Does Breast Cancer Spread to Bones via Lymph Nodes?

Breast cancer is a common cancer in women. If not treated in the early stages, it can spread to other organs, such as the bones, lungs, liver, or brain, which is called metastatic cancer or stage 4 (Stage IV).

Many patients wonder, “Does cancer have to spread to the lymph nodes first before it can spread to the bones?”

The answer is: Breast cancer typically spreads to lymph nodes first, such as the axillary lymph nodes. Cancer cells may then enter the bloodstream or lymphatic system and travel to bones or other organs. Lymph nodes are therefore often the first line of defense against the spread of disease.

However...In some cases, aggressive or specifically mutated breast cancer may spread directly to the bones, even before the lymph nodes are clearly enlarged or cannot be detected by hand or photograph.

Symptoms that may indicate cancer has spread to the bones

• Chronic bone pain, especially in the back, waist, legs, or hips.
• Brittle bones that break easily.
• Weakness, weight loss, loss of appetite.
• High blood calcium (from bone destruction).
  

If any of these symptoms occur, inform your doctor promptly for further tests such as a Bone Scan or PET/CT Scan.