Skin metastases and nodules on the chest

Skin metastases are areas where breast cancer has spread into the skin. In breast cancer they most often appear on the chest wall, near a surgical scar or over the breast, although they can occur on the abdomen, back, scalp or elsewhere. They usually look like small, firm, painless bumps or nodules that may be skin coloured, pink, red or purple. Sometimes they appear as a flat red patch that looks like a rash or infection, thickened skin with a texture like orange peel, or an open sore that bleeds, weeps or will not heal. Skin metastases can be the first sign that cancer has come back, or they can appear in someone already known to have metastatic breast cancer. Because many harmless conditions look similar, a small skin biopsy is needed to confirm the diagnosis. Treatment aims to control the cancer, reduce discomfort, prevent bleeding or infection and help you feel comfortable in your own skin.

Why it happens

Cancer cells can reach the skin through the lymph channels and blood vessels, or grow directly from cancer in the chest wall beneath. The chest skin is the most common site because it lies closest to the original cancer.

How it is diagnosed

A doctor examines the skin, and a punch biopsy takes a tiny core of skin under local anaesthetic. The laboratory confirms whether it is breast cancer and rechecks hormone receptors and HER2. Scans usually look for spread elsewhere.

When to seek help

Report any new lump, rash, thickened area or sore on the chest, scar or nearby skin that does not settle within a couple of weeks.

Skin metastases are visible, which can make them feel especially distressing. Their outlook depends mainly on whether cancer is present elsewhere in the body, the cancer's receptors and how well it responds to treatment.

Response can be seen and felt

Because nodules are on the surface, you and your team can often see whether treatment is working, as they flatten, shrink or stop bleeding.

They can return

Skin metastases sometimes come back after local treatment, so whole-body treatment and regular checks are important.

Wounds need ongoing care

Open wounds may not fully heal, but good dressings, radiation and treatment of infection can greatly reduce smell, discharge and discomfort.

What this page cannot tell you

It cannot predict your own course. Ask your oncologist what treatment aims to achieve and how progress will be checked.

Visible changes to the skin can affect how you feel about your body, going out in public and intimacy with a partner. These feelings are common and valid.

Clothing and comfort

Loose tops, soft scarves and camisoles can cover dressings discreetly, and breathable fabrics keep the skin cool.

Talking with your partner

Sharing how you feel, and what kind of touch feels comfortable, helps couples stay close. Some find it helpful to talk with a counsellor together.

Getting support

Support groups, psychologists and palliative care teams help with anxiety, low mood and practical worries. You do not have to manage these feelings alone.