When breast cancer spreads to other parts of the body, such as the bones, brain, liver, or lungs, it is called metastatic (also referred to as advanced or stage IV) breast cancer. While it is not curable, metastatic breast cancer can be treatable — especially with the advent of new therapies, including biologic targeted treatments and novel drug combinations. Today, women with metastatic breast cancer can live well for many years.
Metastatic breast cancer does not always show what might be considered “typical” symptoms, such as a lump or other change in the breast. Common symptoms of metastatic breast cancer also differ depending on size and location of the cancer’s spread.
The most common areas that breast cancer spreads to are the:
- Chest wall
- Lungs
- Liver
- Bones
- Lymph nodes
- Brain (the brain is far less likely to be the first place that breast cancer spreads, but it can sometimes occur)
What are the symptoms of metastatic breast cancer?
Symptoms of chest wall metastasis can include:
- Severe pain
- Lump(s) in the skin or chest area
Symptoms of lymph node metastatic can include lumps:
- In the underarm area
- Above the collarbone
- In the neck
Symptoms of bone metastasis can include:
- Pain, especially in the bones in the center of the body such as the skull, backbone, ribs, or hips (breast cancer does not frequently travel to the elbows, hands, wrists, knees, ankles, or feet)
- Having bones that are more easily fractured or broken
Symptoms of lung metastasis can include:
- Difficulty breathing
- Chronic cough
- Chest wall pain
- Coughing up blood
Symptoms of liver metastasis can include:
- Swelling in the belly
- Jaundice (yellowing of the skin)
- Abdominal pain, especially in the right side just under the lower ribs
Symptoms of spinal cord or brain metastasis can include:
- Confusion
- Vision disturbances
- Difficulty with speech or movement
- Weakness, especially if it affects one side of the body more than the other
- Severe headache or head pressure
- Vomiting or nausea
- Seizures
General symptoms of metastatic breast cancer, independent of metastasis location, include:
- Fatigue
- Weight loss
- Lack of appetite
Contact your physician’s office if you experience any of these symptoms. Much of the time, talking through your symptoms can be reassuring and no further testing will be needed. However, depending on your symptoms, you may be advised to have additional testing and/or to see your oncology team for an evaluation.
About the Medical Reviewer
Dr. Lin is a medical oncologist specializing in the care of patients with all stages of breast cancer. Her research focuses upon improving the outcomes of people living with metastatic breast cancer, including a particular focus on the challenge of breast cancer brain metastases. She has led multiple clinical trials which have led to new treatment options for patients with breast cancer that has metastasized to the brain.
Dr. Lin received her MD from Harvard Medical School in 1999. She completed her residency in internal medicine at Brigham and Women's Hospital and went on to complete fellowships in medical oncology and hematology at Dana-Farber. In 2005, she joined the staff of Brigham and Women's and Dana-Farber, where she is a medical oncologist and clinical investigator in the Breast Oncology Center.