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.
Investigations For Stages Of Breast Cancer
The following procedures may be necessary to check for metastasis:-
- bone scan
- MRI scan
- blood tests
So, after a breast cancer diagnosis, while in general, the outlook is favorable , it should really be considered a chronic condition.
But the progression is not going to be the same for everyone, even for patients with similar stages of breast cancer presentation. It is SO important to remember that each case is individual. Indeed breast cancer has been known to return even 20 years after a mastectomy, whilst in others, the progression and systemic development of the disease may be rapid.
Are you considering having NO treatment?
Anxiety, fear, panic, anger and sadness are all common emotions following a breast cancer diagnosis. If you are in the middle of a combination of these feelings, today is not a good day to make important decisions.
Here is my quick imagine a way this all gets better line of reasoning, to help you. Firstly, treatments are so effective nowadays and very well organized. Cancer research and treatments are improving all the time and the people who treat breast cancer are experienced experts.
Give the team some trust and time to explain things properly and accept the treatments. Do one step at a time, one day at a time, and you will be amazed at the results.
Add onto that the following self-help methods:-
- lots of sleep
Most Common Places It Spreads
It’s still breast cancer, even if it’s in another organ. For example, if breast cancer spreads to your lungs, that doesn’t mean you have lung cancer. Although it can spread to any part of your body, there are certain places it’s most likely to go to, including the lymph nodes, bones, liver, lungs, and brain.
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Integrative Therapies For Metastatic Breast Cancer
You may find it beneficial to add integrative therapies to your treatment plan. There are many evidence-informed integrative modalities to boost the mind and body. Practices like gentle yoga, meditation, massage and music therapy may feel enjoyable and reduce stress and anxiety levels.
To help our patients maintain quality of life after a metastatic breast cancer diagnosis, our team of breast cancer experts may offer supportive care services to help manage side effects of the disease and its treatments. These may include:
Types Of Bone Metastases
Normally your bones are constantly changing. New bone tissue is being formed and old bone tissue is breaking down into minerals that circulate in your blood. This process is called remodeling.
Cancer cells upset the normal process of bone remodeling, causing bones to become weak or too dense, depending on the type of bone cells affected.
Your bone metastases may be:
- osteoblastic, if there are too many new bone cells
- osteolytic, if too much bone is destroyed
In some cases, your bones may have both types of metastases.
Where Does Breast Cancer Metastasize To
Sometimes, breast cancer spreads to other parts of the body. This does not always happen, but when it does, it is known as metastatic breast cancer.
Metastatic breast cancer is treated differently than localized breast cancer. As a result, oncologists typically check for evidence of metastasis during the diagnostic/staging process. Additionally, breast cancer can spread after a patient has been diagnosed. To watch for potential signs of metastasis, patients are typically scheduled for frequent imaging scans during and after treatment.
Symptoms When Breast Cancer Has Spread To The Bones
The main symptoms of breast cancer that has spread to bone are:
- Pain particularly in the back, arms or legs, often described as gnawing which occurs when resting or sleeping, and may get worse when lying down especially at night
Find out more about the symptoms of secondary breast cancer.
Other possible effects include:
Stages Of Breast Cancer: Stage Iiic
Stage IIIc breast cancers basically involve tumors of any size with significant metastases to:-
- the lymph nodes behind the sternum
- lymph nodes under the arm
- the lymph nodes above or below the collarbone
The extent and depth of lymph node involvement make these patients unsuitable candidates for surgical treatment as a primary mode of therapy. Chemotherapy is the treatment of choice for women with stage IIIb and IIIc breast cancers.
However, up to 70% of patients with stage III breast cancers who have chemotherapy remain alive and disease-free after 7 years.
What Are The Symptoms Of Breast Cancer That Has Spread To The Bones
When it does occur, signs and symptoms of bone metastasis include:
- Bone pain.
- Bowel incontinence.
- Weakness in the legs or arms.
- High levels of calcium in the blood , which can cause nausea, vomiting, constipation and confusion.
Furthermore, where is the first place breast cancer spreads?
Breast Cancer Spreadscancer spreadsbreastmetastaticplacesspreads
What are the signs that breast cancer has spread?
You may have any of the following symptoms if cancer has spread to your liver:
- discomfort or pain on the right side of your tummy where the liver is.
- feeling sick
- yellowing of the skin or itchy skin
Also Check: Breast Cancer Stage 3a
Pathophysiology Of Breast Cancer Metastasis To The Bone
BC spread is a complex multistep process. It begins with the epithelial-to-mesenchymal transition of locally invasive carcinoma cells which then enter the lumina of blood vessels, a process called intravasation . Once in the systemic circulation, these circulating tumour cells must survive a variety of stress factors in order to reach the bone marrow, namely the stress imposed by matrix detachment , the shear forces, and the predation by cells of the innate immune system . To evade these threats, CTCs form relatively large emboli via interactions with blood platelets . However, the majority become trapped in capillary beds during its first passage through the circulation . Nevertheless, some CTCs may avoid this rapid trapping because of their plasticity or chance passage through arteriovenous shunts . Eventually, some CTCs become lodged in the microvasculature of distant organs and initiate intraluminal growth, rupturing the walls of surrounding vessels, and placing cells in direct contact with the parenchyma of a specific organ . Also, CTCs may be able to extravasate from the vessels lumina into the stromal microenvironment by penetrating the endothelial cell and pericyte layers .
Symptoms Point To Cancer’s Spread
Bone metastasis may not have any symptoms. But often, you’ll feel pain in your bones. The ache may come and go and first, often worsening at night and easing up when you’re active. Eventually it can become more intense and flare during activity.
If you have , you may have other symptoms as well, including:
Sometimes a fracture in your arms, legs, or spine is the first sign that your cancer has spread. You may break a bone when you fall, or incur what appears to be a trivial injury during your regular daily activities. The nature of the injury could be minor, and seem insufficient to fracture healthy bone. If occurs, you’ll feel sudden, severe pain. Get immediate treatmentespecially if the pain strikes in your back, a sign of a broken bone in your spine.
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When Can Bone Metastases Occur
Bone metastases may be present when metastatic breast cancer is first diagnosed, or the cancer may spread to the bones at a later time.
The bones are the first site of metastases for almost half of women diagnosed with metastatic breast cancer . For many of these women, the bones will be the only site of metastases .
Stage Iv Breast Cancers May Be Recurrences Following Initial Treatment
Up to 5% of initial breast cancer diagnoses are of the most advanced or metastatic stage. However, this number has significantly reduced with the implementation of widespread breast cancer screening programs.
Metastatic breast cancer can appear to be a rapid deterioration of a disease that has been present for some time undetected.
But metastatic breast cancer can also be the result of a recurrence of breast cancer after successful initial treatment. Sometimes the terms local and regional recurrence indicate a return of breast cancer to the original tumor site or elsewhere in the breast or contralateral breast.
If the cancer returns in other areas of the body it is a distant metastasis or distant recurrence.
For more detail on Stage IV survival rates, recurrence rates and treatment please see our new post HERE.
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Signs That Breast Cancer Has Spread To A Boneand When To Be Aware
- Shoulder blades
- Upper arms and upper legs
These are some of the most common bone sites to which breast cancer can spread. In some cases, this can appear on an X-ray as whats called a lytic lesion, which is a weak area in the bone due to the cancer destroying the bones structure, causing it to lose calcium and other minerals. This may continue for a month or two until something happensa fall, bumping into a wall, even rolling over in bedcausing the weakened bone to break.
A broken bone often is what spurs patients to go to the emergency room. Weakened bones can be a sign of several conditions, including osteoporosis, so its important for your doctors to know your complete medical history and whether you have or have had breast cancer. We can use X-rays and other scans, such as computed tomography or magnetic resonance imaging , to see if theres a tumor or mass on the bone thats causing it to weaken.
The five-year survival rate, or how many people survive at least five years after receiving a breast cancer diagnosis, often is considered the gold standard of breast cancer care. But survival rates dont tell the whole story. Were starting to see relapses of breast cancer much later10, 15 or even 20 years after the original diagnosis. After a cancer diagnosis, even after the five-year mark, continue to see your oncologist at least yearly to increase the chances of detecting relapses as early as possible.
Too Much Calcium In The Blood
Too much calcium in the blood can cause symptoms such as:
- Passing large amounts of urine
Hypercalcaemia is a medical emergency and can be serious if not diagnosed quickly. Its important to know who to report these symptoms to if they occur, so check this with your treatment team.
To relieve symptoms you might be told to drink plenty of water. However, many people will need to be given fluids into a vein to help flush the calcium out of the body.
If youre not already having bone-strengthening drugs, your treatment team will prescribe these.
Eating foods that contain calcium or taking prescribed calcium supplements does not cause hypercalcaemia.
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Metastasis Is A Highly Inefficient Yet Lethal Process
In the next few sections, we introduce the concept of tumour dormancy and discuss its ties with DTC dissemination in order to highlight how its reversible nature might alter the equilibrium between unsuccessful and successful metastases, thus possibly dictating the timing of metastatic relapse, or whether relapse occurs at all. We then focus on two key determinants of relapse in HR+ breast cancer: the extrinsic effect of targeted therapy, and the consequences of intrinsic HR function modulation.
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What Is Secondary Breast Cancer
Secondary breast cancer is when cancer cells from a cancer that started in the breast spread to other parts of the body. The cancer that started in the breast is called primary breast cancer.Secondary breast cancer is also called advanced breast cancer or metastatic breast cancer. The most common places for breast cancer to spread to are the:
Rarely, breast cancer may spread to other parts of the body, such as the bone marrow, ovaries or lining of the tummy which is called the peritoneum.
Breast cancer can spread to different parts of the body. This does not mean it will go to all these places.
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How Effective Are Treatments For Bone Metastases
Although current treatments for bone metastases are unable to completely remove all cancer cells, many women with bone metastases can live for many years with extremely good quality of life.
The effect of bone metastasis on your prognosis is individual and depends on what type of cancer you have, where it has spread to and how you respond to various treatments. The main aim of any treatment is to control pain and other symptoms so you can enjoy your day-to- day activities as much as possible.
Living With Secondary Breast Cancer
You will see your cancer doctor or specialist nurse regularly during and after treatment. This means that any symptoms or problems can be managed early on. You may have regular scans to check how the cancer has responded to treatment.
You may need treatment at different times or have ongoing treatment with hormone therapy. There may be long periods when the cancer is controlled and you are getting on with day-to-day life.
We have more about well-being and coping in our information about living with secondary breast cancer.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation. Macmillan is also here to support you. If you would like to talk, you can:
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Survival Rates Of Bone Metastases
Survival rates for people with bone metastases vary greatly by cancer type and stage. Your general health condition and the type of treatment you received for the primary cancer are additional factors.
Discuss your particular situation with your doctor. Remember that survival rates are averages gathered from large numbers of people. Also, survival data may reflect statistics from a period before the most recent treatment advances.
A large-scale 2017 study of the 10 most common cancers with bone metastasis found:
- Lung cancer had the lowest 1-year survival rate after bone metastasis .
- Breast cancer had the highest 1-year survival rate after bone metastasis .
- Having metastases in bone and also in other sites was found to decrease the survival rate.
Here are some typical figures from a 2018 study of common cancers and bone metastasis:
|Type of cancer|
Youre likely to have a combination of therapies that may include:
- radiation to slow metastasis growth and reduce pain
- chemotherapy to kill cancer cells and reduce tumor size
- hormone therapy to reduce the hormones known to be involved with breast and prostate cancer
- painkillers and steroids for pain relief
- drugs that specifically target bones
- surgery if necessary to stabilize your bone, fix a break, and help with pain
- physical therapy to strengthen your muscles and help you with mobility
- extreme heat or cold that targets cancer cells and may relieve pain
Treatment Of Stage Iii Breast Cancers
Sometimes large breast cancers invade into muscles or attach to major arteries, veins or nerve trunks, which makes them impossible to surgically remove completely.
So, for these patients, the treatment usually starts with radiation or chemo to try to shrink it first, before surgery. But even a large tumor that has not attached itself onto muscle can, sometimes, be completely removed. There is no direct relationship between tumor size and whether or not it may be treated surgically or not.
Obviously, Stage 3 breast cancers that surgeons can completely remove do tend to have a significantly better prognosis than inoperable stage 3 breast cancers. However, some breast tumors, particularly those that are ER-positive, respond very well to chemotherapy. So well, in fact, that they actually downstage.
So, it is difficult to predict the overall prognosis for stage 3 breast cancer, as it will vary from individual to individual. If the response to chemotherapy is favorable, the overall survival rate is around 72%.
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Treatment Options For Metastatic Breast Cancer
Treatment for metastatic breast cancer often is based on systemic therapies, which use drugs rather than surgery or radiation. Metastases treatments are designed to shrink tumors and slow their growth, help ease symptoms and improve quality of life. Treatment may change, such as when one therapy stops working, or the side effects become too uncomfortable. Rather than having only one treatment, most patients undergo several treatments combined to help fight the cancer.
The four broad categories of drug-based treatments are:
The Most Common Places Where It Is Spread
Breast cancer is still a problem even if its an additional organ. For instance, if breast cancer progresses to the lung, it does not mean that youve got lung cancer. While it could be spread to any area of your body There are specific areas it is most likely to spread to, which include bone nodes and lymph nodes the lungs, liver and brain.
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Where Can Breast Cancer Go
Breast cancer mostly spreads to the bones, lungs, liver, and brain. When it does, you may start to notice symptoms that affect that area of your body.
Bones: swelling, intense pain, bones that break easily, and pain in your bones, back, neck, or joints
Lungs: long-lasting cough, trouble breathing, chest pain
Liver: Jaundice, or skin with a yellow tint, rashes and itchy skin, not feeling hungry, stomach pain
Brain: headaches that wonât go away, problems with your vision, seizures, vomiting and nausea, memory troubles, feeling dizzy
Other, less common, places where breast cancer spreads include:
- Adrenal glands
Let your doctor know as soon as you can if you have any of these symptoms. They donât always mean your cancer has moved to another organ, but your doctor might want you to take some tests to make sure.