Breast cancer that has spread to other parts of your body may start to cause new symptoms, depending on the location of metastases. As symptoms develop or progress, treatment and care may also need to change.
Metastatic breast cancer occurs when cancer that started in the breast spreads to another part of the body. It’s also known as stage 4 breast cancer.
When breast cancer spreads beyond the breast, it tends to appear in one or more of the following areas:
- distant lymph nodes
Symptoms of metastases may depend on where breast cancer has spread in your body.
If the cancer is confined to the breast, it’s usually easy to treat. If it has spread, it becomes more difficult to treat. That’s why early diagnosis and treatment of breast cancer are so important.
If breast cancer is diagnosed at a later stage, there may be symptoms that appear in addition to those present with earlier stage breast cancer, such as skin changes, nipple discharge, or a lump in the breast.
Metastasis in the bones
If breast cancer has spread to your bones, symptoms may
- bone pain
- pain in the joints, which can worsen after activity
- weakened bones that are more likely to fracture
Metastasis in the brain
If breast cancer has spread to your brain, you
- headaches that are sometimes persistent or severe
- possible seizures
- behavior changes
- vision problems
- nausea and vomiting
- difficulty walking or balancing
- difficulty moving certain parts of your body
- general weakness
- speech changes
Metastasis in the lungs
If breast cancer has spread to your lungs, symptoms may
- a chronic dry cough that may get worse
- difficulty catching your breath
- shortness of breath
- chest pain
- feeling weak or tired
- coughing up blood or rust-colored spit or phlegm
Metastasis in the liver
If breast cancer has spread to your liver, you
- yellowing of the skin (jaundice)
- weight loss
- lack of appetite and feeling full after a small meal
- vomiting or nausea
- abdominal pain
- pain near your right shoulder blade
- a feeling of fullness under your ribs on the right side due to an enlarged liver
- itchy skin
Late stage breast cancer may eventually stop responding to treatment. This means your care team will shift focus to keeping you comfortable and treating your symptoms.
At this time, you may also experience general symptoms that occur when a person approaches the end of their life. With advanced breast cancer, these symptoms include:
- shortness of breath
- new, unexplained pain
- changes in appetite or digestion difficulties
- weight loss
- emotional changes, including shifts in mood
- depression or anxiety
- problems with memory
Treatments for metastatic breast cancer are becoming so advanced that many people can live for a long time after their diagnosis and still maintain a good quality of life.
Treating metastatic breast cancer might include some of the same techniques used to treat breast cancer in the earlier stages.
However, there are different drugs available depending on the type of cancer. Treatment will likely change as the cancer progresses or stops responding to treatment.
Treatments might include:
- hormone therapy
- biologic therapy
Pain management is often an important part of care for metastatic breast cancer. A doctor may prescribe a
Pain medications are often prescribed in a variety of methods:
- by mouth
- by using a skin patch
A pain-medication pump is sometimes needed to administer appropriate levels of medication.
You and a healthcare team can work together to manage your symptoms. Some things, like lifestyle changes or changes to your environment, can be done at home with the help of loved ones, while others may require a healthcare professional’s advice and supervision.
Talk with a doctor about the best options for easing symptoms and improving your quality of life.
Hospice or palliative care
Hospice and palliative care are special types of medical care focused on:
- symptom management
- maximizing comfort
- maintaining or preserving your quality of life and the quality of life of your loved ones
Palliative care might be recommended from the start of treatment for metastatic breast cancer. It can also be added to your treatment plan at any point, and treatment may continue at the same time.
The following types of professionals might make up a palliative care team:
- specialized doctors
- spiritual care providers
- social workers
The type of support they provide will vary based on your needs.
Palliative care may eventually transition to hospice care. Hospice becomes an option when treatment stops fully and comfort becomes the priority.
It’s recommended when a doctor believes a person may die within
- at home
- in a nursing home
- in a hospital
- at a specialized hospice center
Palliative care support may continue throughout hospice care.
Treatment for emotional symptoms
If you’re experiencing a lot of emotional distress, it may be time to seek out support for your mental health. This could come from a variety of different people or groups, such as:
- social workers
- therapists or other mental health professionals
- spiritual advisers
No matter what stage of cancer you have, joining a
These groups allow you to share your experiences and feelings with others who are in the same situation and understand what you’re going through.
A support group can provide connection and comfort, reduce your isolation, and help improve your well-being, among other benefits.
Find a support group near you via the following sites:
Eating and nutrition
You may also need to adjust your eating habits. You might experience a reduced appetite. Changes in your senses of smell and taste may also make you less interested in food.
Try to experiment with different foods or supplement your diet with protein drinks that are high in calories. This can help you strike a balance between a smaller appetite and maintaining enough strength and energy to get through the day.
It’s best to avoid or limit foods like:
- high fat meats
- dairy products
There are medications available to help ease symptoms of nausea and improve appetite. These might come with the side effect of drowsiness. Consider talking with a doctor if you feel this type of medication may help you eat or drink more.
If you care for someone with metastatic breast cancer, it’s important to know that the support you provide can change as the disease progresses.
It’s likely you’ll be focused on keeping your loved one comfortable at this stage. This may look like:
- Being patient and acting as an advocate: The person you’re caring for may begin to act and feel differently as the cancer progresses or as symptoms change. Try to be patient with them through shifts in mood or other emotional changes. You may need to explain this to visitors or other family members on their behalf.
- Making adjustments to their sleeping environment: You might need to adjust their room temperature, provide extra blankets, or make changes to the room’s ventilation for easier breathing. Someone should also be available to help them out of bed when they need it.
- Accommodating appetite changes: It’s not uncommon for appetite to change with end stage cancer. While this may be concerning as a caregiver, you can work with your loved one’s care team to understand their nutritional needs.
- Coordinating with palliative or hospice care specialists: You may work closely with a palliative or hospice care team to ensure your loved one’s wishes for the end of life are fulfilled.
- Providing emotional support: Providing an ear to listen and speaking a few words of comfort can often be a great way to show your support. If you’re not sure what to say or do, start by asking them what they need.
- Spending quality time together, when they’re feeling up for it: Be sure to monitor their energy levels and avoid overwhelming them with too much social time, including time with visitors.
As a caregiver, it’s also vital to care for yourself. Be sure to check in with yourself often about how you’re feeling and reach out for help when you need it.
The outlook for people with metastatic breast cancer and the length of time between a stage 4 diagnosis and the onset of end-of-life symptoms vary greatly.
Research suggests that about
Keep in mind that these statistics can’t predict your personal outlook. Many individual factors play a role in survival rates.
Newer treatments are helping extend lives and improve the quality of life for people with metastatic breast cancer.
Metastatic breast cancer isn’t curable, but it’s treatable. The outlook for people with the disease isn’t as life limiting as it once was. Advanced treatments are extending lives, and more are being researched every day.
Once breast cancer has metastasized to other areas of the body, you may experience new symptoms. Metastases to the lungs, brain, bones, or liver might each cause different symptoms.
Becoming familiar with what these are can help you recognize any changes in your health and keep your care team informed.
Treatment will focus on managing your symptoms and extending your life. Doctors and other healthcare team members can better manage your care if you report your symptoms, concerns, and what is or isn’t working.