January 9, 2024
January 9, 2024

Metastatic Breast Cancer Symptoms: Insights and Advice

Reviewed By:
Metastatic Breast Cancer Symptoms: Insights and Advice

Every two minutes, a woman in the U.S. is diagnosed with breast cancer. Metastatic breast cancer, also called Stage IV breast cancer, is a type of breast cancer that has spread beyond the breast to the lymph nodes and other parts of the body. 

This spread (metastasis) can occur when cancer cells enter the bloodstream or the lymphatic system. Because it’s a more advanced stage of breast cancer involving more than one site, it requires different treatment approaches compared to earlier stages.

Here, we’ll review the most common metastatic breast cancer symptoms and the areas where breast cancer is most likely to spread first. We’ll also discuss risk factors, breast cancer stages, and treatment options. Plus, you’ll learn proactive strategies to help you detect cancer earlier when treatment is less invasive and more effective. 

What Areas of the Body Does Breast Cancer Spread to First?

When it's not caught early, primary breast cancer tumors continue to grow uncontrolled. Eventually, cancer cells can break away from the primary tumor and spread to other organs and tissues in the body. The most common areas for breast cancer metastases are:

  • Bones
  • Liver
  • Lungs
  • Brain
  • Skin or other organs

What Are the Most Common Metastatic Breast Cancer Symptoms?

Metastatic breast cancer symptoms: woman holding her neck and her lower back

Signs and symptoms of metastatic breast cancer may include general conditions such as unexpected weight loss and poor appetite that occur alongside more specific symptoms based on the size or extent of tumors, the type of breast cancer, and the location of the metastasis. Please note that not all patients will experience the same symptoms. 

Bone metastasis: Bone pain and bone fractures are most common. High calcium levels may occur due to bone loss, leading to symptoms like loss of appetite, nausea, thirst, and confusion.

Liver metastasis: Jaundice (yellowing of the skin and eyes), itching, or abnormal liver enzymes may be detected on blood tests.

Lung metastasis: Metastatic disease may lead to shortness of breath, chest pain, or persistent dry cough.

Brain metastasis: Headaches, seizures, vision problems, or changes in speech or behavior often occur.

How Is Stage IV Breast Cancer Diagnosed and Treated?

When breast cancer spreads to remote parts of the body, the five-year relative survival rate drops to about 29%. This significant drop underscores the challenges in treating advanced breast cancer that has metastasized to other organs and parts of the body. It also emphasizes the importance of early detection and treatment of breast cancer.

What Are Symptoms of Inflammatory Breast Cancer?

Inflammatory breast cancer (IBC) is rare but aggressive. It happens when cancer cells block the lymph vessels in the breast’s skin or when cells infiltrate the lymphatic vessels in the breast, causing symptoms that look like inflammation or edema (heavy with fluid). 

Because there is no breast lump, many women overlook the signs of IBC or attribute them to other causes like injury, dermatitis, or even a viral infection like the flu. IBC may also be more challenging to spot on a traditional mammogram. This means that by the time it’s diagnosed, the cancer is in more advanced stages.

The symptoms that set IBC apart include:

  • The breast's skin appears red and feels warm
  • Enlargement of the breast with a heavy sensation
  • Pronounced orange-peel texture, a notable symptom in IBC
  • Tenderness, pain, or itchiness in the breast area
  • Changes in the nipple, such as inversion or retraction
  • Lymph node swelling under the arm(s) or near the collarbone

What Are Metastatic Breast Cancer Treatment Options?

Most metastatic breast cancer treatment involves removing the cancerous tissue from the body, shrinking cancer tumors, or systemic therapies to target cancer cells throughout the body. Even with a poor prognosis, oncologists may recommend treatment if it might improve the patient’s quality of life. Here’s a closer look at treatments for metastatic breast cancer.

  • Surgery: This is the primary treatment for early-stage breast cancer, with options ranging from a breast-conserving surgery that removes only the tumor (lumpectomy) to a partial or full mastectomy (removal of the entire breast)
  • Radiation therapy: This follows surgery and targets the area around the tumor site to kill any remaining cancer cells
  • Chemotherapy: Similar to early-stage treatment, this may be used alone or with other medications
  • Hormone therapy: For hormone receptor-positive cancers, hormone therapy remains an important treatment option
  • Targeted therapy: These medications target specific molecular defects in cancer cells
  • Immunotherapy: Immunotherapy for breast cancer is a newer approach that helps the body's immune system recognize and attack cancer cells
  • Supportive care: For very advanced cases, treatment is supportive care to limit metastatic breast cancer symptoms. This care may include hospice, comfort measures, and support groups

How Can I Prevent Advanced Breast Cancer?

Finding breast cancer at its earliest stage drastically improves the chances of successful treatment and long-term survival. For cancer that has not spread beyond the breast, the five-year survival rate is nearly 100% per the SEER database. This high rate reflects the effectiveness of treatment when cancer is detected early and confined to its original location.

In cases of regional breast cancer, where the cancer has spread to nearby lymph nodes. According to the SEER database, the five-year relative survival rate is approximately 86%. Compared to localized cancer, this lower survival rate highlights the impact of metastasis.

You can’t always prevent breast cancer from advancing, but there are things you can do to improve your chances of early detection and successful treatment.

Be Aware of Early Symptoms

Unlike metastatic breast cancer symptoms, early signs of breast cancer are more localized. The most common symptoms of early-stage breast cancer:

  • A lump in the breast or underarm area is often the first noticeable symptom of breast cancer
  • Change in the breast’s size, shape, or appearance, including unexplained swelling or breast density, particularly in one breast
  • Changes to the skin over the breast (e.g., redness, puckering, dimpling, or scaling)
  • Changes to the nipple, such as a nipple turning inward, redness, scaly or dry skin, or unusual discharge 
  • Persistent pain in a specific area of your breast — most often, breast cancer is painless; however, constant pain in the breast or nipple could also be a symptom of breast cancer 

Perform Regular Self-Breast Exams

Metastatic breast cancer symptoms: cutaway diagram of a woman's breast

Performing a breast self-exam (BSE) monthly helps you get to know your breasts and is one of the best ways to detect any unusual changes. Perform BSE about 7-10 days after the start of your menstrual period when your breasts are less swollen.

A breast lump can feel different depending on its cause. It can be soft or hard. Read our guide to know what a breast lump feels like and keep these guidelines in mind:

  • Suspicious lumps are round and distinct, with defined edges, making them different from the surrounding tissue
  • They might be painful or painless
  • Some lumps move easily within the breast while others may feel like they are attached to the skin or deeper breast tissue

Remember that not all lumps you feel are cancer—benign breast conditions such as fibrocystic changes and hyperplasia or scarring. As you get to know what your breasts feel like usually, you’ll be better able to notice subtle changes. 

Here's a simple step-by-step guide to walk you through a self-breast exam.

1. Visual Inspection

  • In front of a mirror, place your hands on your hips and keep your shoulders straight
  • Ensure your breasts are not changing in size, shape, or symmetry
  • Observe dimpling or puckering of the skin (deeper indentions), as well as changes to the skin's thickness or texture
  • Take a look at the same changes by raising your arms over your head
  • Look for any nipple changes, such as inversion 

2. Physical Examination (While standing)

  • Examine the left breast using the right hand and the right arm overhead
  • Make a circular pattern with your fingers, moving from the outside to the center; you can also use a vertical or wedge pattern
  • Make sure you examine the entire breast and armpit area
  • To feel the surface and deeper tissues, apply light, medium, and firm pressure
  • Gently squeeze the nipples and look for discharge
  • Check for any nipple changes, like inversion or discharge

3. Physical Examination (While lying down):

  • Place a pillow under your right shoulder and your right arm behind your head when you lie down
  • Gently but firmly move your fingers around the right breast with your left hand in small circular motions
  • Examine the breast area and armpits
  • Using your right hand, repeat for the left breast

Know Your Risk Factors

The Ezra cancer risk calculator can help assess your chances of developing certain types of cancer and it only takes five minutes of your time. It works by assessing known risk factors such as:

  • Personal medical history
  • Family medical history, including inherited genes that increase cancer risk
  • Age
  • Smoking history
  • Breast disease
  • Radiation exposure
  • Obesity

Get Genetic Testing

Genetic testing for breast cancer involves analyzing your DNA to look for specific inherited mutations that increase your risks. This testing is mainly focused on mutations in genes like BRCA1 and BRCA2, which significantly raise the risk of breast and ovarian cancers. The American Cancer Society recommends talking to your oncologist or healthcare provider about whether genetic counseling and potential testing are right for you if you have any of the following:

  • Strong family history of breast cancer or known gene mutations
  • Close relatives with a history of triple-negative breast cancer or HER2-positive breast cancer
  • Moderate family history of breast cancer and are of Ashkenazi or Eastern European Jewish ancestry
  • Recent or current cancer diagnosis at a young age
  • Multiple types of cancer or multiple people with cancer in your family
  • History of breast cancer at a younger age (before age 50)
  • Diagnosis of male breast cancer at any age

Have Regular Mammograms

The American Cancer Society mammogram recommendations are evidence-based and formulated by a panel of oncologists, cancer research specialists, patients, and advocates. 

  • Women between the ages of 40 and 44 have the choice to start annual breast cancer screening with mammograms if they wish to do so
  • Women aged 45 to 54 should get mammograms every year
  • Women 55 and older can switch to mammograms every other year or they can choose to continue yearly mammograms
  • If you are at high risk due to family history or genetics the ACS recommends annual mammograms and breast MRIs

If you’re concerned about elevated risk factors and wish to start having mammograms earlier, you should discuss the risks and benefits with your doctor before deciding on a plan.

What Is the Ezra Mammogram?

At Ezra, we constantly seek ways to empower women and improve health outcomes. The Ezra mammogram is an AI-enabled breast cancer screening mammogram. Developed in collaboration with RadNet, it uses advanced technology such as AI and machine learning to enhance accuracy, reduce false positives, and give our patients greater peace of mind.

AI helps our radiologists detect more subtle lesions, potentially leading to earlier diagnosis and treatment. The importance of early detection of breast cancer can’t be overstated. 

As mentioned earlier, when caught in Stage 1, the five-year survival rate is almost 100%. Regular mammograms, especially with EBCD's advanced technology, have the potential to detect cancer early and improve your long-term health.

Book Your Mammogram Online Now

Metastatic breast cancer symptoms: doctor assisting her patient

As breast cancer advances, it often spreads beyond the primary site into nearby lymph nodes before metastasizing to other parts of the body. Since advanced stages of breast cancer are more extensive, they require different treatment approaches compared to earlier stages when tumors are localized and easier to treat. 

Metastatic breast cancer symptoms vary based on the location it has spread to, the extent and size of tumors, and other factors. You can improve your chances for early diagnosis by knowing early symptoms, assessing your risk factors, and engaging in regular breast self-exams. In some cases, genetic testing is warranted. Evidence shows that annual screening mammography saves lives.

The Ezra mammogram uses advanced technology to detect breast abnormalities early. Regular mammograms may help detect small changes even before symptoms appear. Ezra streamlines the process to make getting a screening fast and easy. Get started today and book your mammogram easily online.