Where breast cancer spreads

Few women enjoy getting a mammogram. But we do it because we like the idea of breast cancer even less. An even bigger worry is the possibility of breast cancer that’s spread. Is there a way to catch that before it happens?

Your best defense is still a mammogram, said Cathryn Johnson, MD, breast surgical oncologist at Baptist MD Anderson Cancer Center.

“The only way to prevent breast cancer from going anywhere is to find it and get rid of it before it has a chance to spread,” Dr. Johnson said. “And the best way to do that is by seeing it before you feel it. You do that with a screening mammogram.”

One in eight women will get breast cancer during her lifetime, according to the American Cancer Society. When caught before it’s spread to other parts of the body, the five-year survival rate is 99%. When it spreads to nearby lymph nodes, the survival rate goes to 86%, and if it spreads to a distant part of the body, the rate drops to 29%.

Traveling the body’s network

Cancer happens when cells in the body divide uncontrollably and then spread into the surrounding tissue. Breast cancer begins in the linings of the breast lobules – the structures that make milk – or in the ducts, which carry milk. One of the ways it’s able to spread outside the breast is through the body’s lymphatic system, a large network of vessels that moves fluid around the body and helps with immune response.

“The tiny lymphatic vessels in the breast are like a super highway to your lymph nodes,” Dr. Johnson said. “From there, cancer cells can go anywhere in your body.”

Spread and symptoms

The most common places breast cancer cells spread to are the lungs, liver, bones, and brain. That doesn’t mean they become lung or liver cancer, though.

“It’s still breast cancer,” Dr. Johnson said. “If a pathologist performs a biopsy on the cancer cells from the lung and conducts special tests, it will show the cancer started in the breast.”

Eventually, the cancer will cause symptoms at the location where it’s spread:

• Lungs: Chest pain, shortness of breath and persistent cough
• Liver: Stomach pain and bloating, loss of appetite and nausea
• Bones: Weak bones, aches and fatigue
• Brain: Headaches, memory problems and seizures

These symptoms can also be caused by other conditions, Dr. Johnson said. They should be evaluated but they don’t necessarily indicate cancer.

“People with metastatic breast cancer are not always symptomatic,” Dr. Johnson said. “By the time the cancer causes symptoms like these, it’s typically quite advanced.”

Don’t wait to deal

If you’re diagnosed with breast cancer, doctors will be monitoring for metastasis long before you feel a possible spread. They may call for additional imaging, depending on the disease stage, type of breast cancer and other factors.

“For example, if we know the cancer is in the lymph nodes in your armpit, we’ll often scan further to see if it’s gone beyond there to somewhere else in your body,” said Dr. Johnson.

Though a breast cancer diagnosis isn’t an emergency in the same way a heart attack would be, it is urgent and needs to be addressed immediately, Dr. Johnson said. There’s no way to tell whether breast cancer will metastasize within a couple of months or take a year or longer. Even small cancers can potentially spread quickly.

“I’ve had patients who’ve said, ‘Can I wait a few months to do something about this?’ And my answer is always, ‘No, I wouldn’t recommend it,’” Dr. Johnson said. “It can mean a whole different prognosis.”

Early detection gives you the best chance of beating breast cancer before it has spread. The Margaret and Robert Hill Breast Center, offering 3D screening mammography, is recognized as a Breast Imaging Center of Excellence by the American College of Radiology. Schedule your mammogram onlineat baptistjax.com/mammo or by calling 904.202.2222.

Sources: American Cancer Society: Breast Cancer Survival Rates and American Cancer Society: How Common is Breast Cancer?