When we hear breast cancer, chills run down our spine. As with most diseases, breast cancer also develops in stages. Although it is true that early detection is the best, it's equally important to know that even at later stages, management and support still play a crucial role in treating and managing this type of cancer. This means that for patients and their families, knowledge of the signs of last-stage, or metastatic, breast cancer is important to make informed decisions about care, pain control, and quality of life. And, to have a clearer understanding of the symptoms of the last stage of breast cancer, we spoke to our expert, Dr Anil Thakwani, Consultant and Senior Oncologist, Shardacare, Health City, Noida. Here is what he shared with us!
Metastatic Breast Cancer (MBC) refers to the spread of the cancer outside the breast and surrounding lymph nodes to other locations in the body. “While an MBC diagnosis can be very tough, knowing the possible symptoms makes it easier to anticipate and manage, and ensures dignity and comfort during this trying time,” Dr Thakwani explained.
Symptoms Of Last Stage Of Breast Cancer
Some of the more important symptoms that can signal last-stage breast cancer, grouped by the parts of the body most involved in metastasis, include:
1. Bone Metastasis
Bones are among the most frequent targets for breast cancer to metastasise to. When cancer cells find a place in the bones, they can be very problematic:
- Persistent Pain in the Bone: This is usually the most significant symptom. The pain might be as dull as aching or as sharp as severe pain and can increase at night or with movement. It's very important to be able to differentiate this from the aches and pains of daily living since bone pain due to cancer is chronic and cumulative.
- Bone Fractures: Cancerous lesions weaken bones, making them more prone to fractures from even slight falls or normal movement. These are commonly known as ‘pathological fractures.’
- Hypercalcemia (Elevated Calcium Levels): As cancer destroys bone, calcium can be released into the blood and cause hypercalcemia. Signs and symptoms include fatigue, thirst, frequent urination, nausea, constipation, confusion, and even cardiac rhythm disturbances. The expert suggested that an immediate medical consultation is necessary for this complication.
- Spinal Cord Compression: When the cancer invades the vertebrae (spine bones), it can compress the spinal cord, leading to pain in the back, weakness, numbness or tingling in the legs, and in severe instances, loss of bladder or bowel function. This again is an emergency.
2. Liver Metastasis
The liver is another common location for breast cancer metastasis. The symptoms usually are related to the detoxification and digestive functions of the liver:
- Jaundice: Yellowing of the skin and eyes, a result of excess bilirubin in the blood.
- Abdominal Pain or Comfort: Pain or pressure in the upper right part of the abdomen.
- Nausea, Vomiting, Loss of Appetite: These may result in severe weight loss and malnutrition.
- Weakness and Fatigue: Non-specific tiredness that is not relieved by rest.
- Ascites (Fluid Buildup): Abdominal swelling caused by fluid buildup.
3. Lung Metastasis
When breast cancer metastasises to the lungs, it can compromise the ability of the body to breathe properly:
- Shortness of Breath (Dyspnea): This can be from mild breathlessness on exertion to extreme shortness of breath even at rest.
- Persistent Cough: Dry or productive cough that persists.
- Chest Pain: Chest pain or discomfort.
- Hemoptysis (Coughing up Blood): Although rarer, this is an urgent symptom that needs immediate medical care.
4. Brain Metastasis
Though more rare than liver, lung, or bone metastasis, breast cancer does metastasise to the brain, producing neurological symptoms:
- Headaches: Refractory, persistent headaches that can progress over time and are not relieved by over-the-counter analgesics. They can be associated with nausea or vomiting.
- Seizures: Intractable brain electrical activity producing convulsions, altered consciousness, or other neurological phenomena.
- Changes in Vision: Blurred vision, double vision, or loss of part of the visual field.
- Weakness or Numbness in One Side of the Body: Like a stroke, this can impair arm or leg movement.
- Cognitive Changes: Memory impairments, confusion, trouble concentrating, or personality changes.
- Balance and Coordination Problems: Dizziness, unsteadiness, or trouble walking.
5. Skin Metastasis
Though less frequent, breast cancer can occur on or metastasise to the skin, even on parts of the body that are remote from the original tumour:
- Lumps or Nodules: New lumps or nodules on the skin.
- Skin Discoloration: Redness, reddish-purple patches, or a rash-like look.
- Open Sores or Ulcers: Skin sores that might be slow to heal.
- Inflammatory Breast Cancer (IBC) Recurrence: If IBC was the initial diagnosis, its recurrence can also be seen with symptoms such as redness, swelling, heat, and orange-peel texture to the skin.
General Symptoms Suggesting an Advanced Stage Of Breast Cancer
Aside from the organ-specific signs, various general signs can suggest advanced cancer:
- Severe Fatigue: Profound tiredness that is not alleviated by rest.
- Unexplained Weight Loss: Pointless weight loss without deliberate dieting.
- Loss of Appetite: General lack of interest in food.
- Generalised Weakness: A sense of general body weakness.
- Fever and Chills: Low-grade recurring fever or repeated fevers, particularly with associated chills, maybe a sign of infection or end-stage cancer.
Bottomline
Though the subject of terminal breast cancer is bleak, learning about its possible manifestations enables the patient and family to better walk this path with awareness and to campaign for the best available care and assistance. The emphasis changes from cure to comfort, dignity, and optimising the quality of life left.