Sometimes cells can break away from the original cancer and spread to the liver, which may happen through the bloodstream or lymphatic system. This is not the same as primary liver cancer.
The liver sits on the right-hand side of your upper abdomen just under the ribs. It is made up of different sections called lobes and is surrounded by a capsule. The liver produces bile that helps digest food. It also produces important proteins that are needed to help the blood to clot.
The liver is a large organ and may be able to carry on working even if part of it is affected by secondary breast cancer.
If you have developed secondary breast cancer in the liver you may have a number of different symptoms. It is important to remember that any symptoms can also be a sign of other illnesses, so you should talk to your specialist team about any new symptoms you have.
Secondary cancer can cause the liver to enlarge, which then causes pressure by stretching the capsule around the liver. The pain can range from mild to severe and each person’s experience of pain is different. Some people may have only localised discomfort, while others may feel pain under their ribs or across their upper abdomen.
Sometimes pain can be felt in the right shoulder. This is called referred pain and is caused by the enlarged liver pressing on nerves that also go to the shoulder. It is important to know that pain can almost always be relieved or controlled.
You may feel sick because of the liver being enlarged and putting pressure on the stomach or because of toxins building up in the body from liver damage. This can be treated with anti-sickness drugs.
Loss of appetite
You might find it easier to eat little and often, rather than trying to eat normal-sized meals. If necessary, your GP or specialist can prescribe nutritional supplements and/or refer you to a dietitian for advice. In some cases drugs to stimulate your appetite may be helpful.
Hiccups may be a result of the enlarged liver pressing on the diaphragm and causing it to spasm. You may find that it helps to sit upright and drink small amounts frequently. There are also drugs that may help.
Ascites is an excessive build-up of fluid in the peritoneal cavity, which is the space between two layers of tissue in the abdomen. It can make your abdomen distended and uncomfortable, and sometimes make you feel breathless. Ascites can take weeks or months to develop and may require drainage of the fluid from time to time.
Tiredness and fatigue
You may find that you tire more easily. This might be because of the secondary breast cancer itself, the treatment you are having or a poor appetite. Tell your doctor how you are feeling as it may be possible to treat the cause of your fatigue. In some cases, steroid drugs can help to boost energy levels. Try to have a balance of rest and physical activity and if you have things you must do or you enjoy doing, try to pace yourself and expect to take longer to do them.
You may become anaemic (decreased number of red blood cells) for a number of different reasons, including problems with blood clotting. A blood test can be done to find out if you are anaemic and in some cases tablets containing iron or a blood transfusion can help.
Jaundice can occur when the bile duct (a tube coming out of the liver) becomes blocked. If you develop jaundice the whites of your eyes and your skin take on a yellow tinge. In some cases your urine may become darker and your stools (faeces) may become pale. You may need to have a stent (tube) inserted into the bile duct to drain the bile.
Jaundice can cause itching, which may be worse at night or when you are hot. It is important to keep your skin well moisturised.
Try using a non-perfumed skin cream such as aqueous cream BP. Sometimes tablets may be needed and your specialist will be able to advise you about this.
Try to avoid alcohol, spicy food, heat (hot baths or direct sunlight), all of which can make the itching worse.
If you experience any of these symptoms it is important to contact the specialist team caring for you. They will be able to help you manage the symptoms. This can mean a change in treatment or trying different symptom control methods such as relaxation techniques.
Content last reviewed May 2012; next planned review 2013