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Stages of Breast CancerWhat is cancer staging?
Cancer staging is the process of finding out how widespread a cancer is when it is diagnosed. Staging of breast cancer is based on whether the cancer is localized or matastatic, the size of the cancer, how many lymph nodes are involved, and whether there is spread to other parts of the body. Therefore, the stage of breast cancer is one of the most important factors in deciding prognosis and treatment options.
To confirm the results of your physical exam and biopsy, sometime your doctor might arrange you to have other imaging tests such as breast mammograms, computed tomography (CT), chest x-ray, magnetic resonance imaging (MRI), bone scans, or positron emission tomography (PET). Blood tests to detect whether the cancer has spread to other parts of your body may also need to be done.
Breast cancer is divided into four different stages. Successful treatment helps to stop cancer from going on to another stage. Most breast cancers never go past stage I or II. The treatment decisions of breast cancer are based on the TNM stage and the grade of the cancer.
Early stage breast cancer
Early breast is described when the cancer has not spread outside the breast or lymph node in the armpit (equivalent to TNM stage I-III). The cancer still has not spread to another part of the body apart from the lymph nodes in the armpit.
Locally Advance
Locally advance is the stage where the cancer has not spread to another part of the body, but there are:
- Bigger than 5 cm
- Growing into the skin or chest wall
- Affected the lymph nodes in the armpit, and these lymph node are stuck together or stick to other structure
Metastatic Breast Cancer
It is also known as secondary breast cancer where cancer cells have spread to other parts of the body such as lungs, liver, bones or brain. This is equivalent to TNM stage IV.
Stage 0
This is a non-invasive breast cancer. The cancer cells are still remained inside the breast. There is no evidence of cells invading other nearby normal tissue within the breast. There are two well known examples of breast cancer stage 0:
- Lobular Carcinoma In Situ (LCIS): It is lobular because the cancer cells stay inside the lobules that are the glands that produce milk in the breast. The term ‘In Situ’ means that the cancer has not spread outside to the surrounding tissues. LCIS is also known as a pre-cancerous.
- Ductal Carcinoma In Situ (DCIS): The cancer cells stay inside the milk duct in which it started. The cells can grow to cover a small or large area of the breast, but it does not spread outside the duct into the normal surrounding area such as to lymph nodes or other organs. DCIS is the cancer that has grown out of control, but is still not an invasive cancer. However, DCIS does not behave like most cancer. The cells have not started to go through normal tissue. Therefore, cancer in DCIS is not life threatening like other stages, but it still requires careful medical attention. If the infected area is small, a lumpectomy will be used to treat your breast cancer. BUT if the are of DCIS is larger, a mastectomy may be needed.
Stage I
Breast cancer in this stage is invasive cancer. Cancer cells have broken into or invaded to surrounding normal tissue in which: - The tumour is smaller than 2 centimetres (cm)
- No involvement of lymph nodes in the armpit are affected
- The cancer cells have not spread. The cancer stay in the breast tissues only has not spread to the outside area such as chest wall or lymph nodes.
Stage II
Breast cancer at this stage is invasive. The cancer cells have: - Spread to lymph nodes in the armpit on the same side as the breast cancer. These affected lymph nodes are still independent in which not yet stuck to one another or to the normal nearby tissues.
- The measured size of the tomour is least two centimeters (cm), but no more than five centimeter
- The cancer has not yet classified to stage III where the cancer cells can be at any size.
Stage III
Stage III breast cancer is divided into three different categories: Stage IIIA. The cancer cells in this stage are: - There is significant involvement of tumor cells in the lymph nodes in the armpit or surrounding tissues
- The lymph nodes are fixed together, but no significant sign of further spread of cancer cells
- The measured size of the tumor is 5 cm or larger
Stage IIIB. The cancer cells in this stage are: - Spread to the skin or chest wall
- The lymph nodes may or may not be affected by cancer cells, but there is no sign of cancer spread to other areas
Stage IIIC. The cancer cells are: - Of any size
- Spread to lymph nodes in the armpit and under the breast bone, or to lymph nodes above and under the collarbone, but no sign of spread to other parts of the body
- Stage IIIC involves in inflammatory breast cancer where is very uncommon but very serious aggressive type of breast cancer. The most common sign of breast inflammatory is redness in which involves part or the entire breast.
Stage IV
This stage is very invasive. The cancer has: - Any size
- Spread beyond the breast, underarm and internal mammary lymph nodes
- Spread to other parts of the body such as lungs, liver, bones, or brain.
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