What are the late-stage symptoms of breast cancer metastasized to the liver?
Sep 22, 2025
Source: Cainiu Health
Dr. Lv Dapeng
Introduction
When breast cancer cells spread to the liver and reach the terminal stage, patients often develop typical symptoms such as persistent upper right abdominal distension and pain, jaundice throughout the body, severe abdominal bloating resembling a drum, rapid weight loss, and marked loss of appetite. These symptoms indicate severe liver dysfunction and necessitate prompt systemic intervention at a specialized oncology center. In the terminal phase, liver function, coagulation, and blood ammonia levels should be monitored weekly, and animal protein intake should be restricted to prevent hepatic encephalopathy.
Generally, when breast cancer cells spread to the liver and reach the terminal stage, patients often develop typical symptoms such as persistent upper right abdominal distension and pain, generalized jaundice, markedly bloated abdomen resembling a drum, rapid weight loss, and significant anorexia. These signs indicate severe liver dysfunction and necessitate prompt referral to an oncology specialty center for systematic intervention. The detailed analysis is as follows:
1. Liver area pain: Tumor traction on the liver capsule or invasion of the phrenic nerve causes deep dull pain, which may radiate to the right shoulder and back and worsen at night. Oral morphine or oxycodone extended-release formulations are preferred for analgesia; local radiotherapy can further reduce pressure-related discomfort.
2. Jaundice: Bile duct compression or extensive hepatocyte necrosis leads to a sharp rise in bilirubin, resulting in yellowing of the skin and sclera, dark tea-colored urine, and pale stools. Obstruction relief can be achieved through percutaneous biliary drainage or stent placement. Medications such as ursodeoxycholic acid may be administered to promote bile excretion.
3. Ascites: Portal hypertension combined with hypoalbuminemia causes fluid leakage into the abdominal cavity, leading to abdominal distension and restricted breathing. Treatment includes diuretics (furosemide combined with spironolactone). For large-volume ascites, paracentesis with concurrent intravenous albumin supplementation is indicated.
4. Weight loss and fatigue: High tumor metabolism and impaired hepatic glycogen synthesis lead to rapid muscle mass loss within a short period. Nutritional management involves high-energy formulas providing 30–35 kcal/kg per day; if oral intake is insufficient, parenteral amino acids and fat emulsions should be added.
5. Decreased appetite: Reduced bile secretion impairs fat digestion and absorption, causing early satiety after meals and prominent nausea. Short-term use of megestrol acetate may help stimulate appetite, along with digestive enzyme supplements and a dietary pattern of low-fat, small, frequent meals.
In the terminal phase, liver function, coagulation parameters, and blood ammonia levels should be monitored weekly. Animal protein intake should be restricted to prevent hepatic encephalopathy. Skin should be kept moisturized to avoid scratching injuries, and swollen lower limbs should be elevated by 30 degrees. Pain management should follow the three-step analgesic ladder; family members should record pain scores and provide timely feedback. Psychological support is equally crucial—patients and families are encouraged to contact palliative care teams or patient support groups to enhance quality of life during remaining time.
