What're the stages of breast cancer?
Once a definite diagnosis of cancer has been made, it is important to know the stage of your cancer. The stage helps determine which treatment will work best for you. The stage of a cancer depends on its size and the extent to which it has spread to other parts of the body. Complete staging may only be possible after surgery or additional tests and it may be
necessary to remove some lymph nodes near the cancer.
Inflammatory Breast Cancer is automatically staged as Stage IIIb or Stage IV if metastasis has occurred. For suspicious, high risk cases, other investigations which include CT scans, nuclear medicine imaging, chest X-rays and blood tests will be done to look for any metastasis or secondary cancer that has spread a long way from the site of the primary tumour.
Oncologists then assign a TNM code as a shorthand categorisation which in turn determines treatment recommendations. One way of categorising tumour is by staging it using the TNM system which is short for Tumour, Nodes and Metastasis. Some biological features of the cancer such as estrogen receptor and HER2-neu oncogene are also determined as they also affect treatment recommendations.
Stage 0. In Situ ("in place") disease in which the cancerous cells are in their original location within normal breast tissue
Stage I. Tumor less than 2 cm in diameter with no spread beyond the breast
Stage IIA. Tumor 2 to 5 cm in size without spread to axillary (armpit) lymph nodes or tumor less than 2 cm in size with spread to axillary lymph nodes
Stage IIB. Tumor greater than 5 cm in size without spread to axillary lymph nodes or tumor 2 to 5 cm in size with spread to axillary lymph nodes
Stage IIIA. Tumor smaller than 5 cm in size with spread to axillary lymph nodes which are attached to each other or to other structures, or tumor larger than 5 cm in size with spread to axillary lymph nodes
Stage IIIB. The tumor has penetrated outside the breast to the skin of the breast or of the chest wall or has spread to lymph nodes inside the chest wall along the sternum
Stage IV. A tumor of any size with spread beyond the region of the breast and chest wall, such as to liver, bone, or lungs
Women with early stage breast cancer may have breast-sparing surgery followed by radiation therapy to the breast, or they may have a mastectomy, with or without breast reconstruction to rebuild the breast. These approaches are equally effective in treating early stage breast cancer. (Sometimes radiation therapy is also given after mastectomy.)
The choice of breast-sparing surgery or mastectomy depends mostly on the size and location of the tumor, the size of the woman's breast, certain features of the cancer, and how the woman feels about preserving her breast. With either approach, lymph nodes under the arm usually are removed.
Many women with stage I and most with stage II breast cancer have chemotherapy and/or hormonal therapy after primary treatment with surgery or surgery and radiation therapy. This added treatment is called adjuvant therapy. If the systemic therapy is given to shrink the tumor before surgery, this is called neoadjuvant therapy. Systemic treatment is given to try to destroy any remaining cancer cells and prevent the cancer from recurring, or coming back, in the breast or elsewhere.
More information on breast cancer
What is breast cancer? - Breast cancer is cancer of breast tissue. Breast cancer starts in the cells of the breast. Breast tissue covers a larger area than just the breast.
What types of breast cancer are there? - Breast cancer is a type of uncontrolled growth of abnormal cells that can develop in one of several different areas of the breast.
What're the risk factors for breast cancer? - Risk factors for breast cancer include age, geographical variation, reproductive factors, inherited risk, previous breast disease.
What're the symptoms of breast cancer? - Symptoms of breast cancer include breast lump, breast discharge, nipple inversion, or changes in the skin overlying the breast.
How is breast cancer diagnosed? - The mainstay of breast cancer diagnosis is the triad of clinical history, physical examination and imaging (mammography or ultrasound).
What're the stages of breast cancer? - The stages of breast cancer depends on its size and the extent to which it has spread to other parts of the body.
What causes breast cancer? - The exact cause or causes of breast cancer remain unknown. Hormonal influences play a role in the development of breast cancer.
What're the treatments for breast cancer? - Treatment for breast cancer begins with a decision about the type of surgery. Breast implants is used for breast reconstruction.
What're the side effects of breast cancer treatment? - The type and extent of breast cancer treatment side effects vary depending on the particular treatment involved, its duration, and its dose.
How is breast cancer treated with surgery? - Surgery is the mainstay of therapy for breast cancer. A breast biopsy is the removal of breast tissue for examination by a pathologist.
What's the chemotherapy for breast care? - Chemotherapy is the use of anti-cancer drugs to treat cancerous cells. Chemotherapy involves being given a combination of anti-cancer medicines.
What's the radiation therapy for breast cancer? - Radiation therapy is often used to destroy any remaining breast cancer cells in the breast, chest wall, or axilla (underarm) area after surgery.
What's the hormone therapy for breast cancer? - Most breast cancer is sensitive to the female hormone oestrogen. Megestrol acetate is used for hormone treatment of advanced breast cancer.
What breast cancer medications are available? - Medications to treat breast cancer include selective estrogen-receptor modulators, aromatase inhibitors, biologic response modifiers.
Can breast cancer be prevented? - There is no known way to prevent breast cancer. But several preventive measures can be take to reduce risk of breast cancer.