Metastatic breast cancer symptoms

Metastatic breast cancer (which includes stage IV breast cancer) can cause a range of symptoms, and not every person experiences them in exactly the same way.

There are some symptoms that can happen no matter where metastatic breast cancer is in the body, including:
• Severe fatigue
• Weight loss
• Poor appetite
• Nausea
• Vomiting
• Generally not feeling well

Other symptoms of metastatic breast cancer are directly related to where in the body the cancer has spread — such as the bones, lungs, liver, or brain. Usually, the symptoms depend on where the new areas of cancer are and their size.

It can be hard to tell the difference between symptoms caused by breast cancer itself and side effects caused by ongoing or past treatments. It can also be hard to tell if a symptom is due to something else entirely. That’s why it’s important get any new symptoms checked out.

It's normal to feel concern when something seems “off” in your body. It’s also important to know that just because you have a symptom, it doesn’t always mean metastatic breast cancer. On this page, you can learn about common metastatic breast cancer symptoms, and we’ll share links to more detailed information.

Talk to your care team

Whether you’ve already been diagnosed with metastatic breast cancer or you're concerned about it due to a past early-stage diagnosis, it’s important to talk to your care team if you have a new symptom that is unusual for you.

Many of the symptoms we talk about on this page can have other causes besides metastatic breast cancer. Headaches, body aches, or a cough are fairly common and can be caused by non-cancerous conditions. Also, if you’re currently receiving cancer treatments or finished them recently, you could still be experiencing side effects from those. Still, if you have a new symptom, share it with your care team and ask if an exam or testing makes sense.

It can be helpful to track any symptoms over time, either by writing them down or creating a file on your computer or phone. This way, you and your doctor can understand more about what you’re experiencing, such as when it happens and if it happens during or after a specific activity.

If your symptom is sudden, severe, or way out of the ordinary for you, your care team may decide to investigate right away. If it’s milder and comes and goes, your team might ask you to track your symptom for several days to a couple of weeks to see if it improves on its own. Remember that you know the most about what does (and doesn’t) feel normal for you.

But there are some general guidelines on when to call your care team, Dr. Mehta says. Let your team know if:
• It’s a new symptom you don’t recognize
• It’s unprovoked, meaning you’re not really sure why it happened (a cough that was not preceded by an upper respiratory infection, a pain that wasn’t from exercise or a fall, for example)
• It doesn’t go away with usual remedies (cough medicine, NSAIDs, or rash creams, for example)
• It lasts for 2-3 weeks

“Two to three weeks is my personal cutoff, since most things tend to resolve on their own in a few weeks,” Dr. Mehta says.

Here are some questions you can ask your care team if you have a new symptom:

• Could this symptom be due to my current treatment, or treatments I had in the past?
• What else besides metastatic breast cancer might be causing this symptom?
• How long should I monitor how I’m feeling before I contact you again? If this symptom worsens, should I call right away?
• If this symptom doesn’t get better, what would you recommend?
• Will I need imaging or blood tests?
• How will we know for sure whether this symptom is or isn’t caused by a metastasis?

It’s important to let your care team know what’s happening if you’re concerned.

You can also call or sign up with the LBBC Breast Cancer Helpline. We’ll connect you with a trained volunteer whose experience matches yours. Our volunteers are ready to listen and offer emotional and practical support.

Symptoms based on location of metastasis

If breast cancer travels beyond the breast, it can spread to organs including the bones, brain, liver, or lung. As the cancer grows, it causes symptoms specific to that area of the body. Here, we’ll talk about some of the most common symptoms.

Keep in mind that many of these symptoms can have less serious causes. A headache can result from eye strain or too much time on the computer. Back, neck, or leg pain can occur after a strain during exercise, sitting for too long, or even sleeping in a strange position. Stress and anxiety can cause physical symptoms, too. Your care team can help you figure out if any unusual or persistent symptom needs to be more closely examined with tests.

Bone metastasis symptoms

Bone metastasis happens when breast cancer cells spread to any bones in the body, such as the spine, rib, hip, pelvis, the long bones in the arms and legs, or the skull. The bones are the most common place where breast cancer tends to spread. Over time, the bones can weaken and fracture more easily. Symptoms can include:

• An unexplained dull or sharp pain in the bone, back, or neck. It may come and go or be persistent.
• A bone fracture or break causing sudden, severe pain. When bones are weakened, even normal activity can result in a fracture.
• Back or neck pain, which may also include numbness in the arms, legs, hand, or feet. These can be signs of spinal cord compression: a tumor in the back pressing down on the spinal cord. Other symptoms may include constipation or trouble urinating.
• Symptoms due to high levels of calcium being released from the bones into the bloodstream. Examples can include fatigue, excessive thirst, muscle weakness and aches, confusion, urinating more frequently, and constipation.

Like many metastatic breast cancer symptoms, some of these can be caused by non-cancerous conditions. Bone or joint pain and bone loss can also be side effects of certain medicines, such as hormonal therapy. No matter what’s happening, let your doctor know. For more information, visit the bone metastases page.

Brain metastasis symptoms

If breast cancer spreads to the brain, it can lead to a wide range of symptoms that are also common to some non-cancer conditions. Some people with brain metastases experience one or more of these symptoms:

• Frequent headaches
• Dizziness or balance problems
• Nausea and vomiting
• Changes in speech, vision, or behavior
• Seizures
• Issues with memory
• Confusion

There are also breast cancer treatments that can cause some of these issues. If you’re experiencing any of these, tell your care team. Visit our brain metastasis page to learn more.

Liver metastasis symptoms

When breast cancer spreads to the liver, it may not cause any symptoms at first. Sometimes, routine blood tests for liver function pick up changes in protein or enzyme levels that can show the possibility of liver metastasis. If the cancer does cause symptoms, these can include:

• Sudden weight loss or poor appetite
• Fatigue or weakness
• New pain, swelling, or discomfort in the abdomen
• Swelling of the legs
• Itchy skin

Some of these, such as vomiting and weight loss, can happen as a result of certain treatments including chemotherapy and targeted therapy. And some of them can have causes that are not cancer. No matter what you’re experiencing, it’s important to check it out with your care team. For more information, visit our section on liver metastasis.

Lung metastasis symptoms

If breast cancer spreads to the lungs, it often causes symptoms such as:

• Shortness of breath, despite little physical activity
• A stubborn, dry cough
• Coughing up blood
• Sudden, severe chest pain

These symptoms can also be caused by non-cancerous conditions. And pain in the chest area can happen after breast cancer surgery. No matter what’s happening for you, it’s important to let your doctor know if you are experiencing any of the symptoms listed above. To learn more, visit our section on lung metastasis.