Stages of Breast Cancer

Breast cancer is a serious and potentially life-threatening disease affecting millions of people worldwide. Breast cancer is staged to determine the extent and severity of the disease.

The stage of breast cancer is based on the size and location of the tumour, whether the cancer has spread to lymph nodes, and whether it has spread to other parts of the body. 

The most commonly used staging system for breast cancer is the American Joint Committee on Cancer (AJCC) TNM staging breast cancer system, which stands for Tumor, Node, and Metastasis.

The TNM staging system helps to assign a stage to the breast cancer, ranging from stage 0 to stage IV and determine the best treatment options and the prognosis for the patient.

1. Tumour (T): The T category describes the size and location of the tumour. When assessing for the T category, the doctor has to answer the following questions:
   1. What is the size of the primary breast tumour? 
   2. What are the biomarkers of cancer?
2. Node (N): The N category describes whether cancer has spread to the lymph nodes. The following questions need to be answered by the doctor for the N category.
   1. Has the primary tumour dispersed to the nearby lymph nodes? If yes, where has it spread?
   2. What is the size of the tumour?
   3. How many tumours are there?
3. Metastasis (M): The M category describes whether the cancer has spread to other body parts. The doctor needs to answer
   1. Has the carcinoma spread to other body parts? 
   2. Which parts or organ systems has it spread to?

In addition to the TNM staging breast cancer system, the results obtained from the biopsy tests and scans are combined to determine a person's cancer stage. This staging that is done can be either clinical or pathological. The clinical staging is done based on the test results obtained in the pre-testing phase. It includes

1. Physical examinations
2. MRI scans
3. Mammogram
4. Ultrasound
5. Pathological staging is done based on what is found during breast and lymph node removal surgery. It is the most accurate method to procure a patient's prognosis information, and these results are generally available for some days post-surgery.

There are five stages of breast cancer, depending upon the severity and advancement of the illness. They have been enumerated as 0, 1, 2, 3 and 4, where stage 0 is the least lethal form, and stage 4 is the fatal form of breast cancer. The doctors use this system to suggest the necessary treatment. 

Stage 0 Breast Cancer

It signifies the beginning of the disease. It is also called ‘Ductal Carcinoma In Situ’ (DCIS), the non-invasive form or pre-cancer stage. 

1. In stage 0, no evidence exists that abnormal cancer cells have invaded neighbouring tissues. 
2. Zero-stage breast cancer is primarily detected through a mammogram followed by a biopsy. 
3. It can be treated with the help of a mastectomy or a lumpectomy. Sometimes radiation therapy is also used.

Stage 1 Breast Cancer

Stage 1 is the second stage. In this breast cancer stage, the cancer is still very early, but it is invasive at this point. The tumour cells spread to the surrounding tissues in the breast but are restricted to a small area. This stage can further be divided into two parts — stage 1A and stage 1B. 

1. In stage 1A, the tumour measures up to 20 millimetres and is about a grape's size. However, cancer has not spread to the lymph nodes. 
2. Stage 1B resembles stage 1A but has small cancer cell clusters.

Stage 2 Breast Cancer

In Stage 2, the cancer cells grow larger, and the lymph nodes may or may not contain cancer cells. This stage can is further divided into two sub-stages:

1. In stage 2A, the cancer size is up to 20 millimetres, and it has spread to the lymph nodes under the arm, or the tumour could even range between 20 and 50 millimetres but not spread to the lymph nodes. 
2. In stage 2B, the tumour could have spread to three lymph nodes or even increased beyond 50 millimetres.

Stage 3 Breast Cancer

In stage 3 breast cancer, the tumour has increased and spread further into the breast region. 

1. It can be found in four to nine lymph nodes or is bigger than 50 millimetres (Stage 3A). 
2. In the next stage, 3B, a tumour spreads to the chest wall behind the breast in the skin, causing an ulcerated wound followed by swelling or inflammation near the breast bones. 
3. In stage 3C, cancer might have spread to ten or more lymph nodes near the collarbone and into the skin.

Stage 4 Breast Cancer

Here is a general chart outlining the different stages of breast cancer and their characteristics:

The breast cancer stages at the time of diagnosis play a crucial role in determining the most appropriate treatment options. The line of treatment for different breast cancer stages does not have too many differences.

Usually, the treatment for different breast cancer stages involves surgery and treatment through medicinal or targeted drug therapies. The below list provides the treatment options as per the stages of breast cancer: 

1. Stage 0 breast cancer: Treatment options for DCIS typically include surgery to remove the affected tissue, such as a lumpectomy or mastectomy, and in some cases, radiation therapy.
2. Stage 1 breast cancer: Treatment options for stage I breast cancer typically includes surgery to remove the tumour, followed by radiation therapy and/or chemotherapy or targeted therapy to reduce the risk of recurrence.
3. Stage 2 breast cancer: Treatment options for stage II breast cancer may include surgery to remove the tumour, followed by radiation therapy and/or chemotherapy. Depending on the case's specifics, hormone therapy or targeted therapy may also be recommended.
4. Stage 3 breast cancer: Treatment options for stage III breast cancer may include Neoadjuvant therapy, surgery (lumpectomy/mastectomy), radiation therapy, chemotherapy, hormone therapy, and targeted therapy.
5. Stage 4 breast cancer: Treatment options for stage IV breast cancer typically focus on managing symptoms and improving quality of life. These may include chemotherapy, hormone therapy, targeted therapy, radiation therapy, and other palliative care measures.

Early detection and diagnosis of breast cancer are crucial in increasing the chances of successful treatment, helping a woman with the best chances of surviving the disease and improving long-term outcomes.

Here are some of the key reasons why early detection and diagnosis of breast cancer are so important:

1. Improved treatment options: When breast cancer is detected and diagnosed early, a broader range of treatment options are available, including less invasive and more targeted treatments. This can help to reduce the need for more aggressive treatments such as surgery or chemotherapy.
2. Better chances of survival: Early detection and diagnosis of breast cancer can significantly improve the chances of survival. According to the American Cancer Society, when breast cancer is detected and treated at an early stage, the five-year survival rate is close to 100%.
3. Reduced need for more extensive treatment: When breast cancer is not detected and diagnosed until later stages, more extensive treatment may be required, including mastectomy or removal of the breast. Early detection can help to reduce the need for these more invasive procedures.
4. Improved quality of life: Early detection and diagnosis of breast cancer can help to reduce anxiety and uncertainty and enable patients to start treatment as soon as possible. This can improve the quality of life and reduce the emotional and physical impact of the disease.

Delayed cancer care reduces the probability of surviving the onslaught and more significant complications and involves higher care costs.

In conclusion, all we can say is — being aware of the breast cancer stages will enable anyone to take care of himself/herself or his/her loved ones and ensure that the disease is detected early so that the treatment is initiated first and foremost.

Additionally, a person will be well-equipped to handle such a delicate scenario and, thus, can avoid panicking. If a person sees any symptoms, then it is wise to consult the doctor at the earliest.

And, if the doctor recommends surgery and the person has any queries regarding that, then the experts of HexaHealth are here to help. We have a team of experts who will guide the querier through the whole process and help find the best possible option for treatment. So, one doesn’t need to run around to find solutions for his/her loved ones anymore and can just contact at HexaHealth.