Symptoms depend on where the metastases are located. Breast cancer typically spreads to the bones, liver, and lungs, but also to the skin, brain, and other organs. Read on for more information about the most common symptoms caused by metastases.
Bone pain and other symptoms related to bone metastases
Since bone metastases are very common in metastatic breast cancer and tend to cause pain, especially when moving, pain relief is an important consideration. The aim is to maintain functional capacity so that the patient can cope with daily activities without being limited by pain. Both pain medicines and radiation therapy are effective. Bone metastases can also cause fractures, and metastases in the spine can press on the spinal cord. These situations call for acute medical attention.
Shortness of breath and other respiratory symptoms
In many cases, individual metastases in the lungs don’t cause any major symptoms. As the metastases increase in number, they may cause shortness of breath or provoke coughing. Shortness of breath can be treated with medications, radiation therapy (if a tumour is obstructing the bronchi), or by removing excess fluid from around the lungs.
Liver metastases and build-up of fluid in the abdomen
Liver metastases don’t usually cause symptoms until there is a large number of them and liver function starts to suffer. A common symptom experienced at this point is increasing fatigue. Corticosteroid medication may be helpful.
Both liver failure and cancer that has spread to the abdominal cavity may cause a build-up of fluid in the abdomen. If fluid in the abdomen is causing distressing symptoms such as a swollen belly, nausea, constipation, or shortness of breath, the fluid can be removed either by performing a one-time ascitic tap or by inserting a drainage catheter that can be used to remove the fluid over the course of several days. This usually provides immediate symptom relief.
Brain symptoms
Symptoms caused by brain metastases, such as headaches, nausea, and various neurological symptoms including vision problems, loss of balance, and paralysis, respond well to corticosteroid medication and radiation therapy. If the cancer is in the early stages, surgery might also be an option.
Skin symptoms
Skin metastases appear as a rash-like skin manifestation or as small nodules or lumps on the skin of the chest. If these symptoms haven’t come up during a previous appointment, it’s recommended that you inform your doctor or nurse about them. Skin metastases can be managed with radiation therapy, and sometimes with surgery. If the skin is broken or bleeding, or there is blood seeping through the skin, there are various local treatments that can be applied.
Lymphatic flow disorders
If cancer spreads to the lymph nodes, the nodes become enlarged and disrupt the lymphatic flow. In breast cancer, symptoms are most commonly caused by metastases in the axillary lymph nodes in the armpit, leading to swelling (oedema) in the arm. The oedema can be treated with compression products (such as sleeves or gloves) or bandages.
Psychological strain
Having an illness puts strain on the mind too. Living with a long-term illness includes both good and bad moments. It’s good to talk to the care team about how you’re coping mentally. Depression and anxiety can be managed both by talking and with medication. Peer support may also be helpful.
