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Symptoms of secondary (metastatic) breast cancer

Secondary breast cancer, also known as metastatic breast cancer and advanced breast cancer, occurs when the tumour spreads beyond the primary site of the breast. Many women diagnosed with secondary breast cancer have already been diagnosed and successfully treated for breast cancer, and for others being diagnosed with secondary breast cancer may be their inkling that they’ve had cancer.

Breast cancer originates in the breast, and can be treated with surgery, radiation, chemotherapy and targeted treatments to eliminate all of the cancer cells. However, we do not currently have sensitive enough tools to know if every microscopic cancer cell has been eradicated, so cancer cells may be left behind in surgery. They may also survive treatment or escape into the blood stream before treatment starts. It only takes a single cancer cell in the body for it to grow into a tumour and spread.

General symptoms

The most common places that breast cancer spreads to are the bones, liver, lung and brain, but not all cancers will spread to all these places. Every woman’s experience of metastatic breast cancer is different and symptoms will depend on what part of the body is affected and they could develop over weeks or months.

It’s unlikely that a woman will have all of the symptoms listed below. Some women may experience general symptoms such as being more tired than usual, low energy levels, feeling under the weather, and having a poor appetite. Many of these general symptoms are the same as for colds or the ‘flu.

Remember that if you have been treated for breast cancer, discuss any new pain with your doctor or breast care nurse.

Symptoms of cancer spread to the lymph nodes

If breast cancer cells have spread, they can usually be found in the lymph nodes around the armpit. You may feel a firm, often painless, swelling under your arm. Breast cancer cells can also spread to lymph nodes in other parts of the body. The most common places are the nodes behind the breastbone or above or below the collar bones. Let your specialist or breast care nurse know if you find swelling or lumps in these areas.


Symptoms of cancer spread to bone

Bone is the most common place for breast cancer to spread to, usually affecting the spine, ribs, skull, pelvis, or upper bones of the arms and legs. One of the first symptoms of cancer in the bone is usually a constant ache or pain in the bone. The pain can get worse during movement and can make it difficult to sleep at night.

Secondary cancer in the bone may damage the part of the bone affected by cancer cells. The more the bone is damaged, the weaker it gets. Pain and weakness can make it hard to move around. A very weak bone may break more easily too.

Sometimes when bones are damaged by secondary cancer, the bone cells release calcium into the blood which can cause various symptoms such as tiredness, nausea, constipation, irritability, thirst, and/or confusion.

Secondary breast cancer in a bone can be treated and usually the treatment can be started long before the bone becomes weak enough to break or cause a lot of pain.

Symptoms of cancer spread to the liver

Symptoms of cancer in the liver include weight loss, tiredness and discomfort in the area of the liver (on the right side of the abdomen or tummy). Some women also feel sick or lose their appetite. Some women develop a swollen abdomen because of a build-up of fluid and have discomfort on the right side of their abdomen (where the liver is).

Secondary breast cancer in the liver can cause pain if the cancer presses on the fibrous tissue covering the liver.

The liver has a lot of functions in the body. One is to make bile to help digest food in the intestine. If the drainage channels leading from the liver are blocked by secondary cancer, bile may build up in the blood. This causes jaundice, where the skin and whites of the eyes become yellow and your skin may feel itchy.

The liver can still work well when part of it, or even most of it, is affected by cancer cells. And the symptoms of secondary breast cancer cells in the liver can usually be well controlled.

Symptoms of cancer spread to the lungs

One of the first symptoms of cancer in the lungs is shortness of breath or a dry cough. Some women also have chest pain or a feeling of heaviness in the chest.

Cancer cells on the outside of the lungs can irritate the lining around the lungs and cause discomfort when breathing. Fluid may build up and press on the lungs and women notice quite a change in their breathing if this happens.

Breathing problems can be frightening. But there are ways to treat breathlessness from secondary breast cancer which soon make it easier to breathe.

Symptoms of cancer spread to the brain

The idea of secondary cancer affecting the brain can be very frightening, but the brain can work well even if part of it is affected by cancer. Secondary breast cancer in the brain can cause different symptoms depending on which part of the brain is affected.

Symptoms can include a headache that doesn’t go away and may be worse in the morning, nausea (feeling sick) and vomiting.

Sometimes cancer in the brain causes changes in the part of the body controlled by that part of the brain. For example, an arm or leg might become weaker or your vision may become blurred. Cancer in the brain can also cause seizures (fits). In rare cases, cancer in the brain can cause confusion or a change in behaviour or personality.

For more information on secondary breast cancer – http://nbcf.org.au/news/research-news/stage-4-secondary-breast-cancer/