Being diagnosed with secondary breast cancer

Women may be diagnosed with secondary breast cancer after having tests to check a new symptom. This can be either through their GP or at a follow-up clinic. Sometimes there are no obvious symptoms and the diagnosis is made after routine follow-up tests.

You’ll see a cancer doctor or a breast care nurse. They will ask about your symptoms and general health, and explain which tests you need. You will have general blood tests to check your blood count and how your liver is working.

The tests you have will depend on your symptoms. For example, you will have a bone scan if you have bone problems. You will often have a detailed scan, such as a CT, MRI or PET-CT scan. Some women may have x-rays of the bones and lungs or an ultrasound scan of the liver. Some women have a sample of tissue taken (a biopsy) from the secondary cancer.

Waiting for your test results can be difficult. You may want to talk to someone close to you or one of our cancer support specialists.

How secondary breast cancer is diagnosed

Some women see their GP with a new symptom. Your GP may arrange some tests or refer you directly to your cancer doctor (oncologist).

Sometimes women don’t have any obvious symptoms. Their doctor may notice something at a routine appointment that needs to be checked further. Tests then show there is a secondary cancer.

Occasionally, women are diagnosed with secondary cancer at the same time as the primary breast cancer is found.


Your cancer doctor (oncologist) will examine you and ask questions about your symptoms and general health. You will usually also see a specialist breast nurse who will give you information and support.

Your doctor and nurse will explain which tests you need. This will depend on your symptoms. You will usually have some of the following tests.

Blood tests

Blood tests cannot diagnose secondary breast cancer but they may show that you need further tests. They can be used to:

  • check how well the liver and kidneys are working
  • check the level of calcium in the blood
  • measure the number of blood cells to show how well the bone marrow (where blood cells are made) is working
  • measure tumour markers – some cancers produce proteins or tumour markers that may be raised – but the results aren’t always reliable so it’s not always helpful to do this.



You may have an x-ray to check a painful area in your bones. It may not be able to detect small areas of secondary tumours. You will usually have a bone scan to confirm the diagnosis.


A chest x-ray can help to see if there is secondary breast cancer in the lungs. It can also see any build-up of fluid between the membranes on the outside of the lungs (the pleura). You’ll also usually have a CT scan.

Bone scan

This test finds any abnormal areas of bone. A mildly radioactive substance is injected into a vein. A scan of your bones is taken two or three hours later. We have more detailed information about having a bone scan.

Liver ultrasound

This uses soundwaves to build up a picture of the liver. It’s painless and only takes a few minutes. The person doing the ultrasound spreads a gel onto your tummy (abdomen). They pass a small device like a microphone, which produces soundwaves, over the area. The soundwaves are converted into a picture by a computer. You may have a CT scan of the liver rather than an ultrasound.

CT (computerised tomography) scan

A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. The scan takes 10–30 minutes and is painless. It uses a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.

CT scan
CT scan

View a large version

Read a description of this image

You may be given a drink or injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It’s important to let your doctor know if you are allergic to iodine or have asthma, because you could have a more serious reaction to the injection.

You’ll probably be able to go home as soon as the scan is over.

Someone having a CT scan

Having a CT scan

A radiographer explains how a CT scan works, and Jyoti talks about her experience.

About our cancer information videos

Having a CT scan

A radiographer explains how a CT scan works, and Jyoti talks about her experience.

About our cancer information videos

PET-CT scan

This is a combination of a CT scan, which takes a series of x-rays to build up a three-dimensional picture, and a positron emission tomography (PET) scan. A PET scan uses low-dose radiation to measure the activity of cells in different parts of the body.

PET-CT scans give more detailed information about the part of the body being scanned. You may have to travel to a specialist centre to have one. You can't eat for six hours before the scan, although you may be able to drink. A mildly radioactive substance is injected into a vein, usually in your arm. The radiation dose used is very small. The scan is done after at least an hour’s wait. It usually takes 30–90 minutes. You should be able to go home after the scan.

MRI scan

This test uses magnetism to build up a detailed picture of areas of your body. The scanner is a powerful magnet so you may be asked to complete and sign a checklist to make sure it's safe for you. The checklist asks about any metal implants you may have, such as a pacemaker, surgical clips, bone pins, etc. You should also tell your doctor if you've ever worked with metal or in the metal industry as very tiny fragments of metal can sometimes lodge in the body. If you do have any metal in your body it's likely that you won't be able to have an MRI scan. In this situation another type of scan can be used.

Before the scan, you'll be asked to remove any metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm, which doesn't usually cause discomfort. This is called a contrast medium and can help the images from the scan to show up more clearly. During the test you'll lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It's painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It's also noisy, but you'll be given earplugs or headphones. You can hear, and speak to, the person operating the scanner.


Some women have a piece of tissue removed (biopsy) from the secondary cancer to confirm the diagnosis.

The biopsy will also help to find out whether the cancer cells have certain receptors (ER or HER2). The secondary cancer may not be identical to the primary breast cancer.

You usually have the biopsy under a local anaesthetic as an outpatient. The doctor uses an ultrasound or a CT scan to help them guide the needle to the right place. Sometimes it may not be possible to do a biopsy if the cancer is in a difficult area to reach.

After the biopsy, the area may feel a bit uncomfortable for a couple of days. You can take regular painkillers to help with this until the pain goes away.

Waiting for test results

Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready. You may find it helpful to talk with your partner, family or a close friend. Your specialist nurse or one of the organisations listed on our database, can also provide support. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.