- Recurrent metastatic breast cancer: In most cases, this is the result of breast cancer coming back (recurring) after initial treatment. Systemic therapies, like chemotherapy and endocrine therapy, are often used after surgery to help ensure cancer cells throughout the body are destroyed, but residual cancer cells sometimes remain. When this happens, the cancer can recur and spread.
- De novo metastatic breast cancer: MBC can be a person’s first diagnosis, though this is more rare. This means that by the time breast cancer is caught, it’s already spread to somewhere else in the body.
How metastatic disease is treated often depends on the biology of the original tumor. Your oncologist will typically test the tumor for biomarkers, including estrogen and progesterone receptor status, HER2 status and gene mutations. Cancers that are HER2-positive or triple-negative breast cancer (which lacks estrogen, progesterone and HER2 receptors) tend to require different treatment approaches than hormone receptor-positive cancers.
Common Sites of Spreading (Metastasis)
The sites within the body that breast cancer most commonly spreads include the:
- Bones (especially the ribs, spine and pelvis)
- Liver
- Lungs
- Brain
While these are the most common locations, stage IV breast cancer can spread to other areas of the body, like the abdomen, the skin or the lymph nodes.
Signs and Symptoms of Metastatic Breast Cancer
The symptoms of metastatic breast cancer vary depending on where in the body the cancer has spread.
Bone Metastasis Symptoms
If breast cancer spreads to the bone it can cause:
- New, sudden bone pain
- Bone fractures
- Tingling and numbness (sometimes related to nerve compression near the spinal cord)
Liver Metastasis Symptoms
If breast cancer spreads to the liver, it usually doesn’t cause symptoms. If symptoms occur, they can include:
- Abdominal pain
- Jaundice
Lung Metastasis Symptoms
If breast cancer spreads to the lungs, it usually doesn’t cause symptoms. If symptoms occur, they can include:
- Persistent cough
- Shortness of breath
- Chest pain
Brain Metastasis Symptoms
If breast cancer spreads to the brain, it can cause:
- Headaches
- Vision issues
- New, unexplained confusion
- Seizures
General Symptoms of Metastatic Breast Cancer
Beyond symptoms tied to a specific site, metastatic breast cancer can also cause more general symptoms, including fatigue, unintended weight loss and loss of appetite. These symptoms are worth discussing with your care team, even if they don’t point to a specific area of spread.
How Metastatic Breast Cancer Is Diagnosed
If you notice symptoms of metastatic breast cancer, your doctor may order one or more of the following tests to diagnose and stage the cancer:
Biopsy
A biopsy involves collecting a tumor sample that a pathologist can review in closer detail under a microscope.
Blood Tests
Blood tests, including a complete blood count (CBC) and serum chemistry tests may be recommended. If these tests come back abnormal, it can suggest the cancer has spread.
Imaging Tests
A range of imaging tests may be used to confirm and stage metastatic breast cancer, including:
- Bone scan: Used if spread from the breast to the bones is suspected
- Chest X-ray: Used if spread from the breast to the lungs is suspected
- CT scan: Used to visualize whether breast cancer has spread to the lungs, liver or bones
- Diagnostic mammogram or ultrasound: Sometimes used to help diagnose de novo metastatic breast cancer
- MRI: Used in certain cases to get a more detailed look at areas of suspected spread
Genetic and Biomarker Testing
Along with biopsy and imaging, your care team will typically test the tumor for biomarkers, including estrogen and progesterone receptor status, HER2 status and certain gene mutations, such as BRCA1 or BRCA2. This genetic testing helps determine the cancer's specific subtype and whether targeted therapy is an option, and it plays a central role in building your treatment plan.Treatment Options for Metastatic Breast Cancer
Metastatic breast cancer is treatable, and newer therapies are available to manage it and help people live longer. The disease is not curable, however.
How metastatic breast cancer is treated depends on the type of breast cancer, where it has spread, overall health, tolerance to treatment and more. Your oncologist will work with you to control its spread, relieve symptoms and improve your quality of life.
Chemotherapy
Chemotherapy uses medication to target and destroy cancer cells throughout the body and is one of the most common systemic therapies for metastatic breast cancer.
Hormone Therapy
For hormone receptor-positive cancers, hormone therapy works by blocking estrogen or lowering estrogen levels in the body to slow or stop cancer growth.
Radiation Therapy
Radiation therapy uses high doses of radiation to target and destroy cancer cells in a specific area, such as a metastatic tumor in the bone or brain.
Immunotherapy
Immunotherapy helps the immune system recognize and attack cancer cells, and may be an option for certain subtypes, such as triple-negative breast cancer.
Targeted Therapy
Targeted therapy focuses on specific features of cancer cells, such as HER2 status or other biomarkers. Some targeted therapies use an antibody-drug conjugate to deliver treatment directly to cancer cells while limiting damage to healthy tissue.
Surgical Treatments
In rare cases, surgery may be used to remove the primary breast tumor or to address complications, such as bone metastases that are causing pain or fractures.
Clinical Trials
Clinical trials continue to explore new treatments and strategies for metastatic breast cancer, including newer targeted therapies. Participating in a clinical trial can give patients access to the most advanced treatments before they’re widely available elsewhere. Visit our clinical trials page to see if there are any active clinical trials for your cancer type.
Living With Metastatic Breast Cancer
Living with metastatic breast cancer can be challenging, but there are ways to help manage your condition and maintain the best possible quality of life. From symptom management and shared decision-making in your treatment plan to self-care and emotional support, our care teams are here for you.
Breast Cancer Support Groups
At Houston Methodist Dr. Mary and Ron Neal Cancer, our breast cancer support groups help women and men at any stage of diagnosis and treatment understand how breast cancer affects them not just physically, but emotionally and spiritually. Through information, empowerment and peer support, our hope is that no one faces breast cancer alone.
Why Choose Houston Methodist as Your Cancer Care Provider
Houston Methodist Neal Cancer Center is where innovation meets personalized treatment, offering compassionate, expert cancer care. Our breast cancer specialists employ some of the most advanced, cutting-edge techniques in the country.
At Houston Methodist, you're not just a patient, you're part of a family united in the fight against breast cancer. You can trust our team to provide top-tier medical care and unwavering support every step of the way.