“How many of you had breast cancer, thought you were finally done with it, and two years later found out it spread to your liver?” asked one member of MyBCTeam.

When breast cancer spreads to other parts of the body, it’s known as stage 4 breast cancer or metastatic breast cancer (MBC). When breast cancer spreads, it’s often to the bone, lung, liver, or brain. Liver metastasis occurs in approximately half of all people diagnosed with MBC.

Symptoms of Liver Metastasis in Breast Cancer

Liver metastasis doesn’t usually cause symptoms. In such cases, doctors can recognize the signs of liver metastasis with blood tests called liver function tests. Signs and symptoms may overlap with side effects of breast cancer treatment, so don’t panic. Be sure to discuss them with your cancer care team, who can identify the cause.

When symptoms of liver metastasis do occur, these are among the most common.

1. Fatigue and Weakness

Fatigue is the feeling of extreme tiredness and an overwhelming urge to sleep that doesn’t resolve with rest. Fatigue and weakness alone are not signs that breast cancer has traveled to the liver — however, they can be a clue that your body is working harder than usual. Speak with your doctor if you’re experiencing extreme tiredness that doesn’t go away with sleep.

2. Weight Loss or Loss of Appetite

Weight loss and loss of appetite occur when you don’t feel hungry or have the desire to eat. Loss of appetite isn’t always an issue, but when it lasts for longer than a week, it’s a sign that your body isn’t feeling well. If you experience significant weight loss due to long-term poor appetite, talk to your doctor. It may be a side effect of cancer treatment or a sign of metastasis.

“I have a tumor in my liver, which the doctor told me will catch up on me soon,” shared one member of MyBCTeam. “Is this why I’m losing weight?”

3. Bloating or Swelling in the Abdomen

Bloating or swelling in the abdomen can also be called abdominal distension (or distended abdomen). Abdominal distension is a feeling that your belly is measurably swollen. This is a common symptom of digestive issues, including having difficulty digesting something you’ve eaten. However, if this feeling persists, it may be a sign that your cancer has metastasized to your liver.

Another member who reported having liver metastasis wrote, “I don’t have pain in the liver, but I am bloated and I feel tired, very uncomfortable.”

4. Pain or Discomfort in the Abdomen

People sometimes refer to pain or discomfort in the abdomen as a “stomachache.” However, this pain can actually be coming from the liver. When abdominal pain occurs in the upper-right area of your abdomen (where the liver is located), it can be a sign that something is wrong with your liver. Communicating clearly just where in your abdomen you feel pain can help your doctor identify the cause.

Pain in this area may also be connected to breast cancer treatment. “I’ve been having quite a bit of pain and soreness around my liver area. Should I expect this as a side effect from chemo?” asked a MyBCTeam member.

Be sure to report any new symptom or side effect of treatment to your breast cancer care team, so they can help you find ways to manage it.

5. Fever

A body temperature of 98.6 degrees Fahrenheit is considered normal, though a person’s baseline temperature may be a little higher or lower. When your body temperature goes above 100.0 F, however, it may be a sign that you’re fighting an illness. Fevers often indicate an infection — but they can also be a sign that your immune system is working harder than usual to fight cancer. If your fever lasts longer than four days, it may be time to consult your doctor.

6. Swollen Legs

Swelling in your legs may be a sign that your liver isn’t working properly. Tumors can cause a blockage in your liver. When they block part of the portal vein, which transports blood from various organs to your liver, fluid can start to build up in your legs. Fluid accumulation that causes swelling may be a sign that your cancer is blocking liver function.

7. Yellowing of the Skin or Eyes

Yellowing of the skin, eyes, or other parts of your body can be a sign of a condition called jaundice. The yellow color is caused by a bile pigment called bilirubin, which is secreted by the liver. If your liver isn’t functioning properly, bilirubin can build up in your skin, the whites of your eyes, and your mucous membranes — the soft tissues lining your mouth, nose, eyelids, and some internal organs. The yellowing can be more difficult to see on dark skin tones.

If your breast cancer has metastasized in your liver, it could block liver function, resulting in the buildup of bilirubin and signs of jaundice. Liver damage can also be caused as a side effect of breast cancer drugs, in which case doctors refer to it as hepatotoxicity.

“I’m a pretty shade of yellow, lol!” shared a MyBCTeam member. “Turns out I’m quite jaundiced and look like a lizard with these yellow eyes.”

Diagnosing Liver Metastasis

In addition to performing blood tests, your oncologist may order imaging tests to identify signs of metastasis in the liver. These tests may include:

• MRI scans
• CT scans
• Ultrasounds
• Positron emission tomography (PET) scans

These painless tests help the doctor see what’s happening in your liver and look for tumors or lesions. In some cases, your doctor may order a biopsy to collect and examine liver tissue. This entails removing a sample of tissue for study under a microscope.

Treatments for Liver Metastasis

When a doctor confirms the presence of liver metastases, they’ll recommend one or more treatments, depending on your breast cancer.

Your oncology specialist may recommend chemotherapy if you’re diagnosed with liver metastasis. If your breast cancer cells are hormone receptor-positive (HR-positive) or HER2-positive, hormone therapy or targeted therapy may be recommended. Several new treatments for MBC have become available after showing good results in clinical trials, including palbociclib (Ibrance) and ribociclib (Kisqali).

Localized treatment for liver metastasis may include:

• Surgery — This is a viable option if the tumor is operable (e.g., there’s an isolated tumor in the liver).
• Radiation therapy — This treatment uses concentrated, high doses of radiation to kill cancer cells.
• Thermal ablation — One form of this is radiofrequency ablation, a type of heat therapy using high-energy radio waves. Another form, cryoablation (also called cryotherapy), uses extreme cold to freeze and destroy tumors.

Some MyBCTeam members report that local treatment of their liver metastases improved their quality of life. One shared, “I also had an interventional radiologist ablate a tumor in my liver. I’m having a great response to my treatment plan so far. I’m two years into this stage 4 breast cancer diagnosis.”

Talk With Others Who Understand

On MyBCTeam, the social network for people with breast cancer and their loved ones, more than 67,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you been diagnosed with liver metastases? Have you undergone metastatic breast cancer treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.