Hematogenous metastases

For haematogenic metastasis, there are certain organs for each tumour that are preferentially affected. The reason for this has not yet been finally clarified. The organs that are typically affected by distant metastases in breast cancer (breast carcinoma) are As soon as distant metastases are diagnosed, the chances of survival of patients are very low. – Bones

Lungs
Liver and
Brain less often also
Heart
Kidney or
Spleen

Lymphogenic metastases

In lymphogenic metastasis, metastases form primarily in lymph nodes. Breast cancer metastases are often found in the axillary lymph nodes (the lymph nodes in the armpit), more rarely other lymph nodes around the breast are also affected. Lymphogenic metastasis is the most common form of metastasis in breast cancer.

The lymph of the breast is directed into large lymph node regions of the armpit and around the collarbone. It first flows into a first lymph node and from there spreads to surrounding lymph drainage pathways before the lymph spreads into the body’s circulation. In the lymph fluid, malignant cells can flow off into the first lymph nodes even in the early stages of cancer.

This first node is also known as the “sentinel or sentinel lymph node“. This lymph node is identified and removed during the diagnostic process. After removal, the sentinel lymph node is examined for malignant cells.

If it is affected by cancer cells, the cancer has probably already spread further, which is why all lymph nodes in this area must be provisionally removed. If the sentinel lymph node is not affected, the prognosis improves and metastasis in the lymph nodes is not expected. If all lymph nodes in the armpit are removed, unpleasant side effects such as lymphedema can occur in the long term.

Above and below the collarbone, there are other large stations of the lymph drainage channels and accumulations of lymph nodes. The lymph drainage of the breast usually runs initially through the armpit. However, if breast cancer is present, all lymph nodes of the shoulder and neck must also be examined by ultrasound.

In the case of conspicuous lymph nodes on the clavicle, these can be obtained in samples and analysed. If lymph node metastases are also present on the clavicle, this indicates that the disease has spread to several lymph node stations, which has a negative effect on the prognosis of the disease. During breast surgery, the affected lymph nodes can be removed and subsequently treated with chemotherapy or radiation.

Liver metastases

As the largest organ of the upper abdomen, the liver is an important station in the treatment of breast cancer. It is often affected by metastases and can become symptomatic. Usually, noticeable symptoms only develop when the liver is largely affected by the cancer.

Only when much healthy tissue has already been displaced can symptoms such as fatigue, loss of appetite, pain and weight loss occur. The liver, on the other hand, is relatively easy to treat. Surgery to remove metastases is often easy to perform, unless the metastasis is located in the centre of the liver or on large blood vessels. Even modern chemotherapies that are limited to the liver can nowadays achieve great success.