Symptoms of secondary breast cancer

Secondary breast cancer means that a cancer that began in the breast has spread to another part of the body. Secondary cancer can also be called advanced or metastatic cancer.

It might not mean that you have secondary breast cancer if you have the symptoms described below. They can be caused by other conditions.

General symptoms

• feeling tired
• low energy levels
• feeling under the weather
• having less appetite
• unexplained weight loss

Where can breast cancer spread?

The most common places for breast cancer to spread to are the lymph nodes, bone, liver, lungs and brain. The symptoms you may experience will depend on where in the body the cancer has spread to. You might not have all of the symptoms mentioned here.

Remember other conditions can cause these symptoms. They don't necessarily mean that you have cancer that has spread. But if you have symptoms that you are worried about, discuss them with your GP, cancer specialist, or breast care nurse so that you can be checked.

Symptoms if cancer has spread to the lymph nodes

Lymph nodes are part of a system of tubes and glands in the body that filters body fluids and fights infection. 

The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen. You might have any of the following symptoms if your cancer has spread to the lymph nodes:

• a lump or swelling under your armpit
• swelling in your arm or hand (lymphoedema)
• a lump or swelling in your breast bone or collar bone area

One of the first places breast cancer can spread to is the lymph nodes under the arm on the same side as the breast cancer. This is not a secondary cancer. 

Symptoms if cancer has spread to the bones

You may have any of these symptoms if your cancer has spread to the bones:

• an ache or pain in the affected bone
• breaks in the bones because they are weaker
• breathlessness, looking pale, bruising and bleeding due to low levels of blood cells - blood cells are made in the bone marrow and can be crowded out by the cancer cells

Sometimes when bones are damaged by advanced cancer, the bones release calcium into the blood. This is called hypercalcaemia and can cause various symptoms such as:

• tiredness
• feeling sick (nausea)
• constipation
• irritability
• thirst
• confusion

Spinal cord compression

Breast cancer can spread to the bones in the spine causing pressure on the spinal cord. The pressure can stop the nerves from working normally. This is called spinal cord compression.

This can be serious and needs urgent medical attention. It is important to speak to your doctor or phone your advice helpline straight away if you have symptoms.

Symptoms include pain anywhere in your back or neck or the sensation of a band around your body.

Symptoms if cancer has spread to the liver

You may have any of the following symptoms if cancer has spread to your liver:

• tiredness
• discomfort or pain on the right side of your tummy (abdomen) where the liver is
• feeling sick (nausea)
• loss of appetite
• a swollen abdomen
• yellowing of the skin or itchy skin (jaundice)

Symptoms if cancer has spread to the lungs

You may have any of these symptoms if your cancer has spread into the lungs:

• a cough that doesn’t go away
• shortness of breath
• ongoing chest infections
• weight loss
• chest pain
• coughing up blood
• a build up of fluid between the chest wall and the lung (a pleural effusion)

A build up of fluid between the lung and chest wall stops the lungs from expanding fully. When you breathe in, it can cause shortness of breath, achy chest, discomfort and heaviness.

Symptoms if cancer has spread to the brain

Cancer that has spread to the brain can cause different symptoms depending on where in the brain is affected. You might have any of these symptoms:

• headaches
• weakness or numbness in your limbs
• memory problems
• behaving in a way that is unusual for you
• feeling or being sick
• seizures (fits)
• changes to your eyesight such as loss of sight (vision)
• confusion and difficulty understanding
• difficulty speaking

Treatment to control these symptoms

Chemotherapy, radiotherapy, targeted drugs, and hormone therapies can all be used to treat secondary breast cancer. These might shrink the cancer and help to control any symptoms you have.

Your doctor or specialist nurse (key worker) can:

• give you medicines
• help you to get equipment that you need
• suggest other ways of controlling your symptoms
• refer you to a symptom control team (a palliative care team)

Your doctor or nurse may ask you to write down your symptoms and the side effects of your treatment. This is to so they can understand how you are coping and how they can help to reduce the side effects.

Symptom control team

There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.