The degree of metastasis in hereditary breast cancer is related to the stage, and is usually more likely to occur in advanced, undiagnosed and untreated cases, through local spread, lymphatic metastasis and hematological metastasis. Axillary lymph node metastasis is about 60% and parasternal lymph node metastasis is 20% to 30%.
Cancer cells can also metastasize to the contralateral axillary or inguinal lymph nodes through the retrograde route. The most common distant metastases are lung, bone and liver in that order, such as chest pain, cough, haemoptysis and shortness of breath in the case of lung metastases, low back pain and pathological fractures (vertebrae, pelvis, femur) in the case of bone metastases, and liver enlargement and jaundice in the case of liver metastases.