What is metastatic breast cancer?

Metastatic breast cancer is when cancer cells spread from your breast and nearby lymph nodes to other parts of your body. It is also known as advanced breast cancer, secondary cancer or stage 4 breast cancer.

Metastatic breast cancer is different to early or locally advanced breast cancer because it has spread outside of the breast and the nearby lymph nodes, to your bones or other organs.

Females and males can get metastatic breast cancer. Transgender women on hormone medicines and transgender men who have had their breasts removed can still get metastatic breast cancer. Treatment is similar for all people. Females and transgender women taking female hormones have a higher risk of breast cancer than males.

What are the symptoms of metastatic breast cancer?

The symptoms of metastatic breast cancer can be general or related to where the cancer has spread to. You may also not have any symptoms. The most common areas for breast cancer to spread are your bones, liver, lung or brain, but it doesn't necessarily spread to any or all these places.

General symptoms include fatigue, depression and anxiety.

Every person's experience of metastatic breast cancer is different. Depending on which body part is affected, you may experience symptoms in different parts of your body:

• bone — pain, broken bones from injuries that wouldn't usually cause a break, high calcium on blood tests
• liver — jaundice, bleeding problems, fluid building up in your abdomen
• lung — difficulty breathing, cough, chest pain when you breathe, coughing up blood
• brain and spinal cord — headache, changes to movement or feeling, thinking difficulties, seizures
• lymph nodes — pain

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes metastatic breast cancer?

Metastatic breast cancer is caused by breast cancer cells spreading to another part of your body. This can happen before or after treatment. You may be diagnosed with metastatic breast cancer months or years after you finish treatment for early breast cancer.

You can be diagnosed with metastatic breast cancer at the same time you are first diagnosed with breast cancer, but this is uncommon.

When should I see my doctor?

You should see your doctor if you have any new symptoms or if your symptoms are getting worse. You should also see your doctor if you have had breast cancer in the past and you are worried.

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How is metastatic breast cancer diagnosed?

Your doctor can diagnose metastatic breast cancer by doing various tests. The tests will depend on where you are in your cancer journey.

After you are first diagnosed with breast cancer, you will have tests to check if the cancer has spread. These tests tell your doctor what stage the cancer has reached. Tests may include:

• blood tests
• bone scan
• CT scan
• PET scan

If you develop symptoms that could be from metastatic breast cancer after you have already had treatment then your doctor will examine you and order tests that relate to the problem you have noticed. Tests may include:

• blood tests
• Bone scan
• x-ray
• CT san
• MRI
• ultrasound.

How is metastatic breast cancer treated?

Metastatic breast cancer can be treated in different ways depending on:

• where the metastases (cancers that have spread) are
• the type of breast cancer you have
• your general health

Medicines include chemotherapy, hormone therapy and targeted therapy. Sometimes surgery or radiotherapy is used.

The goal of treatment in metastatic breast cancer is to increase your life expectancy, improve your quality of life and manage your symptoms, but usually not to cure the cancer.

Being diagnosed with metastatic breast cancer can bring up many emotions for you, your family and friends. It is important to speak to your doctor or nurse about this so they can help you get mental health support.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

What are the complications of metastatic breast cancer?

Complications of metastatic breast cancer can affect many different parts of your body, through the symptoms described above.

Cancer treatments can also cause many different side effects. Some examples include nerve pain, hair loss and changes to memory and thinking.

Can metastatic breast cancer be prevented?

If breast cancer is prevented, then it will not become metastatic.

There is no proven way to definitely prevent breast cancer. However, you can help lower some of the risk factors, by being a healthy weight and limiting alcohol.

Resources and support

• Cancer Council Australia provides services and support to all people affected by cancer. Call on 13 11 20.
• Read more on living with breast cancer and managing physical changes of metastatic breast cancer at the Cancer Australia website.
• The Cancer Institute of NSW has information about cancer in many community languages.
• Read about cancer for Aboriginal and/or Torres Strait Islander people.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.