Understanding the Stages of Breast Cancer

"Navigating the Journey: A Guide to Understanding Breast Cancer Stages"

Stages of Breast Cancer, When a person is diagnosed with breast cancer, doctors determine the location of the cancer to choose the best treatment and predict the chances of recovery. Breast cancer staging is a complex process that looks at various factors, including the size and location of the tumor and whether cancer has spread to other areas of the body or lymph nodes. We’ll go over each Stage of breast cancer and explain how doctors determine the location in this article.

How are breast cancer stages determined?

According to the American Cancer Society (ACS), the most common staging system for breast cancer is the one developed by the American Joint Committee on Cancer. You may also see this called the TNM system, where:

  • T indicates tumor volume
  • N indicates whether or not the cancer has spread to nearby lymph nodes
  • M means whether cancer has spread to distant lymph nodes or other organs in your body

In 2018, this system was also updated to include other factors called biomarkers in breast cancer staging. These include:

  • Hormone receptor and HER2 status for cancer
  • The grade of tumor, which is the way the tumor appears compared to typical breast tissue
  • Oncotype DX is a gene expression test that predicts the likelihood of breast cancer spreading to another part of the body.

Once all of the above factors have been evaluated, your cancer will receive an overall staging. There are five stages of breast cancer, numbered from 0 to 4.

Read more: What are the Recommendations for Breast Cancer Screening?

Vital signs and stages

With the addition of biomarkers, breast cancer staging is now very complex compared to other types of cancer. For example:

  • Cancers that might have been assigned a more advanced stage may now be given a less advanced location because some biomarkers could make cancer easier to treat.
  • Cancers that may have been assigned a lower stage may now be given a more advanced stage if biomarkers indicate that the tumor can grow and spread more quickly.

Due to the complexity of the factors affecting staging, this article will focus mainly on the TNM aspects of the Stage.

What is Stage 0 breast cancer?

Breast cancer at Stage 0 is known as ductal carcinoma in situ, a type of non-invasive cancer. In this Stage, cancerous cells are found only in the breast ducts and have not spread to other tissues.

Read more: Is Breast Cancer Painful?

A word on breast cancer symptoms

Breast cancer symptoms can differ significantly among individuals, even at the same cancer stage. Some people may not have any apparent symptoms, while others may experience noticeable changes in their breasts.

According to the ACS, the most common breast cancer symptom is a painless breast lump. Other possible symptoms of breast cancer may include:

  • Swollen lymph nodes, especially under the armpits or near the collarbone
  • Breast or nipple pain
  • Breast swelling, even if it is just part of your breast
  • changes in the skin of your breast, such as:
    • decrease
    • thickness
    • redness
    • crusting or flaking
  • Nipple discharge that may contain blood
  • A nipple that turns inward

Read more: What Are the Early Signs and Symptoms of Breast Cancer?

What is breast cancer in the first Stage?

When breast cancer cells start to spread from their initial location into the non-cancerous breast tissue, it is called Stage I breast cancer. This is the first stage of invasive breast cancer and is divided into two subcategories – 1A and 1B.

Stage 1a

In Stage 1A cancers, the tumor is no more than 2 centimeters (cm) in size and has not spread outside the breast or to nearby lymph nodes.

Stage 1b

For stage 1b cancers, there may be no noticeable tumor in the breast. If a tumor is present, it is typically 2 cm or smaller. Additionally, the doctor may discover small clusters of cancer cells in nearby lymph nodes.

What is breast cancer in the second Stage?

Like stages, I and II, breast cancer are divided into two subcategories. This is Stage 2a and 2b.

Stage 2a

During Stage 2a, you may not notice any lumps in your breast. However, if a tumor is detected, it will be smaller than 2 cm. The cancer may have spread to three lymph nodes near your breastbone or under your arm. In some cases, the tumor may be more giant, ranging from 2 to 5 cm, but the cancer has not yet spread to nearby lymph nodes.

Stage 2b

Breast cancers categorized as stage 2b can vary in size from 2 to 5 cm. At this stage, clusters of cancer cells may be present in lymph nodes close to the affected area, or the tumor could have spread to a maximum of three lymph nodes near your breastbone or under your arm. Some stage 2b breast cancers may occasionally exceed 5 cm in size but have not yet spread to nearby lymph nodes.

What is breast cancer in the third Stage?

Stage III breast cancer is divided into three different subcategories. These are 3A, 3B, and 3C.

Stage 3A

In some instances of Stage 3a breast cancer, it may not be possible to detect any tumor in the breast. However, if a tumor is present, it could be of any size. The cancer has also spread to four to nine lymph nodes under the arm or near the breastbone. On the other hand, in different types of Stage 3a breast cancer, the tumor may be larger than 5 cm, but it has only spread to a maximum of three lymph nodes located under the arm or near the breastbone.

Stage 3b

If someone has stage 3b breast cancer, the tumor can be of any size and may have spread to their chest wall, breast skin, or both. Additionally, it could have affected up to nine lymph nodes under their arm or lymph nodes around their collarbone.

Stage 3c

In stage 3 breast cancer, the tumor is any size and has also spread to your chest wall, breast skin, or both. This Stage of cancer has also applied to:

  • Lymph nodes under your arm or near your breastbone
  • Lymph nodes around the collarbone
  • Ten or more lymph nodes under your arm

What is breast cancer in the fourth Stage?

Breast cancer that has spread to other parts of the body beyond the breast and nearby lymph nodes is known as metastatic breast cancer or Stage IV breast cancer. This occurs when cancer cells travel to distant lymph nodes and tissues.

According to the National Cancer Institute (NCI), the most common areas of the body for breast cancer to spread are:

  • bones
  • brain
  • liver
  • lung

A study conducted in 2017 found that individuals diagnosed with stage IV breast cancer often encountered metastasis in various parts of their bodies. Specifically, 65.1% of participants demonstrated metastasis in their bones, making it the most commonly affected region. The lungs were the next frequently impacted area, with 31.4% of participants experiencing metastasis there. The liver followed at 26%, and the brain showed metastasis in 8.8% of cases. Furthermore, 33.5% of the participants developed breast cancer that had spread to multiple sites.

Symptoms of metastatic breast cancer can depend on where the cancer has spread. However, some general signs of metastatic cancer include:

  • exhaustion
  • weakness
  • Unintentional weight loss
  • Pain at or around the site of a malignant tumor

Read more: What Is HER2-Positive Breast Cancer? Understanding Your Outlook

What is the outlook for people at different stages of breast cancer?

NCI’s SEER database tracks information about cancer rates and survival statistics. However, it does not use the stages discussed above when estimating forecasts. Instead, the steps of cancer are divided into three categories:

  • Localized, where cancer remains in the breast
  • Regional, where cancer has spread to nearby lymph nodes and tissues
  • Distant, when cancer has spread to distant tissues such as the bones or lungs

Five-year survival rates are the estimated percentage of people with a specific type and Stage of cancer alive five years after their diagnosis. According to the SEER database, the 5-year survival rates for breast cancer are:

SEER stage of the cancer 5-year survival rates
Localized breast cancer 99.1%
Regional breast cancer 86.1%
distant breast cancer 30%
Total 90.6%

Talking about the look

Open dialogue with your care team is essential when dealing with a diagnosis. Relying solely on statistics may not consider personal factors like age and overall health. Additionally, statistics are often based on a large sample size over a significant period and may not reflect the advancements in diagnosis and treatment. It’s worth noting that the breast cancer death rate has been steadily declining since 1989, according to the American Psychiatric Association.

Read more: Exercise Can Help Those Living with IBD. relation between exercise and IBD

away

Regarding breast cancer, the right treatment plan and possible outcomes depend heavily on the Stage of the tumor. Since breast cancer staging is a complex process, having an open conversation with your healthcare team is crucial to comprehend the details of your unique situation fully.

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