Doctronic

Understanding Metastatic Breast Cancer: Symptoms, Tests, and Results

Oghenefejiro Okifo | MD

Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on March 3rd, 2024.

Key Takeaways

  • Stage IV breast cancer occurs when malignant cells spread to distant organs, most commonly bones (69% of cases), followed by lungs (21%), liver (20%), and brain (16%).

  • Bone metastases cause pain, fractures, and elevated calcium levels, while liver involvement produces jaundice, abdominal swelling, and elevated liver enzymes within weeks of spread.

  • Median survival ranges from 18-24 months, though 20-30% of patients live 5+ years with modern targeted therapies like CDK4/6 inhibitors and HER2-directed treatments.

  • Tumor markers CA 15-3 and CA 27.29 are monitored every 2-3 months alongside imaging, with rises often preceding clinical symptoms by 1-6 months.

  • Treatment selection depends on hormone receptor status (70% are ER-positive), HER2 expression (20% are HER2-positive), and prior therapy exposure, with combinations often extending progression-free survival to 12-28 months.

When breast cancer spreads to other parts of the body, it is called metastatic breast cancer. The most common places for breast cancer to spread are the bones, lungs, liver, and brain. If you have had breast cancer before, it's important to be aware of the signs and symptoms of metastatic breast cancer so you can alert your doctor if you experience any of them.

Symptoms of Metastatic Breast Cancer

The symptoms of metastatic breast cancer depend on where the cancer has spread. Some common symptoms include:

Bone Metastases

  • Pain, especially in the back or hips

  • Bone fractures or breaks

  • High calcium levels in the blood

  • Numbness or weakness in an arm or leg

Lung Metastases

  • Shortness of breath

  • Fatigue

Liver Metastases

  • Abdominal pain or swelling

  • Loss of appetite

  • Yellowing of the skin or eyes (jaundice)

  • Fatigue

  • Confusion

Brain Metastases

  • Inability to feel or move part of the body

  • Persistent headaches

  • Seizures

  • Changes in vision or hearing

  • Drowsiness

It's important to note that these symptoms can be caused by other conditions, but it's always best to have them checked out by your doctor, especially if you have a history of breast cancer.

Understanding Metastatic Breast Cancer: Symptoms, Tests, and Results

Diagnosing Metastatic Breast Cancer

If your doctor suspects that your breast cancer has spread, they will order various tests to confirm the diagnosis and determine the extent of the metastases. Some of the tests you may undergo include:

Imaging Tests

  • PET scan: A radioactive sugar is injected into your bloodstream. Cancer cells absorb the sugar more quickly, allowing them to be detected on the scan.

  • Bone scan: A radioactive tracer is injected into your bloodstream and collects in areas of bone that may be cancerous, showing up as "hot spots" on the scan.

  • CT scan: Detailed 3-D images of your internal organs are created using special X-rays. A dye may be used to enhance the images.

  • MRI: Strong magnets are used to create detailed images of your organs and structures, particularly the brain and bones.

  • Ultrasound: Sound waves are used to look for tumors in the liver or other abdominal organs.

  • X-rays: Quick and simple X-rays can reveal changes in bones, such as fractures or breaks, but lack the detail of other imaging tests.

Biopsy

If imaging tests suggest the presence of metastatic breast cancer, your doctor may perform a biopsy to confirm the diagnosis. A small sample of the suspicious tissue will be removed (often with a needle) and analyzed in a laboratory to determine if breast cancer cells are present. Additional lab tests may be conducted to differentiate between breast cancer cells and other types of cancer cells.

Understanding Your Test Results

Waiting for test results can be stressful, but it's important to remember that the relatively short wait time usually does not impact the progression of the cancer. Imaging test results are typically available within a day or two, while biopsy results may take up to a week. Your doctor will inform you of how you will receive your results, whether by phone call or office visit. If you have not heard from your doctor within a week, don't hesitate to call their office.

If you have any questions or concerns during this waiting period, discuss them with your doctor. They can provide you with the information and support you need to better understand your situation and the available treatment options for metastatic breast cancer.

For more information on metastatic breast cancer, visit:

The Bottom Line

While metastatic breast cancer isn't curable, targeted treatments based on tumor biology can significantly extend survival and maintain quality of life for years. Early detection of spread through regular monitoring allows for prompt treatment adjustments that can control disease progression. If you're experiencing bone pain, breathing difficulties, or other concerning symptoms, Doctronic can help you get the diagnostic clarity you need.

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