The Stages of Breast Cancer

After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. Breast cancer can occur in both men and women, but it's far more common in women.

The stage of a breast cancer is determined by cancer’s characteristics, such as whether or not it has hormone receptors and how large it is.

The stage of breast cancer is one of the most important factors in evaluating treatment options. Cancer doctors use a variety of diagnostic tests to evaluate breast cancer and develop the appropriate treatment plan for you.









How a Breast Cancer’s Stage is determined

Your pathology report will include information that is used to calculate the stage of the breast cancer, that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body.





Your specialist doctor will determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. Doctor also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.





Breast cancer staging system, called the TNM system, is overseen by the AJCC, American Joint Committee on Cancer . The AJCC is a community of cancer experts who see how cancer is classified and communicated. This is to ensure that all treatment facilities and doctors are describing cancer in a uniform way so that the treatment results of women can be compared and understood.









Stage number was calculated based on just 3 clinical characteristics, T, N, and M:

Size of the cancer tumor and whether or not it has grown into nearby tissue (T)

Whether cancer is in the lymph nodes (N)

Whether the cancer has spread to other parts of the body beyond the breast (M)





Stage 0 breast cancer

Tumor measures up to two cm and no lymph nodes are involved. Cancer cells have spread beyond the original location and into the surrounding breast tissue.

Because a stage 1 tumor is small, it may be difficult to detect. However, breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.

Stage 1 breast cancer is divided into 2 categories:

Stage 1A: The tumor measures 2 cm or smaller and has not spread outside the breast.

Stage 1B : Small clusters of cancer cells measuring no more than 2 mm, are found in the lymph nodes, and either there is no tumor inside the breast, or the tumor is small, measuring 2 cm or less.





Stage 2 breast cancer

Also known as invasive breast cancer, the tumor in this stage measures between 2 cm to 5 cm, or the cancer has spread to the lymph nodes under the arm on the same side as the breast cancer. Stage II breast cancer indicates a slightly more advanced form of the disease. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue, and the tumor is larger than in stage I disease. However, stage II means the cancer has not spread to a distant part of the body.



Stage 2 breast cancer is divided into 2 categories: Stage 2A : There is no tumor within the breast, but cancer has spread to the axillary, underarm lymph nodes, or The tumor in the breast is 2 cm or smaller and cancer has spread to the axillary lymph nodes, or The tumor in the breast measures 2 cm to 5 cm but cancer has not spread to the axillary lymph nodes. Stage 2B: The tumor measures 2 cm to 5 cm and cancer has spread to the axillary lymph nodes, or tumor is larger than 5 cm but cancer has not spread to the axillary lymph nodes.



Stage 3 breast cancer Tumor in this stage is more than two inches in diameter across and the cancer is extensive in the underarm lymph nodes or has spread to other lymph nodes or tissues near the breast. Stage III breast cancer is a more advanced form of invasive breast cancer. At this stage, the cancer cells have usually not spread to more distant sites in the body, but they are present in several axillary lymph nodes. The tumor may also be quite large at this stage, possibly extending to the chest wall or the skin of the breast.

Stage 3 breast cancer is divided into 3 categories: Stage 3A: No tumor is found in the breast, but cancer is present in axillary lymph nodes that are attached to either other or other structures, or cancer may be found in the lymph nodes near the breast bone. The tumor is 2 cm to 4 cm in size. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breast bone. Stage 3B: The tumor may be any size, and the cancer has spread to the chest wall and/or skin of the breast. Cancer that has spread to the skin of the breast is inflammatory breast cancer. Stage 3C : May be no sign of cancer in the breast or the tumor may be any size and may have spread to the chest wall and/or skin of the breast. Cancer cells are present in lymph nodes above or below the collarbone. Cancer cells may have spread to axillary lymph nodes or lymph nodes near the breastbone. Cancer that has spread to the skin of the breast is inflammatory breast cancer.



Stage 4 breast cancer The tumour can be any size, the lymph nodes may or may not contain cancer cells



the cancer has spread (metastasised) to other parts of the body such as the bones, lungs, liver or brain

Cancer in this stage has spread beyond the breast, underarm and internal mammary lymph nodes to other parts of the body near to or distant from the breast. If a person has stage 4 breast cancer, this means that the cancer cells have spread to other organs in their body, such as the lungs, lymph nodes, bones, skin, liver, or brain.

At stage 4, TNM designations help describe the extent of the disease. Higher numbers indicate more extensive disease. Most commonly, stage IV breast cancer is described as: T: T1, T2, T3 or T4, depending on the extend and/or size of the primary tumor. N1: Cancer has spread to the lymph nodes M1: The disease has spread to other sites in the body



Substantial support for breast cancer awareness and research funding has helped created advances in the diagnosis and treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.

The specialist have many ways to find out what stage of breast cancer. Clues come from physical exams, biopsies, X-rays, bone scans and other images, and blood tests. A doctor called a pathologist puts tissue samples from the breast and lymph nodes under the microscope to find out even more.Based on these findings, doctors string together letters and numbers to assign a stage to every case of breast cancer. It may seem like a strange code, but it’s really just a way to pinpoint exactly what’s going on with your cancer. Think of it like this: The longer the list of letters and numbers, the more exact the diagnosis and the more precise the treatment plan.Stage 0 breast cancer is difficult to detect. There may not be a lump that can be felt during a self-examination, and there may be no other symptoms. However, breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable. Stage 0 disease is most often found by accident during a breast biopsy for another reason, such as to investigate an unrelated breast lump.