Metastatic breast cancer in the skin

Sometimes breast cancer can spread to the skin. A diagnosis of metastatic breast cancer in the skin means breast cancer cells have travelled from cancer in your breast to one or more areas of skin.

This is not the same as cancer that starts in the skin, such as basal cell carcinoma or melanoma.

About skin metastases

Breast cancer deposits in the skin are called skin or cutaneous metastases, or skin secondaries. They develop after breast cancer cells spread through the bloodstream or lymphatic system to the skin. It is still breast cancer (not skin cancer) and is treated with breast cancer drugs.

Symptoms of skin metastases

The most common sites for skin metastases are near the breast, in the chest wall or abdomen.

Rarely, they can appear in areas such as the scalp, neck, back or arms.

Symptoms include:

• skin changes colour to darker pink or red
• a lasting rash
• a firm lump or lumps in different sizes
• a skin sore that doesn't heal
• lymphoedema (swelling of hand, arm or breast area)
• the skin thickens
• pain
• bleeding
• smell (odour).

Tests for skin metastases

Your doctor will examine and look at your skin and also ask you about any other symptoms you may have.

Tests for skin metastases may include:

• a biopsy – taking a very small sample of the skin to test it
• scans to check if the cancer has spread to other parts of the body.

Types of treatment

Treatment options include:

• specialist dressings
• medications for pain
• chemotherapy
• hormone blocking therapy
• targeted therapy
• radiotherapy
• surgery.

What affects treatment decisions

Treatments for skin metastases are often very effective at slowing the growth of the cancer and improving quality of life. The treatments your doctor recommends for you will depend on:

• your symptoms
• the area and features of the skin affected
• whether you have cancer in other parts of the body
• the pathology of the cancer (whether it is ER, PR, or HER2 receptor negative or positive)
• the treatments you’ve had in the past
• your general health
• your personal preferences.