Table of ContentsView AllTable of ContentsEarly DiagnosisRecurrenceFear and UnderstandingHow Breast Cancer SpreadsWhy It Spreads and RecursRisk FactorsSymptomsDiagnosisTreatment and OutlookSummary
Table of ContentsView All
View All
Table of Contents
Early Diagnosis
Recurrence
Fear and Understanding
How Breast Cancer Spreads
Why It Spreads and Recurs
Risk Factors
Symptoms
Diagnosis
Treatment and Outlook
Summary
“Metastasis” is the term for the spread of cancer. About 250,000 women are diagnosed with breast cancer and roughly 40,000 will die from the disease each year.When breast cancer is diagnosed in the early stages, many women go on to live cancer-free lives.
Yet for others, the disease is metastatic at the time of diagnosis or later recurs. It’s thought that metastatic disease is responsible for around 66% of the deaths related to breast cancer.Here’s how breast cancer spreads or recurs.
STEVE GSCHMEISSNER / Getty Images
The risk that breast cancer will recur or spread is correlated with the size of the tumor and extent of spread at the time of diagnosis.
For roughly 20% of women, breast cancer is diagnosed at the very earliest stage. Stage 0 breast cancer orcarcinoma in situis considered pre-invasive breast cancer.Since these earliest cancers have not spread beyond something called the basement membrane (they have not moved beyond the breast ducts), surgery should theoretically cure these cancers.
According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program, around 90% of people are diagnosed with localized or regional breast cancer that has not metastasized (spread to distant organs).These breast cancers, which are considered stage 1 to 3 cancers, may have spread to lymph nodes but are not present in other organs. With treatments such assurgery,chemotherapy,radiation therapy,hormonal therapy, and/or targeted therapies, many of these tumors will remain at bay. The risk, however, that they will appear again (recur) is greater with higher stages and if lymph nodes are involved.
Around 6% of women are diagnosed when cancer has already spread to distant areas of the body.Breast cancer is most likely to spreadto the bones,liver, lungs, and brain.
Most breast cancers that are metastatic are first diagnosed as early-stage breast cancers which later recur.Recurrencesmay be:
When breast cancer recurs at a distant location, it is no longer curable but is still treatable, and treatments can both improve symptoms and extend life.
Many people fear the recurrence of breast cancer, but most are able to find a balance between being aware and being paralyzed with fear. It’s common and normal to have a heightened awareness if you develop symptoms of possible spread after having primary breast cancer.
A headache is likely to be just a normal headache, but the thought of brain metastases may come to mind. Likewise, an ache in your back might make you worry about bone metastases while it’s far more likely that you slept wrong.
It’s important that every woman (and man) who has had breast cancer be knowledgeable about their expectations. Your oncologist can help you understand these based on your specific cancer,its stage, and other characteristics. Having a heightened awareness can ensure that you follow up with the appropriate visits and know when to call your healthcare provider. If the fear becomes emotionally crippling, however, a cancer therapist can help you maintain the balance between being conscientious and fearful.
Breast Cancer Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Download PDF
Email AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
Breast cancer can spread to other regions of the body in a few primary ways:
When breast cancer spreads to another organ, it is still breast cancer. For example, if breast cancer were to spread to the lungs, it would not be called lung cancer. Instead, it would be referred to as breast cancer spread to the lungs or breast cancer with lung metastases. If you were to look at thecancer cellsin the lungs under the microscope, they would be cancerous breast cells, not cancerous lung cells.
Cancers that have spread to other tissues may be different than the original tumor, and this is another area of confusion. Cancers aren’t just clones of abnormal cells that propagate mindlessly. Rather, they are continually changing and developing new mutations. For this reason, a tumor that wasestrogen receptor positivewhen found in the breast may now be estrogen receptor negative.HER2 statusmay change as well.This also explains why metastatic tumors are sometimes more aggressive than the original tumor.
Where does breast cancer spread to first?Breast cancer often first enters the lymphatic system when it begins to spread. Usually, the lymph nodes closest to the tumor are where it will move first.
Where does breast cancer spread to first?
Breast cancer often first enters the lymphatic system when it begins to spread. Usually, the lymph nodes closest to the tumor are where it will move first.
Why do breast cancer cells travel at all? And, why normal don’t cells spread around our bodies?Cancer cells differ from normal cellsin many ways.One of these is that normal cells have what is known as “adhesion molecules.” These adhesion molecules act like glue and keep cells where they belong in a particular part of the body.
Normal cells also have “boundaries” or ways in which cells communicate with each other. This is like one country saying to another, “You don’t belong here.” Cancer cells, in contrast, don’t respect these cellular communications, essentially ignoring the “fences” between different tissues.
Yet another confusing question is why metastasis can happen years or even decades later. We know that, especially with estrogen receptor-positive breast cancers, cancer can seemingly disappear only to recur many years after the original tumor. Nobody is certain exactly how this happens, but there aretheories about recurrencethat suggest that some breast cancer cells are hardier than others and that these cancer “stem cells” are able to lie dormant even through treatment.
How fast does breast cancer usually spread?Rapidly growing breast cancer tumors can double in size every 46 to 157 days. Intermediate ones usually range from doubling in size every 147 days to 531 days. Slower-growing tumors may take much longer.
How fast does breast cancer usually spread?
Rapidly growing breast cancer tumors can double in size every 46 to 157 days. Intermediate ones usually range from doubling in size every 147 days to 531 days. Slower-growing tumors may take much longer.
We don’t know which breast cancers will recur and which won’t, but there are some factors that increase the risk. These include:
General symptoms of metastatic breast cancer may include a feeling of being unwell,unintentional weight loss, or a decrease in appetite.
When breast cancer spreads to the lungs, it may cause shortness of breath and a cough. Liver metastases due to breast cancer may result in abdominal discomfort and jaundice, a yellowish discoloration of the skin.
Knowing this, women who have had early-stage breast cancer may become nervous if they develop any of these symptoms. Be gentle with yourself. Those who have not had breast cancer may think you are overreacting to new aches and pains, but those who have had breast cancer will get it. If it takes getting a symptom checked out so you can relax, make sure to do so.
Doctors have several ways of determining whether cancer has spread or not. These include imaging the body using X-rays, bone scans, MRIs, CT scans, or PET scans.Blood tests can check levels of certain chemicals in the blood, including specifictumor markersassociated with metastasis.
When breast cancer becomes stage 4 (metastatic), it is no longer curable but is still very treatable.Treatment options for metastatic breast cancerinclude chemotherapy, targeted therapy, osteoporosis medications, hormonal therapy, and newer treatments such as immunotherapy drugs in clinical trials. Isolated metastases, such as those to the brain, are sometimes treated with surgery or radiation therapy.
What is the deadliest stage of breast cancer?Stage 4, or metastatic, cancer is the deadliest, with a five-year survival rate of 31% in women and 20% in men.
What is the deadliest stage of breast cancer?
Stage 4, or metastatic, cancer is the deadliest, with a five-year survival rate of 31% in women and 20% in men.
In general, the goal oftreatmentis very different from metastatic breast cancer compared with earlier stages of the disease. With early-stage disease, treatment is often aggressive with the aim of complete remission. With stage 4, however, the least amount of treatment to control the disease is usually the goal. Aggressively treating this stage does not improve outcomes but does increase the risk of side effects and a poorer quality of life.
What is the life expectancy of a person with breast cancer?The life expectancy of someone with breast cancer ranges dramatically depending on factors such as age, general health, the stage of cancer at diagnosis, and how the body reacts to treatment. Five-year survival rates range from 31% to 99%.
What is the life expectancy of a person with breast cancer?
The life expectancy of someone with breast cancer ranges dramatically depending on factors such as age, general health, the stage of cancer at diagnosis, and how the body reacts to treatment. Five-year survival rates range from 31% to 99%.
Recurrence risks vary based on factors like tumor stage, lymph node involvement, and aggressiveness. While metastatic breast cancer is incurable, treatments like chemotherapy and targeted therapies can manage symptoms and help to extend your life.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Special section: Breast cancer in situ; 2015.
National Breast Cancer Foundation, Inc.Metastatic breast cancer.
Natale G, Stouthandel MEJ, Van Hoof T, Bocci G.The Lymphatic System in Breast Cancer: Anatomical and Molecular Approaches. Medicina (Kaunas). 2021 Nov 19;57(11):1272. doi: 10.3390/medicina57111272. PMID: 34833492; PMCID: PMC8624129.
Chiang SP, Cabrera RM, Segall JE.Tumor cell intravasation.Am J Physiol Cell Physiol. 2016;311(1):C1–C14. doi:10.1152/ajpcell.00238.2015
National Cancer Institute.Metastatic Cancer: When Cancer Spreads.
Rong Chen, Morad Qarmali, Gene P. Siegal, Shi Wei.Receptor conversion in metastatic breast cancer: analysis of 390 cases from a single institution.Modern Pathology. Volume 33, Issue 12, 2020. Pages 2499-2506. ISSN 0893-3952. doi: 10.1038/s41379-020-0615-z
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-.Overview: Metastatic breast cancer. [Updated 2024 Jan 23]
National Cancer Institute.What is cancer?; 2015.
Förnvik D, Lång K, Andersson I, Dustler M, Borgquist S, Timberg P.ESTIMATES OF BREAST CANCER GROWTH RATE FROM MAMMOGRAMS AND ITS RELATION TO TUMOUR CHARACTERISTICS. Radiat Prot Dosimetry. 2016 Jun;169(1-4):151-7. doi: 10.1093/rpd/ncv417. Epub 2015 Sep 25. PMID: 26410768.
Cleveland Clinic.Metastatic cancer.
Hamilton W, Barrett J, Stapley S, Sharp D, Rose P.Clinical features of metastatic cancer in primary care: a case-control study using medical records. Br J Gen Pract. 2015 Aug;65(637):e516-22. doi: 10.3399/bjgp15X686077. PMID: 26212847; PMCID: PMC4513739.
American Cancer Society.Imaging tests to find out if breast cancer has spread; 2019.
American Cancer Society.Treatment of stage IV (metastatic) breast cancer; 2019.
National Breast Cancer Foundation.Metastatic Breast Cancer.
American Cancer Society.Survival Rates for Breast Cancer.
Muzes, G., and F. Sipos.Metastatic Cell Dormancy and Re-Activation: An Overview on Series of Molecular Events Critical for Cancer Relapse.Anticancer Agents in Medicinal Chemistry. 2017. 17(4):472-482.National Cancer Institute.Metastatic Cancer.
Muzes, G., and F. Sipos.Metastatic Cell Dormancy and Re-Activation: An Overview on Series of Molecular Events Critical for Cancer Relapse.Anticancer Agents in Medicinal Chemistry. 2017. 17(4):472-482.
National Cancer Institute.Metastatic Cancer.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
