Fast Five Quiz: Metastatic Breast Cancer Signs and Symptoms

Elwyn C. Cabebe, MD; Winston W. Tan, MD, FACP; Stefania Morganti, MD

Disclosures

December 21, 2022

Primary breast cancer cells metastasize through the blood or lymph vessels to distant organs. Most women with metastatic breast cancer are diagnosed with symptoms or abnormalities at physical examination. Frequent sites of breast cancer metastasis are bone, lung, liver, and brain, in addition to lymph nodes.

Approximately 70% of patients with metastatic breast cancer will develop bone metastasis. Bone metastasis may trigger skeletal-related events, including bone pain, hypercalcemia, vertebral and nonvertebral pathologic fractures, and spinal cord compression.

Lung metastasis is common in patients with metastatic breast cancer, occurring in up to 32% of patients. Symptoms may include cough, shortness of breath, chest pain, weakness, hemoptysis, and weight loss. Liver metastasis occurs in about 50%-70% of patients with metastatic breast cancer. Most patients with metastatic breast cancer are asymptomatic at time of diagnosis of liver metastasis, which is detected upon abnormalities in liver function tests. Symptoms caused by liver metastasis are abdominal pain or discomfort, fatigue, weight loss or poor appetite, fever, bloating, jaundice, and leg edema.

Breast cancer is the second most frequent cause of brain metastasis after lung cancer. Approximately 60%-75% of patients present with neurologic symptoms, which vary depending on the location and size. Seizures occur in 10%-20% of patients at time of diagnosis of brain metastasis; an additional 10%-12% of seizure-naive patients at initial presentation will subsequently develop seizures.

Learn more about metastatic breast cancer.

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