Tamoxifen for Stage 4 Breast Cancer: 54 Real Stories

Stage 4 breast cancer: complete remission with letrozole and palbociclib

Patient Info: Anonymized, Female | Stage IV

Biomarkers: Breast cancer was ER/PR positive, HER2 0

Metastatic Site: pleura/pleural effusion

Breast cancer remained in remission on letrozole after palbociclib was stopped; Ph-positive B-ALL achieved complete response with no molecular residual disease after blinatumomab plus ponatinib, with ongoing monthly outpatient monitoring.

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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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HR-positive HER2-negative metastatic breast cancer: bone metastases managed with sequential endocrine therapy

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

Biomarkers: ER 90%+, PR 80%+, HER2-. CA 15-3 was tracked during treatment.

Metastatic Site: skull base; spine; sternum; ribs; left iliac bone;…

Metastatic HR-positive, HER2-negative breast cancer remained under active management; after earlier progression, palbociclib plus fulvestrant and zoledronic acid produced stable/remission findings on PET/CT at 3 months and again 1 year later, with continued 3-month follow-up recommended.

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MSI-High Metastatic Hormone-Receptor-Positive Breast Cancer Responding to Pembrolizumab

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

Biomarkers: ER-positive; PR-positive; HER2-negative; MSI-high; BRCA mutation-negative

Metastatic Site: bone, para-aortic lymph nodes, brain

Pembrolizumab produced marked improvement in metastatic bone and nodal disease. After 1 year it was stopped because of appetite loss; 8 months later she was symptom-free and back at work on endocrine therapy, although asymptomatic brain metastases were documented.

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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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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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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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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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Rare breast cancer subtype that recurred years later in a more aggressive form

Patient Info: Anonymized, Female | Stage IV

Biomarkers: CD117 focally positive in the transformed component; high Ki-67; hormone-receptor status was unknown at the original diagnosis

Metastatic Site: lungs

One year after treatment for the late chest-wall recurrence, CT showed another local recurrence and metastatic nodules in both lungs. She chose to continue treatment elsewhere.

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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 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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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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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.

Stage IV Breast Cancer: Dan's Patient Story

Patient Info: Dan DiNardo, Male, 40s | Stage IV

Metastatic Site: Left femoral ball/hip; spine; lymph nodes; chest

As of January 2020, Dan was living with metastatic recurrent male breast cancer on ongoing hormone-blocking therapy plus a CDK4/6 inhibitor after surgery and hip radiation; his cancer had shown no growth for 1 year.

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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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Breast Cancer Recurrence in the Liver Mimicking Cirrhosis

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

Biomarkers: Original cancer: HER2-negative and PR-positive. Liver recurrence: ER-positive.

Metastatic Site: liver

The breast cancer recurred in the liver after 14 years, produced pseudocirrhosis and portal-hypertension complications, and she died from hepatorenal syndrome five weeks after presentation.

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Stage IV Breast Cancer: Janet's Survivor Story

Patient Info: Janet Klein, Female | Stage IV

Metastatic Site: Bone: left iliac bone

Janet’s Stage 1 breast cancer later recurred and metastasized to the left iliac bone, but she had no sign of cancer from January 2010 onward while continuing palbociclib plus letrozole.

Metastatic Breast Cancer With Liver Progression Treated Through Multiple Chemotherapy Lines

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

Biomarkers: Initial tumor: ER 90%, HER2 3+, Ki67 15%. Liver metastasis: ER 30%

Metastatic Site: pleura, liver

After several periods of response and later liver progression, she remained on active treatment with pegylated liposomal doxorubicin.

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Metastatic Breast Cancer With Bone and Liver Progression After Multiple Therapies

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

Biomarkers: Initial tumor: ER 80%, HER2 negative, Ki67 18%. Liver metastasis: ER 75%

Metastatic Site: bone, liver

After massive hepatic progression and liver failure, chemotherapy was stopped and she died on January 31, 2016.

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Bilateral Breast Cancers Followed by Metastatic Disease and Long Eribulin Treatment

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

Biomarkers: Left primary: ER 90%, HER2 FISH not amplified, Ki67 25%. Right primary: ER 90%

Metastatic Site: lung, pleura, liver, bone

After pelvic bone metastases appeared in 2017, she stopped eribulin, received pelvic radiation and remained on fulvestrant treatment.

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