Ask about immunotherapies. Sometimes they can be miracles.

Thank you for the update OP- best wishes to you and your sister. Your 2nd opinion dr sounds very much like my oncologist- very upbeat and positive without sugar coating. I have found that type of dr to be a great person to have in your corner coordinating treatments.

OP here with an update:

First I want to say thank you to all of you - the more responses I'm reading, the more hopeful and positive I'm feeling.

We just got off a conference call with my sister's 2nd opinion doctor there in Bethesda. She was extremely upbeat and positive. And while she didn't give us any false hope or try to sugar coat my sister's situation, she made sure to tell my sister that she needs to live her life as normally as possible. That a lot of it is about her attitude, and her desire to keep trying new treatments. While we all know this will be a long journey ahead for my sister, she can possibly live many years with MBC as more of chronic condition - as some of you have also said. The doctor also echoed a lot of what many of you have written - that the field of breast cancer research is one of the most active out there. That pharmaceutical companies are constantly coming out with new, and better treatments more so than most any other type of cancer. And that if she gets on the right regimen, she could go into a temporary remission for 2-3 years and when the cancer returns (and it will), they just move on to the next treatment in line.

Thank you again to everyone who has posted. Your thoughts, prayers, and sound advice have really helped me wrap my mind around what's happening with my sister.

Having had a several folks close to me go through cancer treatments, let me say the hardest part is right after diagnosis. Your mind constantly does “what if”. Once you start down a treatment path it’s better because you are actively “doing” something. You must also be prepared that there may be twists and turns in the treatment. Something that was working, stops, or there is a delay in a part of treatment that cause the next part to be delayed etc. My thoughts are with your sister and your family.

I think it is critically important to get second and third opinions and to take the best advice of top experts. One of my dear friends (also single, no kids) was diagnosed and initially treated with radiation and hormonal therapies successfully for 2 years. But when they stopped working effectively, she initially rejected or refused new more aggressive treatments involving chemo because she didn't want to lose her hair (and apparently she had not told her newish employer or many of her friends of her diagnosis). Her close friends and family urged her to seek more opinions (figuring she would be more likely to finally get the recommended chemo) but she was in denial and delayed too long. Of course, it was important for her to feel in control but we were saddened by her reluctance to fully accept her MBC diagnosis, medical advice, and fight hard because (we feel) it would have prolonged her life.

My mother's friend was diagnosed with MBC over 25 years ago. She ended up living with it for over 15 years, treated before the new effective drugs. The chemo ravaged her body/bones but she was still able to get around, though with a cane. She did not die of MBC but from an accidental fall/concussion.

Prayers to your sister and family!

I'm so sorry to hear this OP, but you've gotten a lot of good advice already on this thread. My MIL lived with stage 4 BC for almost 15 years, and she died over 10 years ago so there are even more treatments available now. She was treated at Hopkins - I highly recommend them (I went there myself for BC treatment).

This is an (online) friend of mine who I know from the breastcancer.org message boards - https://www.facebook.com/ButdoctorIhatepink She had stage 4 mets in her liver, but after surgery and chemo, she is still NED (no evidence of disease) 10 years later.

Your sister is lucky to have you - take care.