Table of ContentsView AllTable of ContentsMost Common SitesLymph NodesBoneLungLiverBrain
Table of ContentsView All
View All
Table of Contents
Most Common Sites
Lymph Nodes
Bone
Lung
Liver
Brain
Researchers are working to identify the reasons why breast cancer spreads, especially because it appears to spread along these preferred pathways. They’re focused on newbiomarkersand new tools to detect metastasis and improve the prognosis (outlook) for breast cancer.
Beyond lymph nodes, the areas of the body to which breast cancer spreads vary but often within certain patterns. A 2024 study of breast cancer metastasis reported the most common spread to organs includes:
Spread to the adrenal glands and other sites in the body occurs rarely.
Where breast cancer spreads also depends on the specific genetic mutations and subtype of cancer. For example, some studies find luminal (HR+/HER2+/HER2-) breast cancers more likely to spread to bone, whiletriple-negative breast cancertrends toward the liver and lungs.
Treatment optionsmay be similar no matter where breast cancer has spread, but some treatments are used for specific sites of metastasis as well. However, in roughly a third of cases, cancer spreads to multiple organs at the same time.
Lymph Nodes and Spread
Lymph-node positive canceris considered a regional spread and not a distant spread, even though the spread may be referred to as metastasis. Yet lymph-node positive breast cancer can be a stage 2 through stage 4, since breast cancer often spreads to lymph nodes first. Additionally:
Keep in mind that any breast cancer that spreads is still referred to as breast cancer, not liver, lung, or brain. The cancer in these other sites is a secondary rather thanprimary cancer, unless a new one occurs.
The most common site of distant breast cancer metastases is in the bones.The ones most commonly affected include the spine, ribs, pelvis, and long bones of the arms and legs.
Pain can but does not always occur with bone metastasis. Apathologic fractureto a cancer-weakened bone may be the first sign, or the spread may be found on a routine bone scan.
Bone metastases tend to have a fairly good prognosis when compared with spread to the brain and other sites. Treatment can include:
Lung metastases may be suspected based on a scan, which often shows multiple small areas of metastases (in contrast to lung cancer, for example, which is more likely to appear as a single large mass).
In addition to other cancer treatments, radiation may help to remove tumors blocking the airway. However, it’s important to make sure that a nodule in the lung is, indeed, due to breast cancer. Primary lung cancer is treated differently than breast cancer that spreads to the lungs.
Metastatic breast cancer often causes fluid build-up in the space between membranes that line the lungs. Thesepleural effusionsalso occur with spread to the lymph nodes near the lungs (themediastinum).The fluid may be benign and related to inflammatory changes or contain cancer cells. It can be treated with drainage or apleurodesisprocedure to prevent its recurrence.
Breast cancer metastasis to the liver is common.Liver metastasesmay be present without any symptoms. If symptoms do occur, they can include:
Sometimes, liver metastases are detected based on abnormalliver function blood testsor tests such as a positron emission tomography (PET) scan. Treatment can include:
The liver acts as the detoxification center of the body, so treatments must be delicately balanced. Sometimes, liver metastases reduce the ability to tolerate chemotherapy.
Cancer Recurrence and MetastasisMetastasis may occur months, years, or even decades after the original tumor was detected and treated; some cancer cells can survive and lie dormant, waiting to grow at a later time. Arecurrencecan be local (at the original tumor site), regional, or distant.
Cancer Recurrence and Metastasis
Metastasis may occur months, years, or even decades after the original tumor was detected and treated; some cancer cells can survive and lie dormant, waiting to grow at a later time. Arecurrencecan be local (at the original tumor site), regional, or distant.
Breast cancerspreads to the brainin some cases. It’s more common withHER2+ tumorsand triple-negative breast cancer.Symptoms can include:
Not everyone with brain metastases has symptoms, though. Sometimes, they’re only found because of imaging tests performed on the brain. Treatment can include:
Treatments such as chemotherapy and targeted therapies are often ineffective due to the blood-brain barrier, which is a tight network of capillaries designed to protect the brain from toxins (such as chemotherapy). Researchers are working on ways to modify this barrier, such as using targeted ultrasound to allow drugs to pass through.
Leptomeningeal MetastasesLeptomeningeal metastases, also called carcinomatous meningitis, occurs when cancer cells spread to the cerebrospinal fluid that bathes the brain and spinal cord. Cancer cells float freely in the space between the leptomeninges (the subarachnoid space), typically late in the disease.
Leptomeningeal Metastases
Leptomeningeal metastases, also called carcinomatous meningitis, occurs when cancer cells spread to the cerebrospinal fluid that bathes the brain and spinal cord. Cancer cells float freely in the space between the leptomeninges (the subarachnoid space), typically late in the disease.
Summary
Treatment for metastatic breast cancer includes radiation and chemotherapy, as it does with other cancer types. Targeted therapies may be used with specific cancer types. Talk to your cancer care team about your treatment options if your breast cancer has spread to other organs.
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