Targeted Therapy for Stage 4 Breast Cancer: 142 Real Stories

HER2-positive breast cancer with brain, skin, and lymph-node metastases responding to dual-targeted therapy

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

Biomarkers: HER2-positive breast cancer. Initial tumor was ER/PR negative with Ki-67 30%; skin metastasis had Ki-67 70%.

Metastatic Site: brain, left cervical lymph nodes, skin of left chest…

After 1 cycle of inetetamab trastuzumab, pyrotinib, and capecitabine, skin metastases regressed, CEA and CA125 decreased, brain lesions shrank, and the largest lesion decreased by about 46%, meeting partial response; disease remained stable as of September 2024.

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Stage IV HER2-Positive Breast Cancer: Elissa's Patient Story

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

Biomarkers: HER2-positive; no hereditary mutation reported

Metastatic Site: lymph nodes, liver, spine

Elissa had Stage IV HER2-positive metastatic breast cancer with an early strong response to systemic therapy, but she described the disease as long-term and not curative. As of July 2025, she had lived with metastatic breast cancer for about 4 years and had received roughly 5 lines of treatment.

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Isolated adrenal metastasis from breast cancer: adrenalectomy and exemestane plus palbociclib

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

Biomarkers: ER-positive; PR-positive; HER2-negative; GATA3-positive; CK7-positive; mammaglobin-positive; GCDFP-15 rare staining

Metastatic Site: right adrenal gland

After laparoscopic right adrenalectomy for isolated metastatic breast carcinoma, follow-up CT abdomen/pelvis and PET-CT showed no metastatic disease elsewhere; surveillance while on exemestane and palbociclib showed no recurrence so far.

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HER2-low lobular breast cancer with bone marrow involvement responding to T-DXd

Patient Info: Anonymized, Female | Stage IV

Biomarkers: Initial surgical specimen: ER-positive; PR-negative; HER2-negative. Bone marrow relapse: breast cancer infiltration with low HER2 staining.

Metastatic Site: bone marrow

Two years after starting T-DXd, this patient remained free of bone marrow disease and continued the same treatment regimen.

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HER2-low lobular breast cancer with bone marrow involvement treated with T-DXd

Patient Info: Anonymized, Female | Stage IV

Biomarkers: Initial surgical specimen: ER-positive; PR-negative; HER2-negative. Bone marrow relapse: breast cancer infiltration with low HER2 staining.

Metastatic Site: bone marrow

Two years after starting T-DXd, this patient remained free of bone marrow disease and continued the same treatment regimen.

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HER2-positive breast cancer with metastatic recurrence and complete response to T-DM1

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

Biomarkers: HER2 IHC 3+ and hormone receptor-negative in primary and metastatic breast cancer; no liver metastases seen.

Metastatic Site: major pectoralis muscle, lung, broncho-hilar lymph…

After complete radiologic response on T-DM1, treatment was stopped after 22 months because of porto-sinusoidal vascular disorder. Seven months later, she remained asymptomatic and under surveillance with no signs of recurrent disease.

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Stage IV HER2-Positive Breast Cancer: Kathleen's Patient Story

Patient Info: Kathleen McEvoy-Schufreider, female, 60s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: liver, bones

Kathleen continued long-term treatment for metastatic breast cancer, including infusions every 3 weeks after resuming the PATINA regimen outside the trial.

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Stage IV HER2-Positive Breast Cancer: Jennifer's Survivor Story

Patient Info: Jennifer Masters, Female, 60s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: Chest wall/skin near surgery incision; lymph nodes

As of May 2025, Jennifer had no reported recurrence for several years after Stage IV HER2-positive metastatic breast cancer responded completely to clinical-trial treatment with T-DM1 and neratinib; she continued annual Cleveland Clinic visits and remained active with family and volunteering.

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Metastatic male breast cancer: complete metabolic response after restarting anastrozole, leuprolide, abemaciclib, zoledronic acid, and radiation

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

Biomarkers: ER >95%; PR >95%; HER2/neu-negative; Ki-67 30%; PIK3CA exon 21 pathogenic variant; BRCA1 not mutated; BRCA2 not mutated

Metastatic Site: bone (vertebral bodies T2-T6, L1, and L5)

As of May 2025, after restarting endocrine and targeted therapy and receiving palliative radiation, the last two PET scans showed complete metabolic response without disease progression, and brain MRI showed no metastasis.

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Metastatic ER-positive pleomorphic lobular breast cancer: psoas metastasis and stable disease on eribulin

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

Biomarkers: Primary and chest-wall recurrence were ER/PR positive, HER2 negative. Later psoas metastasis was ER positive, PR/HER2 negative.

Metastatic Site: skin of left chest wall; bone; left psoas muscle;…

As of May 2025, one year after diagnosis of malignant psoas syndrome from breast cancer metastasis, she remained on outpatient treatment with eribulin and had stable disease.

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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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HER2-Positive Breast Cancer With Brain and Leptomeningeal Metastases Responding to Intrathecal Treatment

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

Biomarkers: HER2-positive

Metastatic Site: brain, leptomeninges

More than 5 years after her September 2019 diagnosis, neurological symptoms had resolved, cerebrospinal fluid remained negative for tumor cells, and maintenance treatment was continuing in February 2025.

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Stable Metastatic Breast Cancer During Treatment With a CDK4/6 Inhibitor and Fulvestrant

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

Biomarkers: HER2-negative

Metastatic Site: liver

Metastatic breast cancer remained stable after 18 months of tiremciclib and fulvestrant.

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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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Stage IV HER2-Positive Breast Cancer: Stephani's Survivor Story

Patient Info: Stephani St. Cyr, Female | Stage IV

Biomarkers: HER2-targeted treatments reported; no inherited cancer gene mutation found.

Metastatic Site: Bone; liver; brain

As of March 2025, Stephani had Stage IV metastatic breast cancer involving bone, liver, and brain, had no evidence of disease since July 2021, and continued HER2-targeted/systemic therapy.

Stage IV HER2-Positive Breast Cancer: Anne's Patient Story

Patient Info: Anne Keane, 40s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: bones, liver

Anne had an extraordinary response to first-line treatment for metastatic HER2-positive breast cancer and remained on the same HER2-targeted therapy for 6 years.

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Stage 4 hormone receptor-positive breast cancer: remission with PARP inhibitor

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

Biomarkers: HR-positive breast cancer with HER2-low/negative recurrence, and pathogenic BRCA2 R2318* mutation.

Metastatic Site: pleura

As of January 2025, she had maintained complete response for 36 months after sequential FEC/docetaxel and olaparib for hormone receptor-positive, HER2-negative/HER2-low metastatic breast cancer with BRCA2 R2318* mutation.

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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 Recurring Years Later With Leptomeningeal Spread and a Brief Response to Trastuzumab Deruxtecan

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

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

Metastatic Site: peritoneum, retroperitoneum, bones, leptomeninges

Died on May 10, 2024, about 18 years after her April 2006 breast-cancer diagnosis and about 6 years after metastatic recurrence.

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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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Metastatic breast cancer with receptor evolution: sequential endocrine, immunotherapy, CDK4/6, and antibody-drug conjugate treatment

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

Biomarkers: Markers changed over time: initial tumor ER-positive/HER2-negative; local recurrence triple-negative/HER2-low; pleural fluid ER-negative.

Metastatic Site: mediastinal lymph nodes, pleura; pulmonary nodules…

More than 7 years after diagnosis, she remained on sequential systemic therapy for metastatic breast cancer, with at least a partial response 3 months after starting sacituzumab govitecan for presumed triple-negative pleural disease.

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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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Breast Cancer Recurrence in the Small Intestine and Bone More Than 5 Years After Diagnosis

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

Biomarkers: Initial ER-positive, PR-positive, HER2-negative; metastatic lesion ER-negative, PR-negative, triple negative

Metastatic Site: small intestine, bone, right fallopian tube

More than 5 years after her December 2018 diagnosis, she was alive at 1-year follow-up after metastatic recurrence, with multiple bone metastases still present.

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