What is the incidence of Stage 4 (metastatic) breast cancers in the United States (US)?

From the Guidelines

Stage 4 breast cancer accounts for approximately 6-10% of all newly diagnosed breast cancer cases in the United States, representing about 20,000-30,000 new cases annually, as estimated by recent studies 1. The incidence of Stage 4 (metastatic) breast cancers in the United States is a significant concern, with breast cancer being the most common malignancy in females in the US and the second leading cause of cancer death 1.

Key Statistics

• Approximately 313,510 Americans are estimated to be diagnosed with breast cancer in 2024, with 42,780 expected to die from the disease 1.
• The 5-year relative survival rate for stage 4 breast cancer is approximately 29%, varying based on factors like hormone receptor status, HER2 status, age, overall health, and response to treatment 1.

Treatment Options

• Systemic therapies, including hormone therapy, targeted therapies, chemotherapy, and immunotherapy, are commonly used to treat stage 4 breast cancer 1.
• Local treatments like surgery or radiation may be used to manage specific symptoms 1.

Quality of Life

• While stage 4 breast cancer is generally considered incurable, many patients can live for years with good quality of life through ongoing treatment, and clinical trials continue to advance available therapies 1. It is essential to prioritize the most recent and highest-quality study, which in this case is the 2024 NCCN Clinical Practice Guidelines in Oncology for Breast Cancer 1. This guideline provides the most up-to-date information on the incidence, treatment, and management of breast cancer, including stage 4 disease.

From the Research

Incidence of Stage 4 Breast Cancer in the US

• The incidence of Stage 4 (metastatic) breast cancer in the US is estimated to be around 6-10% of all breast cancer cases in the developed world 2.
• A more specific estimate for the US is not provided in this study, but it is noted that the incidence is higher in other parts of the world.
• De novo metastatic breast cancer, which is metastatic breast cancer diagnosed at the initial diagnosis, represents approximately 3% to 6% of new breast cancer diagnoses in high-income countries, including the US 3.

Epidemiology of Metastatic Breast Cancer

• The number of women living with metastatic breast cancer in the US is estimated to be around 154,794 as of 2017 4.
• The median survival and 5-year relative survival for de novo metastatic breast cancer have increased over the years, especially in younger women 4.
• The incidence of metastatic breast cancer has not declined despite decades of widespread use of population-based mammography screening 3.

Trends in Metastatic Cancer

• The incidence of metastatic cancer in the US has been studied, and it was found that the most frequent primary cancers were lung, colorectal, and ovarian 5.
• The use of local therapies has decreased for almost all sites, and the use of systemic therapies has increased across multiple sites, including breast cancer 5.
• The overall breast cancer death rate has continuously declined during 1989-2022 by 44% overall, but the mortality rate remains higher for Black women compared to White women 6.