Metastatic breast cancer in the liver

A diagnosis of metastatic breast cancer in the liver means that breast cancer cells have travelled from the original cancer in your breast to one or more places in your liver.

What is metastatic breast cancer in the liver?

Metastatic breast cancer is invasive breast cancer that has spread through the bloodstream or lymph vessels to other parts of the body such as the liver.

It is still breast cancer (not liver cancer) and is treated with breast cancer drugs rather than with treatments for a cancer that began in the liver.

Metastatic breast cancer deposits in the liver are called liver metastases or liver secondaries.

When you have metastatic breast cancer in the liver, your body is less able to break down:

• drugs (including your breast cancer medicines)
• alcohol
• other toxins

This can lead to a build-up of toxins in your body. You may have new side effects, or your existing side effects may become worse.

Symptoms of liver metastases

The symptoms of metastases in the liver can vary. You may experience none or only some of them. The disease can be identified via an abdominal scan and sometimes blood tests, even when there are no symptoms.

It can be helpful to know that symptoms of liver metastases can often be well controlled. Your treating team will tell you what to expect in your individual situation and who to contact about symptoms that worry you.

Feeling sick (nausea)

Nausea is one of the most common symptoms. This may be because:

• the liver cannot work properly because of the cancer
• the liver is getting bigger as a result of the cancer.

When you eat, you may feel full easily, or feel sick because your liver is putting pressure on your stomach.

Read about nausea related to metastatic breast cancer.

Loss of appetite and weight loss

Loss of appetite and weight loss are common, especially if your liver is enlarged and pressing on your stomach. You may feel ‘full’ in a way that makes you not want to eat.

Find out how you can improve a poor appetite related to metastatic breast cancer.

Tiredness and fatigue

Feeling exhausted is very common with metastatic breast cancer of the liver. This can be due to:

• the cancer itself
• not eating well, leading to weight loss
• anaemia, which is another symptom of liver metastases
• the treatments themselves.

For help, go to fatigue and tiredness.

Pain

Metastatic breast cancer can enlarge the liver and stretch the capsule surrounding it, causing pain.

This may feel like a dragging sensation or heaviness across the upper right abdomen or under the right side of the ribs, especially when you are bending forward.

Sometimes, you may feel pain in the right shoulder. This does not mean that there is something wrong with the shoulder. The nerves that sense the pain in the diaphragm are connected to the nerves in the shoulder. This is called ‘referred’ pain.

Find ways to deal with pain: Managing pain associated with metastatic breast cancer. 

Bruising

Metastatic breast cancer in the liver can affect how well your blood clots. You may bruise after a small bump or sometimes without any obvious cause.

Hiccups

If the liver is enlarged it can press on the diaphragm. This causes the diaphragm to spasm, resulting in hiccups.

Yellowing of skin or whites of eyes (jaundice)

If you have jaundice, your skin and the whites of your eyes can turn yellow. Your urine may become a darker colour.

Reasons for this can include:

• a build-up of bile or bilirubin in the blood. Cancer cells can block the tubes (‘ducts’) that take bile out of the liver and into the intestine. When there is too much bile in the blood, stools (faeces) can become pale and your skin may itch
• cancer cells affecting how the liver works
• a drug that may cause liver damage
• the breakdown of large numbers of red blood cells (haemolysis) resulting in high levels of bilirubin in the blood from the broken blood cells.

Fluid in the abdomen (ascites)

Liver metastases can cause fluid to build up in the abdomen. This is called ascites and causes the abdomen to become swollen. 

This can be very uncomfortable. It can increase constipation, nausea and loss of appetite or make you feel out of breath.

Treatment for metastatic cancer in the liver

Metastatic breast cancer in the liver can be treated and may be controlled for long periods of time. While it can’t be cured, people with liver metastases may live for years and enjoy a good quality of life.

For information about treatment, read treating metastatic breast cancer in the liver.

Medications and alcohol 

Prescription medications

If the medication you are taking is having a significant effect on your liver, you may need to change.

Complementary medicines and herbal products

If you have reduced liver function, your body may not be able to absorb complementary medicines such as vitamins and herbal products.

It is important you tell your medical oncologist about all medicines you’re taking (or thinking about taking). Your doctor will be able to talk you about which are safe for you to take and which may be harmful.

Alcohol

Ask your medical oncologist if any amount of alcohol is safe for you.

Resources

Planning ahead can help you answer difficult questions. Use this guide to help you to plan, and discuss with others, your values, experiences and preferences. It can also provide a sense of relief when it is done, as you can then focus on living life fully.