Stage 4 ER Positive Breast Cancer: 87 Real Stories

Male Breast Cancer Controlled for Years Through Multiple Lines of Targeted and Endocrine Therapy

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

Biomarkers: Initial tumor ER-positive, PR-positive, HER2-positive; later ER-positive, PR-negative, HER2-negative; PIK3CA mutation; germline BRCA1/2 negative

Metastatic Site: bones, pleura, liver

After a 5-year and 6-month disease-free interval, the cancer recurred in bone and later progressed to the pleura and liver. He died in January 2021, more than 13 years after his 2007 breast-cancer diagnosis.

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Male breast cancer in both breasts linked to Klinefelter syndrome, initially missed

Patient Info: Anonymized, Male | Stage IV

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

Metastatic Site: spine / bone

With advanced metastatic disease and an estimated prognosis of weeks or less, care focused on symptom relief under the palliative-care team.

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Metastatic Breast Cancer Treatment Complicated by a Supplement–Drug Interaction

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

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

Metastatic Site: bones

She resumed ribociclib with letrozole after the supplement was discontinued and the treatment-related neutropenia improved enough to restart therapy.

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Exercise Trainer Helps Detect Brain Metastases in a Woman With Long-Standing Metastatic Breast Cancer

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

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

Metastatic Site: liver, bones, lymph nodes, kidney, brain

She died 5 months after the brain metastases were diagnosed, roughly 7 years after her original 2014 breast-cancer diagnosis.

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Occult Metastatic Breast Cancer First Appears as a Sternal Mass

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

Biomarkers: ER-positive, PR-positive, HER2-negative; BRCA1/2 testing negative

Metastatic Site: sternum

More than 3 years after the sternal mass was first detected, imaging showed no active breast or chest-wall disease and the cancers were described as appearing in remission while she continued tamoxifen.

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Metastatic breast cancer with a blood condition that mimicked multiple myeloma

Patient Info: Anonymized, Female | Stage IV

Biomarkers: Oestrogen receptor-positive

Metastatic Site: bone

Her pain came under control and the metastatic breast cancer remained stable for approximately 5 years. MGUS did not progress to myeloma, and she later died from causes unrelated to cancer.

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Stage IV HR-Positive Breast Cancer: Abigail's Patient Story

Patient Info: Abigail Myers, female, Under 40 | Stage IV

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

Metastatic Site: bones, brain

Abigail continued living with Stage IV metastatic breast cancer after about 8 years of multiple treatment lines, including therapy for bone and brain metastases.

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Chemotherapy complication: methotrexate absorbed into the bloodstream after spinal injection

Patient Info: Anonymized, Female | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-negative; Oncotype DX Recurrence Score 20

Metastatic Site: leptomeninges / central nervous system; brain

Five months after leptomeningeal carcinomatosis was recognised, she developed a new 2 cm brain lesion and neurological decline. Her family chose supportive care, and she died 10 days after transfer to inpatient hospice.

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Breast cancer that spread to the thymus gland

Patient Info: Anonymized, Female | Stage IV

Biomarkers: Oestrogen receptor-positive; progesterone receptor-positive; HER2-negative

Metastatic Site: thymus

She had a good response after 4 cycles of abemaciclib, anastrozole and goserelin and continued endocrine treatment with surveillance of the opposite breast.

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Stage IV HR-Positive Breast Cancer: Bethany's Patient Story

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

Biomarkers: ER-positive / hormone-positive

Metastatic Site: Liver; bones; lymph nodes; stomach

As of December 2022, Bethany was living with Stage IV metastatic breast cancer after recurrence to the liver, bones, lymph nodes, and stomach, and was on lifelong maintenance treatment after disease shrinkage.

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Breast Cancer Spread to the Sinuses, Eye Sockets and Skull

Patient Info: Anonymized, Female | Stage IV

Biomarkers: ER-positive; PR-positive

Metastatic Site: ethmoid and frontal sinuses; both orbits; multiple…

At 1-year follow-up, the sino-orbital metastases had not progressed on neuroimaging, right-eye visual acuity remained good, and chemoradiotherapy had been tolerated without complication.

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Metastatic Breast Cancer Reclassified After NTRK Fusion Testing

Patient Info: Anonymized, Female | Stage IV

Biomarkers: ETV6-NTRK3 fusion detected in tissue but not circulating tumor DNA; ER low-positive; PR-negative; HER2-negative; PD-L1-negative; germline CHEK2 variant of uncertain significance

Metastatic Site: lungs and pleura; hilar, mediastinal and retrocaval…

After tissue testing identified an ETV6-NTRK3 fusion, treatment with larotrectinib produced a rapid clinical and radiological response.

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Recurrent Lobular Breast Cancer Spread to the Opposite Armpit Lymph Node

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

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

Metastatic Site: Contralateral right axillary lymph node

After surgery for the recurrence and removal of the opposite-side axillary nodes, the patient proceeded with adjuvant chemotherapy and remained in active treatment.

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Breast cancer recurrence in the mandibular condyle causing jaw pain

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

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

Metastatic Site: right mandibular condyle with extension into the…

After anastrozole and 60 Gy of radiation, her jaw pain, mouth opening, and function improved, although some discomfort remained and palliative systemic treatment was continuing.

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Right breast cancer with contralateral axillary lymph-node metastasis

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

Biomarkers: Right breast primary: ER-positive; PR-positive; HER2-negative; Ki-67 70%. Left axillary metastasis: ER-positive; PR-negative; HER2-negative; Ki-67 15%; GATA3-positive.

Metastatic Site: contralateral left axillary lymph nodes

Two years after bilateral surgery, clinical and radiological follow-up showed no metastasis or disease recurrence.

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A durable response to trastuzumab in heavily pretreated metastatic breast cancer

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

Biomarkers: Initial tumor ER-positive and PR-positive. Metastatic liver biopsy ER-negative and PR-negative with HER2 IHC 1+ and nonamplified. Later biopsy ER and PR weakly positive at 5%–10%, HER2 IHC 1+ and nonamplified, and ERBB3 p. with evidence of HER2/HER3 pathway activation.

Metastatic Site: lungs; hilar and mediastinal lymph nodes; liver; bone

She had ongoing benefit for more than 10 months on trastuzumab and capecitabine, with improved symptoms, lower tumor markers, and a confirmed partial response.

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Occult lobular breast cancer first discovered through colon metastases

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

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

Metastatic Site: colon

Her tumour marker decreased during letrozole and palbociclib treatment, but recurrent infections interrupted therapy, and she died from urosepsis 2 years after diagnosis.

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HER2-positive breast cancer diagnosed during pregnancy and later spread to bone and brain

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

Biomarkers: Initial tumour: ER 0%, PR <1%, HER2 3+

Metastatic Site: bone (L3)|brain

After treatment and surveillance without new lesions, she developed a large symptomatic occipital brain metastasis 14 months after completing paclitaxel and radiation and died after rapid neurological deterioration.

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Recurrent Breast Cancer With a Benign-Appearing Chest-Wall Rash

Patient Info: Anonymized, Female | Stage IV

Biomarkers: Initial tumor: ER-positive; PR-negative; HER2-negative.

Metastatic Site: mediastinal lymph nodes

She had recurrent chest-wall and mediastinal metastatic disease; a later rash biopsy showed dermatitis rather than another skin recurrence.

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Young woman with ductal breast cancer and bleeding gastric metastases

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

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

Metastatic Site: pancreas|liver|kidney|stomach

After rapid progression to the pancreas, liver, kidney and stomach, she chose palliative care and died 1 month after presenting with gastrointestinal bleeding.

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Lobular breast cancer later spread to the stomach, bone, neck and mediastinum

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

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

Metastatic Site: stomach|bone|neck|mediastinum

After gastric metastasis was diagnosed and later imaging showed bone, neck and mediastinal spread, her oral intake and health declined; she chose palliative care and died 7 months after the diagnostic endoscopy.

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Lobular Breast Cancer Spread Into a Nasal Tumor

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

Biomarkers: Metastatic lobular focus: ER 8/8; PR 8/8; HER2-negative; E-cadherin-negative.

Metastatic Site: liver; bone; right nasal cavity within an olfactory…

The nasal lesion was removed with no residual local disease on imaging, and capecitabine was restarted while oncology follow-up continued for metastatic breast cancer.

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Stage IV Breast Cancer: Kirby's Patient Story

Patient Info: Kirby Lewis, Male | Stage IV

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

Metastatic Site: lung|spine

Kirby was living with metastatic breast cancer, and his most recent scans showed the right-lung tumor was stable with no signs of progression while he continued fulvestrant and palbociclib.

Metastatic ER-positive breast cancer complicated by osteonecrosis of the jaw

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

Biomarkers: ER-positive.

Metastatic Site: bone (sternum, spine, pelvis, and proximal femur)

After progressive metastatic bone disease and severe medication-related osteonecrosis of the jaw, she entered end-of-life care and died three weeks after discharge to a nursing home.

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