Staging
The stage describes the extent of cancer in a person’s body at the time of diagnosis. Staging is an important factor in determining the patient’s prognosis and best course of treatment. There is anatomic staging and prognostic staging for breast cancer. Anatomic staging considers the size of the tumor in the breast, lymph node involvement, and whether the cancer has spread to other parts of the body (metastasis). Prognostic staging uses the information from the anatomic stage, and then adds in additional information including whether the tumor expresses estrogen and/or progesterone receptors, is positive or negative for Her2/neu, and the tumor grade to obtain a more precise picture about how the cancer will behave and the likely course of disease.
Using the TNM system, the "T" plus a letter or number describes the size of the tumor, the "N" stands for the lymph nodes involved and the "M" describes whether the cancer has spread to other parts of the body.
Based on the stage of the breast cancer, the doctor may give treatments before surgery (neoadjuvant therapy), to shrink the tumor. Or, the doctor may give additional treatments after surgery (adjuvant therapy), to destroy any remaining cancer cells in the body.
Prior to surgery, the determination of cancer stage is based on results of your mammogram, ultrasound, MRI and any additional studies that may have been performed. This staging is referred to as the clinical stage.
Once surgery is performed, your doctor will look at the pathology report to calculate the precise stage of your cancer. This is called the pathologic stage, and it may be somewhat different than what was determined prior to surgery. This is because the size of the tumor as measured under the microscope is the true, accurate measurement, whereas the size of the tumor based on imaging studies is more of an estimate of what is expected to be found in the tissue at surgery. Treatment of each stage of breast cancer may include some combination of surgery, radiation, chemotherapy, and/or targeted cell therapy. Ask your doctor for details about each stage and what goes into determining the stage of your cancer.
Anatomic Staging of Breast Cancer
Stage 0
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Description
Called “carcinoma in situ”. Cancerous cells are found in the breast, but these cells remain in their original location and have not yet spread into the surrounding tissue. In situ carcinomas can eventually become invasive cancer.
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- Ductal Carcinoma in situ (DCIS): In ductal carcinoma in situ (DCIS), cancerous but non-invasive cells are found in the lining of a milk duct.
- Lobular Carcinoma in situ (LCIS): In lobular carcinoma in situ (LCIS), cancerous but non-invasive cells are found in the milk-producing lobules of the breast.
It is also called non-invasive cancer (Tis, N0, M0) Stage 0 .
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- N0 means that either no cancer was found in the lymph nodes or areas of cancer smaller than 0.02 cm were in the lymph nodes.
- M0 means that the disease has not metastasized.
Please see Staging System Explained for more information.
Stage Ia
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Description
Stage Ib
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Description
Stage IIa
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Description
Tumor is less than 2 cm in and it has spread to axillary lymph nodes (T1, N1, M0) .
- T1 means that the tumor is 2 cm or smaller in diameter.
- N1 means that the cancer has spread to 1 to 3 axillary lymph nodes and/or internal mammary lymph nodes (lymph nodes near the breast bone.
- M0 means the disease has not metastasized.
OR
There is no evidence of tumor in the breast but the cancer has spread to 1 to 3 axillary lymph nodes and/or tiny amounts of cancer are found in internal mammary (near the breast bone) lymph nodes (T0, N1, M0) .
- T0 means that there is not evidence of cancer in the breast.
- N1 means that the cancer has spread to 1 to 3 axillary lymph nodes and/or internal mammary lymph nodes.
- M0 means the disease has not metastasized.
OR
Tumor is larger than 2 cm but less than 5 cm. Cancer has not spread to lymph nodes or distant sites (T2, N0, M0) .
- T2 means that the tumor is larger than 2 cm but not larger than 5 cm.
- N0 means that either no cancer was found in the lymph nodes or only areas of cancer smaller than 0.2 m have been found in the lymph nodes.
- M0 means the disease has not metastasized.
Please see Staging System Explained for more information.
Stage IIb
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Description
Stage IIIa
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Stage IIIb
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Stage IIIc
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Description
Stage IV
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Description
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- Cancer has invaded distant organs or spread to other parts of the body. Breast cancer most commonly spreads to the bones, lungs, liver, or brain (any T, any N, M1) .
Please see Staging System Explained for more information.
