued with eribulin after paclitaxel was stopped because of vision toxicity in early 2021.

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HER2-Positive Breast Cancer With Metastatic Progression and Drug-Induced Lupus During T-DM1

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: ER-positive, PR-negative, HER2-positive

Metastatic Site: bones, axillary lymph nodes, intra-abdominal lymph…

More than 5 years after her March 2018 diagnosis, she was living with metastatic breast cancer, but T-DM1 had been stopped after disease progression in 2023.

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Stage IV luminal A breast cancer: liver resection and disease-free follow-up

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: luminal A; ER-positive; PgR-positive; HER2-negative

Metastatic Site: lung, liver

Disease-free after R0 hepatic segmentectomy for breast cancer liver metastasis, with May 2021 MRI showing no remaining liver nodules while she continued maintenance letrozole and goserelin.

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Stage 4 HR-positive breast cancer: stable disease on ribociclib

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-negative

Metastatic Site: left iliac bone

Metastatic HR-positive, HER2-negative breast cancer remained without progression as of October 2024 while she continued ribociclib 400 mg plus letrozole after SBRT to a left iliac bone metastasis.

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Stage IV luminal B breast cancer with liver, bone, and bone marrow metastases

Patient Info: Anonymized, Female, Under 40 | Stage IV

Biomarkers: ER 90% positive; PR 20% positive; HER2-negative; Ki-67 60%; luminal B

Metastatic Site: liver, bone, bone marrow

The patient had marked clinical and hematologic improvement on leuprorelin, letrozole, ribociclib, and zoledronic acid, with sustained complete remission reported for 4 months from September to December 2023 and monthly follow-up advised.

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Metastatic Male Breast Cancer Responding to Abemaciclib and Letrozole

Patient Info: Anonymized, Male, 60s | Stage IV

Biomarkers: ER-positive, PR-negative, HER2-negative

Metastatic Site: soft tissue, distant lymph nodes, bone

The tumor and metastatic soft-tissue and lymph-node disease shrank markedly, with no progression on July 2024 imaging and good clinical condition in September 2024.

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Severe Corneal Injury After Trastuzumab for Metastatic HER2-Positive Breast Cancer

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: ER-positive, PR-positive, HER2-positive

Metastatic Site: lungs, spine, left adrenal gland, calvarium, orbit,…

She was living with widespread metastatic breast cancer when trastuzumab was stopped because of severe eye toxicity.

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Hormone receptor-positive breast cancer metastatic to the pituitary: surgery and disease-free follow-up

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: ER 2+; PR 1+; HER2 0; GATA3 positive; CA125 elevated

Metastatic Site: pituitary

Disease-free 11 months after surgical resection of pituitary metastasis from prior hormone receptor-positive, HER2-negative breast cancer, with postoperative recovery supported by antibiotics, hormone replacement/supportive therapy, and electrolyte management.

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Stage IV HR-Positive Invasive Ductal Carcinoma: Dee's Patient Story

Patient Info: Dee, Female, Under 40 | Stage IV

Biomarkers: ER-positive

Metastatic Site: Bones

As of October 2024, Dee was living with Stage IV metastatic ER-positive breast cancer after bone metastases were found in 2023 and had adapted to treatment with ribociclib.

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Stage 4 breast cancer: ongoing treatment with multi-line chemotherapy

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: Initial tumor: hormone receptor-negative; HER2 2+. 2011 recurrence: ER 10%; PR 70%; HER2 2+.

Metastatic Site: pleura/pleural effusion; lung

Metastatic breast cancer with malignant pleural effusion achieved complete response after chemotherapy and long-term endocrine therapy; PET-CT in October 2023 still showed complete response, with ongoing cardiac and bone-health management.

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Triple-positive breast cancer: complete response to targeted therapy

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: Triple-positive breast cancer; SBDS variants present; no detected TP53 variant on MyeloSeq.

Metastatic Site: liver

Stage IV triple-positive breast cancer with liver metastasis achieved complete response after paclitaxel, trastuzumab, pertuzumab, and G-CSF support; complete response was maintained for 18 months after treatment initiation while on maintenance HER2-directed and endocrine therapy.

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Stage 4 luminal A breast cancer: tumor regression on hormone therapy

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-negative

Metastatic Site: skin, soft tissue, lungs

Metastatic Luminal A breast cancer involving skin/soft tissue and lungs showed regressing tumors and stable lung metastasis after 3 months of anti-hormone therapy plus capecitabine; longer-term control was not reported.

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Invasive lobular breast cancer with isolated scalp metastasis: excision and endocrine therapy

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: Original breast tumor: ER-positive; PR-positive; scalp metastasis: CK7-positive; ER-positive; GCDFP-15 partially positive

Metastatic Site: scalp/skin

As of April 2024, she had no signs of recurrence in the breast or scalp and no distant metastasis after excision of the isolated scalp metastasis while continuing anastrozole.

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Metastatic Breast Cancer With Recurrent Severe Hypocalcemia During Treatment - Case 1

Patient Info: Anonymized, female, Under 40 | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-negative

Metastatic Site: bone, liver, ovaries

She died about 9 years after her breast-cancer diagnosis after progression of liver metastases.

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Metastatic hormone receptor-positive breast cancer with paraneoplastic eosinophilic fasciitis

Patient Info: Anonymized, Female, 70+ | Stage IV

Biomarkers: ER-positive; PR-positive; eosinophilia during paraneoplastic eosinophilic fasciitis flare

Metastatic Site: pelvis

As of February 2024, paraneoplastic eosinophilic fasciitis had remitted after prednisone plus systemic breast-cancer therapy, and 6-month follow-up showed no further skin recurrence or cancer progression.

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Metastatic invasive lobular breast carcinoma to pancreas: biliary stent and paclitaxel

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: Primary breast tumor was triple-negative. Pancreatic metastasis was ER-positive/GATA-positive

Metastatic Site: pancreas; coelio-mesenteric lymph nodes

After 21 years of remission, she developed pancreatic and coelio-mesenteric nodal metastases from invasive lobular breast carcinoma; palliative paclitaxel was stopped after 2 courses because her condition deteriorated, and she was lost to follow-up.

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BRCA2-Positive Breast Cancer in a Woman With Down Syndrome

Patient Info: Anonymized, female, Under 40 | Stage IV

Biomarkers: ER-positive, PR-negative, HER2-negative, germline BRCA2 pathogenic variant

Metastatic Site: lungs, bones

The cancer later progressed with lung and bone metastases and extensive cancer spread through lymphatic vessels in both lungs. She died 59 months after breast surgery.

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Breast Cancer Recurs After a 19-Year Remission and Responds to Later Chemotherapy

Patient Info: Anonymized, female, 50s | Stage IV

Biomarkers: Initial tumor: PR-positive, ER-negative, HER2-negative. Recurrence: ER-positive, PR-negative

Metastatic Site: bones

The cancer recurred after a 19-year remission and later spread to bone. More than 21 years after the original diagnosis, she had marked tumor shrinkage, was in good general condition, and had 10 months of progression-free survival after utidelone plus capecitabine.

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