Sometimes breast cancer cells spread to the skin through the blood and lymphatic system.
Secondary breast cancers can sometimes form on or just below the skin. This is usually referred to as skin metastases. The cells that have spread to the skin are breast cancer cells. It’s not the same as having cancer that starts in the skin.
Breast cancer skin metastases are different to local recurrence. Local recurrence is when breast cancer has come back in the chest/breast area, or in the skin near the original site or scar, but has not spread to other parts of the body.
About a fifth of people with secondary breast cancer will develop skin metastases. The most common sites affected are the areas near where the original cancer was – for example the skin of the chest wall, around the surgical scar or on the abdomen (belly). Less commonly, skin metastases can occur on other areas of skin, such as on the scalp, neck, back and upper limbs.
When breast cancer spreads to the skin, it can be treated but it cannot be cured. The purpose of treatment is to try and relieve symptoms, improve quality of life and slow the growth of the cancer.
You may notice a change in the colour of the skin or have a persistent rash. You may have a firm, painless nodule (small lump) or multiple nodules of different sizes.
Sometimes the symptoms of skin metastases, such as redness and inflammation, may look like cellulitis (infection of the skin). Skin metastases can also cause lymphoedema (swelling of the arm, hand or breast area).
Other possible symptoms include pain, bleeding, infection and odour (smell).
Tests for skin metastases
Your specialist will examine you and look at your skin. They’ll also discuss any other symptoms you might have.
To confirm a diagnosis of secondary breast cancer in the skin, a punch biopsy may be performed. For this you’ll be given a local anaesthetic before a tiny cutter device is used to take a very small piece of tissue from the area. It’s not unusual for the area to bleed a little after the biopsy so you’ll usually be given a small dressing or plaster afterwards.
Your specialist may also arrange for a CT (computerised tomography) scan (also known as a CAT scan). This uses x-rays to take a series of detailed pictures across your body to check for any other areas of spread. To help show up any abnormalities more clearly, you may have a dye injected into one of your veins. The scan is painless but you will have to lie still for about half an hour.
Treatment for skin metastases
The aim of treatment for skin metastases is to relieve symptoms, improve your quality of life and slow down the growth of the cancer. The treatment offered will depend on a number of factors. These include:
- your symptoms
- the type and characteristics of the cancer
- treatments you have had in the past
- your general health.
Your specialist team will discuss treatment options with you, help you weigh up the potential benefits against possible side effects and explain what the aim of treatment will be for you.
Types of treatments
Your treatment may include:
Living with skin metastases
Knowing that your cancer has spread to the skin may leave you feeling a range of emotions. There may be times when you feel overcome by fear, anxiety, sadness, depression or anger.
If you’re not in contact with a specialist nurse who is able to offer you ongoing support, you can ask for a referral to be made through your GP (local doctor) or by the specialist team at the hospital caring for you. A counsellor or psychotherapist may be more appropriate if you need more help to look at ways of coping with your secondary diagnosis.
If you have any questions or just want to talk through your feelings you can call us free on 0808 800 6000 or use our Ask the Nurse email service.