Signs and symptoms of secondary breast cancer

The symptoms of secondary breast cancer depend on where it has spread to. The most common places are the bones, lungs, liver or occasionally the brain.

Symptoms can include the following:

  • If the cancer has spread to the bones, you may have pain in the bone that makes moving around and sleeping difficult.
  • If the cancer has spread to the lungs, you may be breathless or have a cough that doesn’t get better.
  • If the cancer has spread to the liver, you may feel pain in the right side of the tummy, or feel sick, tired or generally unwell.
  • If the cancer has spread to the brain, you may have headaches and feel or be sick.

Women may have general symptoms such as feeling very tired or generally unwell, or weight loss. All these symptoms can be caused by other conditions but it’s very important to see your doctor or breast care nurse.

Your doctor will prescribe drugs to control your symptoms. The symptoms will also improve once your treatment starts working.

Symptoms

The symptoms of secondary breast cancer depend on where in the body the cancer has spread.

You may have some general symptoms. These can include feeling much more tired than usual, losing your appetite or feeling generally unwell for no obvious reason.

The symptoms we mention here can be caused by other conditions. But if you have any of them, see your doctor or breast care nurse. Always tell them if you develop new symptoms, especially if they last more than a week or two.


The bones

The most common symptom is a nagging ache in the bone. It may be painful when you move around or make it difficult to sleep. Aches and pains are common and can be caused by different things, such as hormonal therapy or menopause. But it’s important to tell your doctor if your symptoms continue.

If the cancer has spread to the bones, it can often be controlled for many years with different treatments.

Some other bone problems may develop. These are not common when you have just been diagnosed, but it’s important to know about them.

Too much calcium in the blood

If the cancer damages the bone, it can cause calcium (a mineral stored in bones) to be released into the blood. A high level of calcium in the blood (hypercalcaemia) can cause symptoms such as feeling tired, sick or thirsty, passing more urine, constipation or feeling confused. Doctors can see that calcium levels are rising on a blood test before symptoms develop. They can treat this with drugs.

A break in the bone

If the cancer gradually damages the bone, it may become weaker. Occasionally a very weak bone can break (fracture). But treatment is usually started before a bone is weak enough to break.

Pressure on the spinal cord

If the cancer has spread to the bones of the spine, it may cause pressure on the spinal cord.

The symptoms can include:

  • unexplained pain in the back, around the chest, neck, or down the arm
  • numbness or pins and needles in toes, fingers or buttocks; unsteadiness or difficulty walking
  • problems with bladder or bowel control.

It is very important to let your cancer doctor or nurse know immediately if you have any of these symptoms. Doctors can usually treat spinal cord compression successfully when it is diagnosed quickly.


The lungs

The first symptoms may be a cough that does not get better or feeling breathless.

If cancer cells settle in the tissues that cover the lungs (called the pleura), it can lead to irritation. This causes fluid to build up and press on the lungs, making you breathless. This is called a pleural effusion. Your doctor can drain the fluid away to make your breathing easier.

Doctors use different treatments to treat and manage breathlessness.


The liver

Some women may have discomfort or pain in the right side of the tummy (abdomen) under the ribs around the liver. Other symptoms can include feeling sick, losing your appetite, or feeling very tired and generally unwell.

Occasionally, secondary breast cancer in the liver causes a build-up of bile in the blood causing jaundice. This makes the skin and whites of the eyes yellow and your skin feels itchy.

You usually have chemotherapy to improve these symptoms.


The brain

A secondary cancer in the brain may cause headaches and feeling or being sick. These symptoms are caused by increased pressure in the brain and they may be worse first thing in the morning.

Other symptoms will depend on the part of the brain that’s affected. They can include weakness or numbness in an arm or a leg, dizziness, loss of balance, or changes in mood or personality. Some women may have seizures (fits).

It is natural to feel worried about a cancer that affects the brain, but treatments can usually control the symptoms quickly.

Doctors give radiotherapy to the head and drugs called steroids to improve the symptoms.

The meninges

Occasionally breast cancer cells may spread to the tissue called the meninges that covers the brain and spinal cord. Doctors call this meningeal metastases or carcinomatous meningitis. It causes symptoms similar to a secondary cancer in the brain.

Back to Understanding secondary breast cancer

Why do cancers come back?

Sometimes, tiny cancer cells are left behind after cancer treatment. These can divide to form a new tumour.