Metastatic breast cancer occurs when breast cancer cells move into other parts of the body. Although not usually considered curable, it can be treated, and it is important to recognize early signs of spread.
The most common areas for breast cancer to spread are into the bones, lungs, liver, and brain. When cancer cells begin to grow in other organs, various symptoms may occur as the cancer affects how the organs function. Learn the different symptoms associated with metastatic breast cancer.
Bone Pain That Doesn’t Go Away
A possible early sign of metastatic breast cancer when it spreads to the bones is bone pain; breast cancer cells can cause inflammation and weakening of the bones as they destroy bone cells.
This type of pain is persistent and gradually worsens over time. It is often described as an aching or pressure that is difficult to pinpoint. It may spread across a large area, such as the back, hips, or ribs.
The pain may also get worse at night and may not improve with changing positions or even with over-the-counter (OTC) pain medication. A fracture may occur in the area where the cancer is growing.
Unusual and Persistent Back or Neck Pain
Unusual or persistent neck or back pain can be a sign of metastatic breast cancer, most often when the cancer has spread into the bones of the spine. The cancer cells that get into the bones of the neck or back can break down normal, healthy bones and cause pain.
The pain may worsen over time and not be relieved by rest, position changes, or OTC medications. In some cases, the pain may radiate to other parts of the body, such as the shoulders or arms. The pain is often worse at night or when lying down.
Unexplained Shortness of Breath or a Dry Cough
Unexplained shortness of breath or a persistent cough can be a sign of metastatic breast cancer that spreads into the lungs or the tissue lining the lungs, which is called the pleura.
When breast cancer metastasizes to the lungs, it can cause a buildup of fluid in the space between the pleura and the lung, which is called a pleural effusion. This fluid buildup can cause pressure on the lungs, preventing them from fully inflating with breathing.
This leads to difficulty breathing, which doesn’t go away. A cough can also occur with a pleural effusion, but it can also happen without a pleural effusion if cancer cells are present in the lung tissue, causing inflammation.
Difficulty Urinating
Difficulty urinating can be a sign of metastatic breast cancer, most often when the cancer has spread to the bones of the spine or the pelvis, compressing the nerves that control the bladder and urinary function. This condition is called spinal cord compression.
With the urinary system, spinal cord compression can cause difficulty beginning urination, a weak urine stream, or difficulty fully emptying the bladder. These symptoms may also be accompanied by back pain or numbness or tingling in the legs.
In rare cases, breast cancer has directly spread into the wall of the bladder, which could cause symptoms such as blood in the urine, abdominal or pelvic pain, or difficulty urinating.
Loss of Appetite
Loss of appetite can be a sign of metastatic breast cancer, often when cancer has spread to organs such as the liver, lungs, or bones. When breast cancer metastasizes, the body’s metabolism can change as inflammatory chemicals are released that affect appetite.
Pain, fatigue, or nausea from the cancer or its treatments can also cause someone to have a decreased appetite. Unlike appetite changes due to stress or illness, this type of appetite loss can lead to significant weight loss.
Severe Headaches
A severe headache can be a sign of metastatic breast cancer that has spread to the brain. When cancer metastasizes to the brain, the increased pressure or swelling can cause severe headaches.
Other symptoms can accompany the headache, such as vision changes, nausea, vomiting, confusion, or difficulty with balance and coordination. The headache might be worse when waking up, lying down, or engaging in activities that increase pressure in the skull, such as coughing or bending over.
Vision Problems
Vision problems can be a sign of metastatic breast cancer if the cancer has spread to the brain. The increased pressure in the brain from the cancer can affect the parts of the brain responsible for vision, such as the occipital lobe or the optic nerve.
This can lead to various vision problems, including the following:
- Blurred vision
- Double vision
- Partial vision loss
- Sudden blindness in severe cases
Symptoms such as headaches, nausea, dizziness, or difficulty with balance may also be present.
Difficulty With Speech
Difficulty with speech is another symptom of breast cancer that has metastasized to the brain. When swelling from breast cancer affects the areas of the brain that control language, speech, and motor functions, it can prevent these systems from working normally.
This may be seen as the following:
- Difficulty finding words
- Slurred speech
- Suddenly losing the ability to speak
These speech difficulties can occur suddenly or develop gradually. Other symptoms that may be present include headaches, confusion, or weakness in one side of the body.
Loss of Balance
Loss of balance can be another sign of metastatic breast cancer to the brain or spinal cord. When cancer cells grow in these areas, they can put pressure on the areas responsible for the coordination of movement and balance.
Symptoms can include:
- Stumbling
- Swaying while walking
- Falling, even when doing simple activities on a flat surface
In addition, the following may also be present:
- Dizziness
- Weakness in the arms or legs
- Numbness and tingling sensations
Confusion or Memory Problems
Confusion or memory problems can be a sign of metastatic breast cancer in the brain. The cancer cells can put pressure on areas of the brain that affect memory and thought processes.
Symptoms might include problems with short-term memory or finding that things that once seemed familiar are now confusing. There might also be difficulty organizing thoughts to speak clearly.
Seizures
Seizures can be a sign of metastatic breast cancer that has spread to the brain. The cancerous tumor in the brain can interfere with the electrical impulses in the brain, causing them to be erratic, which results in a seizure.
Symptoms of a seizure can include convulsions, twitching of the arms or legs, or even loss of consciousness. Seizures may also affect only one part of the body.
Abdominal Bloating, Pain, or Tenderness
Abdominal bloating, pain, or tenderness can be a sign of metastatic breast cancer that has spread to the liver or the lining of the abdominal cavity, called the peritoneum. When cancer spreads to these areas, fluid can build up in the abdomen, causing bloating and discomfort.
There can also be a sense of fullness, pressure, or pain in the abdomen.
Constant Nausea, Vomiting, or Weight Loss
Constant nausea and vomiting, with or without weight loss, can be a sign of metastatic breast cancer if the cancer has spread into the liver or another part of the gastrointestinal tract.
When breast cancer spreads to these areas, normal processes of hunger and digestion are affected and can lead to persistent nausea and vomiting, which ultimately leads to weight loss. Constant nausea and vomiting can also be a symptom experienced when breast cancer metastasizes into the brain.
Numbness or Weakness Anywhere in the Body
Numbness or weakness anywhere in the body can be a sign of metastatic breast cancer, seen when cancer spreads into the spinal cord or into the cerebrospinal fluid.
The spread of cancer into the spine can compress the spinal cord and other nerves, leading to symptoms such as weakness, numbness, or tingling. The location of these symptoms will depend on the location of cancer within the spine.
Itchy Skin or Rash
Itchy skin or a rash can be a sign of metastatic breast cancer when the cancer has spread to the skin or lymph nodes. When breast cancer metastasizes to the skin, it can cause skin symptoms such as itching, rash, nodules, or ulcers. Cancer cells can lead to inflammation that can irritate the skin, causing itching, redness, or discoloration.
Jaundice
Jaundice is the yellowing of the skin and eyes and can be a sign of metastatic breast cancer when it has spread to the liver. Cancer in the liver interferes with the normal processing of bilirubin, which is made from the breakdown of red blood cells.
As bilirubin levels go up, the skin and whites of the eyes turn yellow. Other symptoms of jaundice can include dark urine, pale stools, and abdominal pain or swelling.
Profound Fatigue or Malaise
Profound fatigue or malaise can be a significant sign of metastatic breast cancer. Fatigue is more than just feeling tired. It is an overwhelming sense of exhaustion that doesn’t get better with rest or sleep and can keep someone from being able to perform daily activities.
Malaise is a general feeling of being unwell. In addition to fatigue and malaise, other symptoms that might be present include appetite changes, weight loss, and weakness.
Medical Review
By Julie Scott, MSN, ANP-BC, AOCNP
Medically Reviewed by Doru Paul, MD, Verywell Health Medical Expert Board
