Tim wrote << Yes.

Bone, lung and brain are the commonest mets, skin and other organs are also
possible sites.

Tim Jackson

I was told that breast  cancer can metastasize anywhere if there is
lymphovascular invasion.  However, when talking about 'common' one for breast
mets to be found, it is generally assumed that one is referring  to both the
most common area(s) for mets to occur as well as this being for the most common
of the breast cancers--invasive ductal.
The second most common cancer, found in about 12 ro 15% tends to have a
different metastatic pattern.  It is more common for that to metastasize in the
abdominal areas and gastrointestinal tract, including colon, I believe.  The
3rd most common site for metastases for lobular is the retroperitoneum.

Interestingly, I recently learned that this is not common knowledge amongst
radiologists, I learned.  We had a discussion with an acquaintance/friend who
is a general radiologist who works in a private hospital setting.  He was
unaware that lobular metastasized differently and that the retroperitoneal area
was a common site for mets from lobular.

Thus, that makes us even further question the findings from the first CT scan
I had.  Although it was 'clear' for metastatic disease, it reported that there
were several enlarged retroperitoneal nodes (up to 1 cm in size)  not likely
associated with breast cancer.
That statement is true for the majority of breast cancers but not true for
lobular.  Retroperitoneal node involvement can be associated with colon/rectal
cancers.

Prior to my first surgery (bilateral mastectomy) which was done 23 days after a
somewhat invasive biopsy (core biopsy where 5 areas were taken) at a time when
my nipple had begun to show daily change and 9 mos. after mass was first shown
to dr.s, I first had rectal bleeding.  It surprised me.  Since it happened in
the dr's office, in a small restroom, I showed it to the surgeon.  She thought
it possibe hemmrhoids (sp?) or fissure.  I guess those are plausible
explanations but no further evaluation was done.  It coninued over the next
month or two--bright red blood.  It stopped though after I completed the first
4 rounds of the first chemo I had (4 AC).

Interestingly, I also learned that doctors are only held responsible for
knowing what most doctors are assumed to know.  I am guessing that perhaps he
is required to know only the 'most common' of expected events that occur in the
majority of cases.  I have no idea if the radiologist who interpreted my first
CT scan was aware of the different metastatic pattern for lobular.  I also
don't believe that he was even aware of the type(s) of b.c. that I had nor was
he requred to know.  In addition, he never had any direct contact with me--the
patient.  

I didn't know  most of the above until recently.  I am not sure I would have
wanted that information from the start, though.  It does lead me to think that
this may contribute to one of the reasons cancer patients tend to have a better
outcome, overall, if treated at a specialized cancer center.  Just some food
for thougt...

Again, I may be a bit of a rebel here but it is hard for me to accept the
rhetoric that early treatment of metastases does not increase overall survival.
There is lack of standardization in which metastases are diagnosed.  There may
be general guidelines, but they are not strict enough in terms of being
followed or in their interpretation to insure valid standardization.  In
addition, patients are monitored under differing schedules.

On another board one patient questioned whether or not she was receiving too
many scans.  After treatment of stage II bc with I believe 2 positive nodes,
she was receiving both bone and CT scans every 3 mos.  Most wrote back to her
that was excessive.  She finally asked her oncologist who told her this is the
protocol he uses for those with aggressive (high grade) cancers in which there
was positive node involvement for the first year after treatment.

I also found my oncologist more aggressive after the first year.  Now, if early
treatment of metastases does not improve long-term survival, why would this be
a practice used by some oncologists?

I also recently found a medical site which discusses the lack of consistency
used in terms of deciding when/what to use for treatment (of mets) I think.
So, if this lack of consistency is widespread with so many of these related
issues, there have been no valid studies to evaluate the efficacy of early
treatment of metastases.

Latest studies of initial adjuvent treatment, though, are showing that those
who have sequential, polychemotherapy seem to do better than those who have
only a single regimen.  And, although the following may have some confounding
ascertainment bias, but the only two women I know who are alive for more than
10 years who had many positive nodes (one had 14 and the other had over 20
positive nodes) and were somewhat younger at time of dx, had one thing in
common.  They were both given weekly chemotherapy for over a year.  The gal who
had 14 nodes was dx'd in her early 30's with a very aggressive form of b.c.
although she doesn't remember the type.  As far as her treatment, she was given
3 different drugs, and one of them was not or not yet a commonly used drug (had
some obscure number).  Her dr. told her she was going to be given a higher
dose, more frequently because of her young age.  This was 16 years ago, and she
had had no signs of recurrence as of this time.

IIRC, the liver is also a fairly common site.

Ann T.
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