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Breast Cancer Staging   

To plan your treatment, your doctor needs to know how far your breast cancer has developed. The different stages of breast cancer are based on the size of the tumor, and whether the cancer has spread. Staging is done through x-rays, examination of the lymph nodes, and other clinical tests. These tests can show whether the cancer has spread and, if so, to what parts of the body. The stage is often not known until the tumor has been removed.

Breast cancer is most commonly staged on the basis of the American Join Committee on Cancer (AJCC) TNM System. This system stages breast cancer based on results from either physical exams, biopsies, or imaging tests, plus findings after surgery. The pathologic form of staging is more accurate than the clinical form, because it gives doctors the ability to exam the cancer more extensively.

Breast Cancer Stages:

According to the TNM system there are 5 stages of cancer, stages 0 to IV. Stage 0 being the non-invasive cancer, stage I the least advanced, and stage IV the most advanced.

Stage 0

Stage 0 is referred to as ductal carcinoma in situ (DCIS); it is the earliest form of breast cancer. When a woman is diagnosed with stage 0, the cancer cells have not yet invaded into the surrounding fatty breast tissue.

Lobular carcinoma in situ (LCIS) is sometimes also categorized as stage 0, however, many oncologists do not believe that it is a true form of breast cancer. In LCIS, abnormal cells grow within the lobules, but do not penetrate the lobules' wall.

Paget disease of the nipple (without a tumor mass) is also categorized as stage 0. In all cases the cancer has not spread to lymph nodes or other tissues.

 

Stage I

With stage I the tumor is smaller than 2 cm (3/4 in.) in diameter, and has not spread to the lymph nodes or other, distant, tissue.

 

Stage IIA

There are many classifications for Stage IIA breast cancer, any of the following applies:

  • The tumor is less than 2cm in diameter, or not found, and has spread to 1-3 axillary lymph nodes.
  • The tumor is less than 2 cm in diameter, or not found, and tiny amounts of cancer can be found in internal mammary lymph nodes on sentinel lymph node biopsy
  • The tumor is less than 2 cm in diameter, and has spread to 1-3 axillary lymph nodes, and tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.
  • The tumor is larger than 2 cm but smaller than 5cm in diameter, but has not spread to the lymph nodes.

 

Stage IIB

Similar to stage IIA, stage IIB cancer can have any of the following characteristics:

  • The tumor is larger than 2 cm, but less than 5 in diameter. It has also spread to 1-3 axillary lymph nodes and/or tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.
  • The tumor is larger than 5 cm in diameter but does not grow into the chest wall or surrounding tissue, and has not spread to the lymph nodes.

 

Stage IIIA

  • The tumor is not more than 5cm in diameter, or cannot be found. It has furthermore spread to 4 to 9 axillary lymph nodes, or it has enlarged the internal mammary lymph nodes.
  • The tumor is larger than 5 cm in diameter, but has not grown into the surrounding tissue. It has spread to 1-9 of the axillary nodes, or to internal mammary nodes.

 

Stage IIIB

With stage IIIB cancer, the tumor has grown into the chest wall or skin, and one of the following applies:

  • It has not spread to the lymph nodes.
  • It has spread to 1-3 axillary lymph nodes and/or tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.
  • It has spread to 4-9 axillary lymph nodes, or it has enlarged the internal mammary lymph nodes.

Inflammatory breast cancer is also classified as stage IIIB unless it has spread to distant lymph nodes or organs, in which case it would be stage IV.

 

Stage IIIC

Stage IIIC tumors are of any size, or cannot be found, and one of the following applies:

  • The cancer has spread to 10 or more axillary lymph nodes.
  • The cancer has spread to the lymph nodes under the collarbone.
  • The cancer has spread to the lymph nodes above the collarbone.
  • The cancer involves axillary lymph nodes and has enlarged the internal mammary lymph nodes.
  • Cancer involves 4 or more axillary lymph nodes, and tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.

 

Stage IV

The cancer can be any size and may or may not have spread to nearby lymph nodes. It has spread to lymph nodes far from the breast, and distant organs; the most common sites being: the bone, liver, brain, and lung.

 

Breast Cancer » Basic Information about Breast Cancer » Breast Cancer Staging
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