Metastatic breast cancer

When breast cancer spreads to the lungs

Breast cancer is a difficult diagnosis and the possibility of metastasis, where cancer spreads to other areas of the body, can lead to feelings of worry and anxiety. Out of all women who are initially diagnosed with breast cancer, nearly 30% may develop metastatic disease.

Staying informed about breast cancer metastasis to the lung allows you to make better treatment decisions. It also empowers you to monitor your health status and make necessary lifestyle changes that may help with survival. This article explains the symptoms, detection, treatment, and prognosis of lung metastasis from breast cancer.

In the Inspire Advanced Breast Cancer Community, members share their personal experiences of living with breast cancer. Please remember that this content is for informational purposes only and you should always consult your doctor before beginning any treatment.

How common is it for breast cancer to spread to the lungs?

Secondary or metastatic breast cancer in the lung is possible among breast cancer patients. The lung is one of the most common metastatic sites for breast cancer and about 60% of patients experience lung metastasis, if not bone metastasis, at some point in their life. Of these patients, 21% to 32% will specifically have metastasis to the lungs.

When lung metastasis occurs, it usually develops within the first five years following the initial diagnosis of breast cancer.

It’s important to note that the tendency of breast cancer to spread to other organs, such as the lungs, can be influenced by its molecular subtype. The term "molecular subtype" refers to the classification of breast cancer based on the specific characteristics of the tumor.

These key subtypes include:

Luminal A: Hormone receptor-positive, HER2-negative breast cancer
Luminal B: Hormone receptor-positive, and can be HER2-positive or HER2-negative
HER2-enriched breast cancer: HER2-positive, and can be hormone receptor-positive or hormone receptor-negative
Triple-negative (TN) or basal-like breast cancer (BLBC): Estrogen receptor-negative, progesterone receptor-negative, and HER2-negative

Of these subtypes, BLBC has a higher tendency to metastasize to the lungs compared to other subtypes — and it affects 32% of patients. For this reason, patients diagnosed with BLBC will benefit from more frequent monitoring to detect metastasis early and manage it effectively.

For those wanting to learn more, here’s a guide to breast cancer hormone receptor status and a guide to HER2 breast cancer types.

What are symptoms of breast cancer metastasis to the lungs?

Metastatic lesions that are small do not produce symptoms immediately, so you won’t necessarily experience any noticeable changes or discomfort right away.

However, if symptoms do develop, which signifies the growth of the metastatic lesions, they include:

a persistent cough (one that lasts longer than expected or fails to resolve with typical treatment)
fatigue
loss of appetite
discomfort or pain in the chest area
coughing up blood
wheezing (high-pitched whistling sound during breathing that happens as the airways narrow)

I had a cough that wouldn't go away for a few weeks. I didn't have chest pain, but a little shortness of breath and thought it was due to me being very physically active. When I was properly diagnosed with bilateral breast cancer and after my CT scan and lung biopsy, it was confirmed my breast cancer spread to my lungs. I have multiple nodules on both sides.

Metastases can disrupt normal lung function by taking over the space normally occupied by healthy lung tissue, and this can reduce the lungs' ability to oxygenate blood. Cancer cells also irritate the pleura (a thin layer of tissue covering the lungs), which then causes fluid to accumulate in the pleural space.

These symptoms can often prompt patients to visit their doctor, but sometimes, lung metastasis may be discovered as the patient undergoes a routine imaging test like a CT scan or an MRI.

When a scan reveals suspicious findings such as lung nodules, the next step would be to perform a biopsy. This involves a sample of tissue from the suspicious area to determine whether it is cancerous or not.

A biopsy will also indicate whether the cancer is a primary lung cancer (originating in the lung) or metastatic cancer (originating from another site, such as the breast).

How long can you live with metastatic breast cancer in the lungs?

According to research, up to 33.9% of patients with lung metastases survive for at least three years, and up to 17.8% of patients survive for at least five years. Moreover, prior studies have found that patients who undergo pulmonary metastasectomy can have a survival rate as high as 30.8% to 36%.

These rates indicate that although the prognosis for lung metastases is generally poor, a notable proportion of patients can survive longer with appropriate treatment.

Treatment options for breast cancer metastasis to lung

Lung metastases are usually treated with systemic therapies. These are treatments designed to target the cancer cells throughout the body rather than just the area (in this case, the lungs) where metastasis is found.

Systemic treatments for lung metastases

Chemotherapy: This destroys and prevents cancer cells from growing, especially when the cancer is aggressive. For patients diagnosed with TNBC, chemotherapy is considered the main form of treatment since TNBC does not have estrogen and progesterone receptors, and does not overexpress the HER2 protein. This would make hormone therapy and HER2-targeted therapies ineffective.
Hormonal therapy: Also called endocrine therapy, hormonal therapy is used to treat hormone receptor-positive metastatic breast cancer. They work by preventing hormones from binding to hormone receptors or reducing the body’s production of estrogen. Both of these mechanisms stop or slow the growth of cancer.
Targeted therapy: As the name implies, targeted therapy is designed to target specific proteins or genes that drive the growth of cancer. Unlike chemotherapy, targeted therapy is less likely to affect normal, healthy cells, and it leads to fewer side effects. The types of breast cancer that benefit the most from targeted therapy include HER2-positive breast cancer, hormone receptor-positive breast cancer, TNBC, and patients with BRCA gene mutations.
Immunotherapy: This treatment works by helping your immune system work harder to attack cancer cells. Immunotherapy is usually given to patients in combination with other treatments — for example, immunotherapy plus chemotherapy for TNBC.

As a survivor of both lung and breast cancer primaries I’ve had to learn about both. A breast cancer that mets to lungs is still a breast cancer, has all the attributes of breast cancer and will respond to breast cancer treatment.
There may be some targeted therapies available for your breast cancer type. An Immunotherapy was recently approved for breast cancer. It all comes down to the genomics of your cancer.

Local treatments for lung metastases

Pulmonary metastasectomy (PM), a surgical procedure for breast cancer patients with lung metastases, is also an option to remove cancerous lesions.

However, note that it is done with patients that meet certain criteria. Patient selection criteria may include the following:

the primary tumor (breast cancer site) is being effectively treated or managed
there should be no other metastases (cancer spread to other parts of the body)
if other systemic metastases are present, they should be effectively managed
an adequate DFI (disease-free interval) to confirm “oligometastatic” disease (a stage of cancer spread where there are only a few metastatic lesions)

Radiation therapy is another form of local therapy that can be considered, and is used to help a patient in the following ways:

breathe better by shrinking the tumor and relieving the obstruction it has caused
reduce bleeding into the airway

In these cases, the primary goal of radiation therapy is palliative, meaning it relieves symptoms so that patients may feel comfortable and still be able to perform their activities for as long as possible.

How to reduce the likelihood of breast cancer spreading to lungs

Regular, early screening can reduce breast cancer metastasis to the lungs. The sooner breast cancer is diagnosed and treated, the better the chances of preventing it from spreading to other parts of the body. Keep in mind that early-stage breast cancer is generally more treatable.

After a breast cancer patient receives initial treatment, breast cancer cells can remain dormant in the body and later become active again, which may result in metastasis. This is why patients need regular self-monitoring and medical check-ups to catch any signs of recurrence early.

Lifestyle changes and healthy practices, such as regular physical activity to manage body weight and quitting smoking, may help lower the risk of cancer recurrence and metastasis.

Ok, you folks have convinced me. In the last year, I have finally recovered enough to liberate myself from a wheelchair, to cook, take care of the house, light gardening, shopping, etc. A normal life pretty much.
Now I think I WILL go for exercise that actually works up a sweat. I am in the mountains now- so a brisk walk up and down the hills to my favorite scenic spot and back should do the trick. Might have to stop a few times along the way due to hills and high altitude, but hey, gotta start somewhere.

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Disclaimer

Member comments have been lightly edited for length and clarity. This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.

Written by: Tiffany Joy Yamut, BSN, RN

Published on 4/29/25

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