Is my mother’s cough a sign her breast cancer has spread?

Question

Hello doctor,

I am writing on behalf of my mother, who is 48 years old and was diagnosed with stage 2 breast cancer about 14 months ago. She completed her chemotherapy with Docetaxel and Cyclophosphamide, and also finished radiation.

Her oncologist said things looked good after treatment, but for the past six weeks, she has been having this dry, persistent cough that does not go away, and she gets breathless even when climbing one flight of stairs. She never had breathing problems before this.

Her last CT scan was five months ago and showed no metastasis at that time. She also complains of a dull ache on her right side below the ribs, which comes and goes. She has lost around 8.8 pounds in the last two months without trying.

What are the early signs of breast cancer spreading to the lungs in a 48-year-old woman, because some of what she is experiencing is making me very, very worried.

Her next oncology appointment is still three weeks away, and I do not know if we should wait or go to the emergency department. Her oxygen reading at home shows 94 to 95 percent on the pulse oximeter.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query.

I know why you are feeling concerned. Being aware of new symptoms for your mother after all she has undergone before can really get one anxious.

Persistent cough without improvement, along with difficulty breathing even during light activities, needs to be looked into, especially when the person has been diagnosed with breast cancer before.

In cases where cancer metastasizes to the lungs (spread of the cancer to another part from its primary source), symptoms can be in the form of chronic cough, increasing difficulty breathing, chest discomfort or heaviness, as well as weight loss.

However, it is important to know that these symptoms are not specific to cancer spread alone. Many patients after chemotherapy or radiation develop similar complaints due to treatment-related lung inflammation (irritation of lung tissue), mild fibrosis (scarring of lung tissue), or even infections. These are relatively common and, in many cases, treatable once identified.

The dull pain on the right side and recent weight loss do mean we should not delay evaluation, but they do not confirm anything by themselves. At this point, the priority is to identify the cause rather than assume the worst.

I would not recommend waiting for three weeks. It would be better to have her reviewed sooner, ideally within the next few days, by her oncologist or a pulmonologist. A repeat CT (computed tomography) scan of the chest, along with a clinical evaluation, will help clarify what is going on.

For now, since her oxygen levels are around 94 to 95 percent and she is comfortable at rest, this does not appear to be an emergency. That said, if her breathlessness worsens suddenly, her oxygen level drops below 92 percent, or she develops significant chest pain or difficulty speaking, she should be taken to the emergency department without delay.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.