The symptoms of primary breast cancer and metastatic breast cancer can be very different. Metastasis occurs when the cancer spreads (metastasizes) beyond the breast where the tumor originated to other tissues or organs throughout the body, such as the bones, lungs, liver or brain.
Also known as stage 4 or advanced breast cancer, metastatic breast cancer may be present at the time of an initial breast cancer diagnosis. Or, it can develop months or even years after early or locally advanced breast cancer (stage 1, 2 or 3) is diagnosed and treated. For instance, after a primary breast tumor is removed, microscopic cancer cells can sometimes remain in the body. Over time, those residual cancer cells may grow, invade nearby healthy cells and cause breast cancer recurrence. The cancerous cells may also enter the bloodstream or lymphatic system, travel to distant tissues and organs and cause a breast cancer metastasis.
Signs of a breast cancer metastasis
The symptoms of metastatic breast cancer can vary depending on the area of the body and the type of tissue or organ affected, such as:
Breast cancer that has spread to the brain may cause:
- Attention or memory problems
- Blurred vision, double vision or vision loss
- Severe headaches
- Behavioral or personality changes
- Loss of balance
- Constant nausea or vomiting
Breast cancer that has spread to a lung may cause:
- Constant dry coughing
- Shortness of breath
- Chest pain
Breast cancer that has spread to the liver may cause:
- Jaundice (a yellowish tinge to the skin and the whites of the eyes)
- Itchy skin or a skin rash
- Loss of appetite
- Constant nausea or vomiting
- Unintended weight loss
- Pain, tenderness or swelling in the belly
- Swelling in the hands or feet
- A change in bowel habits
Breast cancer that has spread to a bone may cause:
- Severe and progressive neck, back, bone or joint pain
- Bone fractures without significant trauma
Other tissues & organs
Breast cancer that has spread to other tissues and organs may cause:
- Unexplained fatigue
- Difficulty passing urine
- Swollen lymph nodes in the armpits
- Numbness or weakness anywhere in the body
Most metastatic breast cancer symptoms can also be related to other health conditions or treatment side effects, but it is important to discuss them with a physician if they persist for more than two weeks.
Follow-up care after breast cancer treatment
After completing treatment for early or locally advanced breast cancer, most patients have regular follow-up care to help manage any lingering side effects of treatment and to check for possible signs of local recurrence or metastasis. This routine medical care may involve:
Most breast cancer patients are initially scheduled for follow-up appointments with their physician every few months. Over time, the frequency of the visits will gradually decline. When the patient reaches the five-year mark, the follow-up visits may be scheduled yearly.
Patients who have breast-conserving surgery, such as a lumpectomy or a partial mastectomy, are generally advised to have a mammogram six months after completing radiation therapy, and then at least every year after that. Patients who have a single mastectomy are advised to have yearly mammograms on the remaining breast.
To help prevent a breast cancer recurrence, some patients take tamoxifen, a hormone drug that can slightly increase the risk of endometrial (uterine) cancer. Patients who take tamoxifen and have an intact uterus are advised to have a yearly pelvic exam and to be especially watchful for uterine cancer symptoms, such as abnormal vaginal bleeding.
Bone density tests
Most breast cancers require the female hormone estrogen to survive and grow. Some treatments, such as aromatase inhibitors, work by starving the cancer of estrogen. Because estrogen is important for maintaining bone strength in women, breast cancer treatments that act against estrogen can lead to bone weakening. Additionally, estrogen levels decline naturally after menopause. For these reasons, it may be important to monitor a patient’s bone health with periodic bone scans.
Testing for breast cancer metastasis
If a patient’s symptoms, follow-up exam or screening test suggests a possible breast cancer recurrence or metastasis, a physician may suggest a:
- Blood test (including tumor markers)
- Whole-body bone scan (with or without X-rays of specific bones)
- X-ray or ultrasound of the belly or chest
- CT scan of the chest, belly, pelvis or brain
- MRI of the spine or brain
- PET scan
- Tap, which involves the removal of fluid from the area with symptoms to check for cancer cells (a pleural tap removes fluid from the area between the lungs and chest wall, while a spinal tap removes fluid from the area around the spinal cord)
Discuss your symptoms with a specialist at Moffitt
If you are concerned about metastatic breast cancer symptoms, you can consult with the outstanding team of experts in the Don & Erika Wallace Comprehensive Breast Program at Moffitt Cancer Center, where all of our diagnostic, treatment and supportive care services are available in a single location. To request an appointment, please call 1-888-663-3488 or complete our new patient registration form online.