Treatment of stage 4 breast cancer in Germany | Booking Health

Treatment of stage 4 breast cancer in Germany

The article was reviewed by an expert in the field of medicine Prof. Dr. med. Thomas Vogl
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Breast cancer is diagnosed in more than 2 million women every year. This disease is most common amongst the female population. About 15% of all cases are malignant tumors. The tumor is detected at an early localized stage in 70% of cases, but 10% of patients are diagnosed with stage 4 breast cancer with metastases. Thanks to constant research and the development of new effective treatment methods for stage 4 breast cancer, it is possible to achieve positive results and thereby increase a patient’s life expectancy by several years.


  1. What are the limitations and disadvantages of standard stage 4 breast cancer treatment?
  2. The very latest and the most effective treatment methods for stage 4 breast cancer
  3. Selection of the specialized oncology hospitals in Germany. Where is it best to undergo treatment?

What are the limitations and disadvantages of standard stage 4 breast cancer treatment?


Stage 4 breast cancer means that the tumor has already metastasized. It does not matter what size the primary tumor was.

The standard treatment methods for breast cancer are not without their drawbacks. The main problems are:

  • The disease cannot be completely cured.
  • Toxic chemotherapy regimens are used, which cause many side effects and sometimes lead to critical complications.
  • Chemotherapy suppresses the immune system and prevents the immune system from fighting the tumor.

German hospitals have innovative treatment methods for stage 4 breast cancer. These include targeted molecular therapy, chemoembolization of tumor vessels, and immunotherapy. Thanks to these methods, it’s become possible to achieve tremendous results in the treatment of this disease, with a minimal risk of complications.

The very latest and the most effective treatment methods for stage 4 breast cancer


Germany is one of the world leaders in the effectiveness of breast cancer treatment. The doctors in this country pay great attention not only to the patient's life expectancy, but also to the quality of their life. The preference is given to sparing treatment methods, which are well tolerated and allow the patient to return to an active life.

German hospitals have state-of-the-art equipment and employ the most reputable oncologists in the world. About 80% of all research in oncology is also carried out here. The very latest treatment methods for stage 4 breast cancer are developed and implemented here.

The innovative and the most effective treatment methods for IV stage breast cancer in Germany include:

Embolization of metastases


Some specialized German hospitals use transarterial chemoembolization or embolization for stage 4 breast cancer. The essence of this method is to close the lumen of the vessels. The procedure is used in different modifications and for different purposes.

Cytoreductive regional therapy


Regional chemotherapy or chemoembolization for the treatment of the fourth stage breast cancer can be used for local control of the primary tumor. The administration of chemotherapy agents directly into the arteries feeding the tumor is more effective, since this allows for creating high drug concentrations in the tumor tissues. The procedure avoids traumatic surgery and breast removal.

The tumor can have different sources of blood supply. Prior to the procedure, the doctor injects a contrast agent into the arteries and takes X-ray images to determine which vessels feed the tumor. He then injects emboli into these vessels: these can be mammary, internal thoracic, intercostal artery, or branches of the subclavian artery. Such targeted embolization is called selective embolization. It leads to the partial death of the tumor, the healing of ulcerative defects, and pain relief, as early as 2-3 days after the procedure.

The manipulation is minimally invasive. It is performed through a small incision in the groin. The doctor inserts a catheter into the vessels and delivers emboli to the target vessels under X-ray guidance.

The main indications for chemoembolization are as follows:

  • inoperable tumors;
  • recurrence after surgery, which is resistant to other treatment methods;
  • hemorrhages and sores on the breast skin – these heal quickly after embolization.

Chemoembolization involves the use of microspheres saturated with drugs. They are injected into the arteries feeding the tumor. In Germany, doctors use emboli to block the vessels located as close to the tumor as possible. Such an approach allows the specialists not only to achieve better results in stage 4 breast cancer treatment, but also to reduce the number of complications that can arise.

The procedure is almost always effective. At the very least, it allows the doctors to stabilize the oncological process. Some patients have a partial response (reduction of the primary tumor). In addition, the procedure reduces the risk of complications and heals any ulcers on the breast skin.

Chemoembolization is often combined with radiation therapy. It is also complemented by systemic treatment methods.


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Embolization for metastasis control 


Liver metastases occur in 80% of patients with metastatic breast cancer. These can be controlled by  hepatic artery chemoembolization.

The surgical removal of metastases is possible in only 10% of patients. Even if surgery is performed, the risk of recurrence is 70% within 3 years and 90% within 5 years. Transarterial chemoembolization of the hepatic artery is used for inoperable metastases, as well as for their recurrence after surgery.

The liver has a double blood supply:  it receives 70% of its blood from the portal vein and 30% from the hepatic artery, but tumor nodes receive 95% of their blood supply from the hepatic artery. Therefore, when its lumen is closed, metastatic tumors decrease by several times their size, and sometimes – by several tens of times their size. At the same time, the healthy parenchyma does not really suffer, so the liver function is preserved.

Chemoembolization involves the introduction of emboli with chemotherapy agents into the branches of the hepatic artery: they not only block the blood supply to the tumor, but also release cytostatics, which destroy cancer cells for several weeks.

This method has the following advantages:

  • minimal invasiveness;
  • no need for long-term hospitalization and rehabilitation; 
  • minimal risk of complications;
  • repeated use in cases of disease progression.


Immunotherapy for breast cancer




Breast cancer is not a highly immunogenic tumor. Immunotherapy as a treatment for this disease was not used in medicine for a long time. However, with the development of molecular diagnostic methods, the situation has changed. It turns out that at least two types of breast cancer are highly immunogenic. These are:

  • Triple-negative breast cancer (TNBC)
  • HER2-positive breast cancer

In these types of cancer, the doctors use immunotherapy for stage 4 breast cancer and it successfully increases the life expectancy of patients.

The most researched group of drugs are checkpoint inhibitors. These are antibodies which target PD-L1 and PD-1 proteins. In triple-negative breast cancer, a combination of two drugs allows doctors to achieve a response in 70-90% of cases. Most patients receive a partial response to therapy – reduction of the tumor and metastases by 30% or more of the original size. 10% of patients get a total response – the complete absence of tumors during radiation diagnostics. Another 10-20% of patients achieve stabilization – the cessation of tumor growth, or its reduction, by less than 30%.

Other variations of immunotherapy can be used as part of clinical investigations. These include:

  • Treatment according to the TIL protocol. Immune cells are obtained from the patient's tumor tissue. They are characterized by their higher aggression against cancer cells. The lymphocytes are then cultured in the laboratory to increase their number, the most aggressive ones are selected and cultured again. After a few weeks, the cells are injected into the patient's body. They attack the primary tumor and metastases. If successful, the pathology regresses.
  • CAR T-cell therapy. The chimeric antigen receptor is attached to the patient's immune cells. After the injection of the modified T-lymphocytes into the body, they attack targets – certain protein molecules on the surface of the cancer cells. This method has proven itself especially well in hemoblastosis.
  • Vaccines. Breast cancer vaccines targeting Her-2 and MUC-1 antigens demonstrated good results in their clinical investigations. The vaccine helps immune cells recognize the tumor so they can destroy it. Phases 2-3 of the clinical investigations on vaccine therapy have already confirmed good results. Different vaccines have shown efficacy in 30-40% of cases (stabilization or partial response). Some patients achieved stabilization of the disease for more than 3 years.


Treatment of stage 4 breast cancer in Germany


Selection of the specialized oncology hospitals in Germany. Where is it best to undergo treatment?


It is no longer a secret that patients who undergo treatment in Germany are sure to get high-quality and effective results. State-of-the-art medical equipment, doctors who are constantly improving their qualifications, the introduction of the very latest achievements in the treatment of various types of diseases, and top-class services – all of these factors make it possible to achieve the highest results in the treatment of patients.

The leading German hospitals that successfully treat women with stage 4 breast cancer are:

  • University Hospital Tuebingen, Department of Adult and Pediatric Gynecology, Mammology, Obstetrics
  • University Hospital Ulm, Department of Obstetrics, Adult and Pediatric Gynecology
  • University Hospital Frankfurt-am-Main, Department of Adult and Pediatric Gynecology, Obstetrics and Mammology
  • Charite University Hospital Berlin, Department of Adult and Pediatric Gynecology, Mammology
  • University Hospital Erlangen, Department of Adult and Pediatric Gynecology, Mammology, Obstetrics

It is not easy to make a decision to undergo medical treatment abroad. Especially when it comes to organizing all the nuances of stage four breast cancer treatment in the shortest possible time. In this case, you need to act promptly and clearly.

To undergo personalized stage 4 cancer treatment in one of the best oncology hospitals in Germany, you can use the services of Booking Health. If you contact us, you will not only save precious time, but also get qualified assistance. Our doctors and managers will take care of the complete organization of your treatment. We will select a specialized oncology hospital and an oncologist for you as soon as possible. In addition, we provide a full package of services. This includes:

  • selection of a highly qualified hospital and direct communication with the attending physician;
  • preliminary preparation of your medical treatment program, without repeating any previous diagnostic examinations;
  • provision of a favorable average cost of treatment, without any extra charges and coefficients for foreign patients (saving up to 50%);
  • doctor's appointment on your desired date;
  • control of your medical program at all its stages;
  • assistance in buying and forwarding medicines;
  • communication with the hospital after your treatment’s completion; 
  • monitoring of invoices and return of unspent funds;
  • organization of additional diagnostic examinations;
  • top-class services for booking hotels, airline tickets, transfers, and interpreting services.

To get professional help in planning treatment in Germany, please leave your request on the official Booking Health website. A competent medical consultant will discuss with you all the medical details and help you to correctly prepare for your flight and treatment.


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The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Alexandra Solovey. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

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