How Do I Know if I Have Metastatic Breast Cancer?

If your breast cancer spreads to other parts of your body, doctors will call it “metastatic.” ("Metastasize" means to spread.) It tends to go to the bones, lungs, liver, and brain. You’ll get tests before and during treatment to see if your breast cancer has spread. Signs and symptoms depend on where it is.

When it’s in your bones you may have:

If breast cancer spreads to your lungs, it can make you feel:

When it spreads to your liver, it can cause:

  • Belly pain or swelling
  • Appetite loss
  • Yellow skin or eyes
  • Tiredness
  • Confusion

If it’s in your brain, you might notice:

  • You can’t feel or move part of your body
  • Headaches that don’t get better or go away
  • Seizures
  • Vision or hearing changes
  • You feel sleepy

Your doctor may find it before you have symptoms. But if you have any of the signs listed here, tell your doctor right away Other things can cause these symptoms, but you should get them checked out, especially if you’ve had breast cancer before.

Tests

You might get blood tests done, but these can’t show for sure that cancer has spread. You’ll need to get imaging tests to see if the cancer has spread, and, if so, how far and to what parts of your body. Some of the tests that you may get include:

PET scan: You’ll get a radioactive sugar injected into your blood. Cancer cells will quickly use it up. A scan then shows all the places in your body where the sugar has collected. These areas could be cancer.

Bone scan: A radioactive tracer put into your blood collects in changed areas of bone that might be cancer. These “hot spots” can then be seen on a whole-body scan.

CT scan: Special X-rays show detailed 3-D pictures of your insides. Sometimes, doctors use a dye to get clearer pictures. You may get this test done at the same time as a PET scan (called a PET-CT).

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MRI: This test uses strong magnets to get detailed pictures of organs and structures inside your body. It’s very good at finding brain metastases, which are places in your brain where the cancer has spread.

Ultrasound: This type of test uses sound waves to look for tumors in your liver or other parts of your belly.

X-rays: These tests are fast, and doctors can use them to look for changes in bones, like fractures or breaks. But they won’t have as much detail as other imaging tests.

Biopsy: When an imaging test shows changes that might be cancer, you may need a biopsy. Your doctor may use a CT or ultrasound to help find the right spot to test. You’ll get a small piece of the changed area taken out (often with a needle) and tested in a lab.

Doctors will look for cancer cells and may do other tests, too. When cancer cells are found, your doctor will order more lab tests to see whether they’re breast cancer cells or another kind of cancer.

Test Results

It takes time to schedule and get your imaging tests, and then more time to get a biopsy.

Your imaging test results might be ready in a day or two. Biopsy results can take up to a week. Your doctor can give you an idea of how long it will take. Ask how you’ll get the results -- A phone call? An office visit? If you don’t hear from your doctor within a week, call the office.

It can be hard to wait. If you’re concerned that the cancer could get worse during that time, keep in mind that in most cases, the relatively short wait (though it feels long to you) won’t make a big difference to the cancer. If you have questions or are worried, tell your doctor. The answers may help you better understand your situation and the help you can get.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on March 30, 2017

Sources

SOURCES:

National Cancer Institute: “Metastatic Cancer,” “Diagnosis,” “Feelings and Cancer.”

American Cancer Society: “What is metastatic cancer?” “Managing symptoms of advanced cancer, by location,” “Tests to Find Out if Breast Cancer Has Spread (CT, PET, Bone Scan, MRI),” “Nuclear Medicine Scans for Cancer,” “CT Scan for Cancer,” “MRI for Cancer,” “X-rays and Other Radiographic Tests for Cancer,” “Reasons for delays in getting your biopsy and cytology test results,” “Hearing the news.”

American Society of Clinical Oncology: “Positron Emission Tomography and Computed Tomography (PET-CT) Scans,” "Bone Scan,” “Computed Tomography (CT) Scan,” “Ultrasound,” “After a Biopsy: Making the Diagnosis.”

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