Staging and receptors for secondary breast cancer

The stage of a cancer describes its size and if it has spread from where it started. This information affects the decisions you and your doctor make about your treatment. Doctors often stage breast cancer using a system that divides it into four number stages.

Secondary breast cancer is stage 4. This is when the cancer has spread to other parts of the body such as the bones, liver or lungs.

Doctors sometimes call secondary breast cancer metastatic breast cancer.


Breast cancer cells often have receptors (proteins) that hormones or other signals can attach to and encourage the cells to grow.

A pathologist does tests on the cancer cells to find out whether receptors are present and what type they are. The results help you and your doctor to decide on the most effective treatment for you.

You will usually have had tests for HER2 (human epidermal growth factor 2) and hormone receptors done when you were first diagnosed with breast cancer.

You may have a biopsy taken from the secondary cancer to re-check the hormone and HER2 receptors. This is because they may not be identical to the primary cancer. Your cancer doctor will explain more about this.

Hormone receptors

If you haven’t been treated for breast cancer before, your doctor will take a biopsy from the secondary cancer. If this is not possible, they will take a biopsy from the primary cancer.

Some cancers have receptors for the hormones oestrogen and progesterone. Hormones act as chemical messengers and influence how cells grow and what they do.

Breast cancer that has oestrogen receptors is called oestrogen receptor-positive or ER-positive. ER is used because the American spelling of oestrogen is estrogen.

ER-positive breast cancer usually responds well to treatment with hormonal therapies.

Breast cancer that does not have oestrogen receptors is known as ER-negative.

Protein receptors

Some cancers have receptors for a protein called HER2 or human epidermal growth factor 2. Breast cancers with high levels of HER2 are called HER2-positive. Targeted therapy drugs such as trastuzumab (Herceptin®) are helpful treatments.

Women diagnosed with breast cancer now always have the cancer cells tested for HER2 receptors. If you were diagnosed with primary breast cancer a long time ago, you may not have had this done. Your doctor will try, if possible, to take a biopsy from the secondary cancer or use cells from previous biopsies or surgery for testing.

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Treatment overview

Treatment aims to control the cancer, relieve symptoms and help you live longer with a good quality of life.