Breast Cancer: What are the stages?
Staging the breast cancer is the result of various diagnostic tests done on the tumour and lymph nodes. Different stages of breast cancer tumour denote varying degree of severity of the disease, and it is an important factor used by doctors in determining the treatment plan.
Let’s take a look at the various stages of breast cancer, from stage 0 to stage IV:
Stage 0 – Non-invasive, carcinoma in situ
Cancer cells are detected but not spreading out at this stage. This stage can manifest in three forms:
- Ductal carcinoma in situ (DCIS) – Abnormally growing cells are found in the lining of a breast duct.
- Lobular carcinoma in situ (LCIS) – Abnormal cells are found in the breast lobules.
- Paget disease – This is a condition in which cancer cells are found in the breast nipple.
Breast tumour measures a maximum of two centimetres, and not found in lymph nodes. This stage is divided in two – IA and IB:
- Stage IA – Tumour is less than 2cm and has not spread out from the breast.
- Stage IIB – Small groups of cancer cells of size 0.2mm–2mm are found in lymph node, along with a 2cm or less breast tumour or no breast tumour.
Stage II (Invasive)
The breast cancer is growing but is still limited to the breast or extended to nearby lymph nodes. The breast tumour measures between 2-5 cm. The cancer could have spread to under-arm lymph nodes on the same side of the breast. This stage is further divided into two, IIA and IIB:
- Stage IIA – Either one of the following happens:
- One to three axillary lymph nodes or ones near the breastbone show cancer larger than 2mm.Tumour in the breast tissue (2-5cm) may or may not be present, or
- Cancer has not spread to lymph nodes but the breast tumour is between 2-5cm in size.
- Stage IIB – Either one of the following happens:
- The tumour is 2-5 cm in size and has spread to up to 4 axillary nodes, or
- Tumour is larger than 5 cm but has not spread to axillary nodes.
Stage III or the locally advanced stage is when the tumour is greater than two inches in diameter, with the cancer extensively spread through lymph nodes of the underarm or in tissues and lymph nodes around the breast. This stage is divided into IIIA, IIIB and IIIC:
- Stage IIIA – Either of the three presentations can happen:
- No tumour in breast or tumour of any size, and cancer spread to 4-9 axillary lymph nodes or nodes near breastbone.
- Breast tumour larger than 5 cm, small cancer cells found in lymph nodes.
- Breast tumour larger than 5 cm, and cancer spreads to 1-3 axillary lymph nodes or nodes near breastbone.
- Stage IIIB – The cancer may occur as
- Any sized breast tumour, and also spread to the chest wall and/or skin with swelling and to up to 9 axillary lymph nodes, or
- Cancer had spread to lymph nodes around the breastbone.
- Stage IIIC – This stage is characterised by either of the following:
- No cancer in the breast or any size of tumour if present, cancer spread to chest wall and/or breast skin, and has spread to 10 or more axillary lymph nodes, or
- Cancer spreads to lymph nodes below or above the collarbone, or
- Cancer spreads to lymph nodes near the breastbone or to axillary lymph nodes.
Stage IV (Metastatic)
This is the invasive breast cancer stage in which cancer spreads beyond the breast tissue and surrounding lymph nodes to other organs like skin, lungs, liver, bone, distant lymph nodes or brain. This stage is also termed as ‘advanced’ or ‘metastatic’.
Recurrent breast cancer
In this form, breast cancer returns in a patient despite treatment. This usually happens in the first two to three years but cancer can resurface later on too. If it redevelops in the initial area, it is known as local recurrence, but termed metastatic breast cancer if it reappears in another part of the body.
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“How is breast cancer staged?” Cancer.org, American Cancer Society, http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-staging
“Stages of Breast Cancer,” Beastcancer.org, http://www.breastcancer.org/symptoms/diagnosis/staging
“Stages of Breast Cancer,” Cancer.gov, http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/page2