Metastatic breast cancer symptoms

Metastatic (secondary) breast cancer occurs when breast cancer cells spread from the primary (first) cancer in the breast to other parts of the body.

You may also hear it called stage 4 breast cancer.

Breast cancer cells can spread through the lymphatic system or the blood stream.

General symptoms

Many symptoms of metastatic (secondary) breast cancer are very similar to those of other conditions. Any new symptom will understandably cause worry. It is always important to get any concerns checked out.

Some general symptoms that breast cancer may have spread include:

• Feeling constantly tired

• Constant nausea (feeling sick)

• Unexplained weight loss and loss of appetite

Signs that breast cancer may have spread to the bones

The main symptoms of metastatic breast cancer in the bone include:

• Pain in your bones, which doesn’t get better with pain relief and may be worse when lying down or at night

• Bone fractures (breaks)

• Unexplained back pain, difficulty walking, numbness and loss of bladder or bowel control

• Feeling sick and being sick, fatigue, passing large amounts of urine, confusion and being thirsty, which may be signs of high levels of calcium in the blood

Signs that breast cancer may have spread to the lungs

Symptoms of metastatic breast cancer in the lungs include:

• Feeling out of breath either when doing activity or resting

• A cough that doesn’t go away

• Pain or tightness in the chest that doesn’t go away

Signs that breast cancer may have spread to the liver

Symptoms of metastatic breast cancer in the liver include:

• Pain in the tummy (abdomen) which may also be felt in the right shoulder

• Discomfort or pain in the right side of the abdomen under the ribs

• Feeling sick (nausea) 

• Loss of appetite and weight loss 

• Hiccups 

• Build-up of fluid in the abdomen causing swelling (ascites)

• A general feeling of being unwell 

• Feeling constantly tired

• Itching and yellowing of the skin (jaundice) 

Signs that breast cancer may have spread to the brain

Symptoms of metastatic breast cancer in the brain include:

• Headache

• Feeling sick (nausea) and being sick (vomiting) especially when waking in the morning

• Weakness or feeling numb down one side of the body

• Dizziness, unsteadiness or loss of balance and co-ordination

• Fits (seizures)

• Difficulty with speech

• Problems with vision

• Changes in behaviour, mood or personality

• Confusion

• Memory problems

Signs that breast cancer may have spread to the skin

Symptoms of metastatic breast cancer in the skin include:

• A change in the colour of the skin

• A persistent rash

• A firm, painless small lump (nodule) or multiple lumps of different sizes

• Lymphoedema (swelling of the arm, hand or breast area)

• Pain

• Bleeding

• Infection

• Smell

Signs that breast cancer has spread to the lymph nodes

• A lump or swelling under your arm, breastbone or collarbone area

• Swelling in your arm or hand

• Pain

• Dry cough

Signs that breast cancer has spread to the abdomen (belly)

• Abdominal pain

• Swollen belly

• Feeling sick all the time

• Loss of appetite

• Feeling full quickly when eating

• A build-up of fluid in the belly

• Constipation

• Feeling bloated

It’s important to talk to your GP or breast care nurse if you have any symptoms that are:

1. New

2. Don’t have an obvious cause

3. Don’t go away

This also applies to new symptoms if you have already been diagnosed with metastatic (secondary) breast cancer as it may be a sign of the cancer progressing.

It’s natural to worry about breast cancer spreading to other parts of the body.

While it’s important to get any new and persistent symptoms checked, aches and pains in the bones can be due to ageing, arthritis or side effects of treatment for breast cancer. Being out of breath and having a cough can be symptoms of a cold or flu-type illness. And many people experience tiredness and loss of appetite after cancer treatment.

Whatever your worry or concern, our free helpline is here to offer you support - please see below.