For many women who are treated for primary breast cancer, which starts as a lump in the breast, the primary cancer doesn’t come back after treatment. However, sometimes cancer cells can spread through the bloodstream or lymphatic system – part of the immune system – to other parts of the body, forming another tumour or cancer. This is known as secondary, stage 4, metastatic or advanced breast cancer.

Although when breast cancer is diagnosed, the treatment is tailored to try to remove all of the cancer cells, in some cases some cells do escape treatment. Most commonly, if the breast cancer spreads, it goes to the bones, brain, lungs or liver, but it can also spread to other parts of the body, such as the ovaries, skin or bone marrow. It can also spread to more than one organ at the same time. Of the small proportion of women who develop secondary breast cancer, the disease often doesn’t appear until years after the initial breast cancer treatment.

Unfortunately, secondary breast cancer can’t be cured, although it can be treated, to relieve symptoms, control the cancer and give you the best quality of life for as long as possible. The most common treatments for secondary breast cancer are hormone therapy, targeted therapy and chemotherapy, although radiotherapy may be used if the cancer has spread to the brain or bones.

As secondary breast cancer affects different parts of the body, it can be hard to give a single list of symptoms. Some symptoms of secondary breast cancer include:

• Persistent, nagging pains in your bones and joints that tends to be there day and night
• Fractures in the bones

• Reoccurring headaches
• Trouble with speech, vision or coordination
• Numbness or weakness in a part of the body
• Behavioural changes
• A cough that doesn’t get better
• Breathlessness

• Discomfort around the abdomen
• Jaundice, where the skin and whites of the eyes turn yellow

If you notice that you are feeling sick, tired and generally unwell, or have been losing weight, it’s always a good idea to visit a GP to put your mind at ease.

For further information on secondary breast cancer visit: www.christie.nhs.uk/patients-and-visitors/your-treatment-and-care/types-of-cancer/breast-cancer-secondary