Numbers or letters after T, N, and M give more details about each characteristic. Higher numbers mean the cancer is more advanced. Jump to more detailed information about the TNM system.
Adding information about tumor grade, hormone-receptor status, HER2 status, and possibly Oncotype DX test results has made determining the stage of a breast cancer more complex, but also more accurate.
So, a woman diagnosed with stage II disease that is triple-negative [estrogen-receptor-negative, progesterone-receptor-negative, and HER2-negative] will have a very different treatment plan than a woman diagnosed with stage II disease that is estrogen-receptor-positive.
The staging guidelines now take into account what doctors have been doing all along. In general, according to experts, the new staging system classifies triple-negative breast cancer estrogen-receptor-negative, progesterone-receptor-negative, and HER2-negative at a higher stage and classifies most hormone-receptor-positive breast cancer at a lower stage.
The updated AJCC breast cancer staging guidelines have made determining the stage of a cancer a more complicated but accurate process. So, the characteristics of each stage below are somewhat generalized. So, a person who was diagnosed in with stage II breast cancer and then had the cancer come back in the bones in technically is considered to have stage II breast cancer with metastatic recurrence to bone.
Still, this is not how most people — and even most oncologists — talk and think about cancer. This allows the organizations to compile statistics on cancer outcomes. N2b: Cancer has spread to one or more internal mammary lymph nodes, causing them to become enlarged. Cancer has spread to 10 or more axillary lymph nodes, with at least one area of cancer spread greater than 2 mm,. Cancer has spread to the lymph nodes under the collarbone infraclavicular nodes , with at least one area of cancer spread greater than 2 mm.
Cancer is found in at least one axillary lymph node with at least one area of cancer spread greater than 2 mm and has enlarged the internal mammary lymph nodes,. Cancer has spread to 4 or more axillary lymph nodes with at least one area of cancer spread greater than 2 mm , and tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy. N3c: Cancer has spread to the lymph nodes above the collarbone supraclavicular nodes with at least one area of cancer spread greater than 2 mm.
M followed by a 0 or 1 indicates whether the cancer has spread to distant organs -- for example, the lungs, liver, or bones. M0: No distant spread is found on x-rays or other imaging tests or by physical exam. M1: Cancer has spread to distant organs most often to the bones, lungs, brain, or liver.
It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs — such as the lungs, liver , or brain — or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread. Call Available 7 days a week, am - pm , ET. Make an Appointment. Stages of Breast Cancer. Anatomy of the Breast. Types of Breast Cancer. Breast Cancer Risk Factors. Overview Breast Cancer Screening Guidelines.
Breast Cancer Diagnosis. Breast Cancer Treatment. Breast Reconstruction. Breast Cancer in Young Women. Lymphedema Treatment after Breast Cancer. Overview Lymphedema Surgery. Living Beyond Breast Cancer. Often, stage 0 is considered a precancerous condition that typically requires close observation, but not treatment. 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 of breast cancer , 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. Ductal carcinoma in situ DCIS occurs when breast cancer cells develop in the breast ducts. Today, stage 0 DCIS is being diagnosed more often because more women are having routine mammogram screenings. DCIS can become invasive, so early treatment can be important. Lobular carcinoma in situ LCIS occurs when abnormal cells develop in the lobules.
These cells are not cancerous and this condition rarely becomes invasive cancer. However, women who develop LCIS may be at increased risk for developing breast cancer in the future. For women who develop LCIS, the risk of getting an invasive cancer is 20 percent to 25 percent over 15 years after the initial diagnosis. This breast cancer is the earliest stage of invasive breast cancer. In stage 1, the tumor measures up to 2 cm and no lymph nodes are involved.
At this stage, the 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 two categories:. Stage 1A: The tumor measures 2 cm or smaller about the size of a pea or shelled peanut 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. The survival rate for stage 1A breast cancer may be slightly higher than for stage 1B. However, all women with stage 1 breast cancer are considered to have a good prognosis. At stage 1, TNM designations help describe the extent of the disease. For example, there may or may not be cancer cells in the lymph nodes, and the size of the tumor may range from 1 cm to 2 cm.
Most commonly, stage 1 breast cancer is described as:. 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 2 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 1 disease.
However, stage 2 means the cancer has not spread to a distant part of the body. At stage 2, a tumor may be detected during a breast self-exam as a hard lump within the breast. Breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable. The survival rate for stage 2A breast cancer may be slightly higher than for stage 2B.
However, all women with stage 2 breast cancer are considered to have a good prognosis. At stage 2, TNM designations help describe the extent of the disease. Most commonly, stage 2 breast cancer is described as:. Also known as locally advanced breast cancer, the tumor in this stage of breast cancer is more than 2 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 3 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 underarm lymph nodes. The tumor may also be quite large at this stage, possibly extending to the chest wall or the skin of the breast. The survival rate for stage 3A breast cancer may be slightly higher than for stage 3B, and the survival rate for stage 3B may be slightly higher than for stage 3C.
However, all women diagnosed with stage 3 breast cancer have several promising treatment options.
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