For those people who have been diagnosed with breast cancer, the first thing your doctor will do after the initial diagnosis is to find out what stage and grade the cancer is at. This helps you and your doctor find out more and decide on future treatment accordingly. There are several ways of determining what stage of breast cancer you have. These include physical examinations, X-rays, biopsies, bone scans, blood tests, and many other imaging tests. A pathologist will take tissue samples from your lymph nodes and breast in order to observe under the microscope and find out more information about the cancer.
Depending on these results, doctors assign a stage to every case of breast cancer. Staging is usually done by assigning letters and numbers that seem like some kind of code, but it helps other doctors know exactly what is happening with your breast cancer. The fact that most people don’t know is that the longer this list of letters and numbers, the more accurate and exact the diagnosis is. This means that your treatment plan can be designed more precisely.
Here are the five major stages of breast cancer and what to expect at each stage.
What are the 5 Stages of Breast Cancer?
The stages of breast cancer range from the number zero and has the Roman numeral I, II, III, or IV following the number. The Roman numerals are often followed by A, B, C. In most cases, the higher the number, the more advanced is the stage of the breast cancer.
Here are the main stages of breast cancer.
Stage 0: Stage zero means that the cancer was caught in its early stages. The cancer began in the milk glands or breast ducts and has remained confined to that place itself. It is common to hear your doctors throw around the term in situ at this stage, which means that the cancer remains in the original place where it began.(1, 2, 3)
Stage I: This is still a starting level, but from stage one, breast cancer is said to be invasive. This means that the cancer cell has broken free from where they began and have started attacking other healthy tissue.(4, 5)
- Stage IA: This means that the cancer has spread into the nearby fatty breast tissue. It also indicates that the tumor, though, is no bigger than a shelled peanut. In many cases, it is also possible there is no tumor present at this stage.(6, 7)
- Stage IB: At this stage, there are some cancer cells present, but in a very small amount. These have been found in some of your lymph nodes.
Stage II: By stage II, the cancer has already grown or spread, or it could be both.(8, 9)
- Stage IIA: This stage refers to the breast’s tumor to still be small, and in some cases, there might be no tumor even by this stage. There might also be no cancer in the lymph nodes, or it is possible that the cancer has spread to a maximum of three lymph nodes.
- Stage IIB: By this stage, the breast tumor is getting bigger – about the size of a walnut or even as big as a lime. It might or might not be present in the lymph nodes.
Stage III: By stage three of breast cancer, the cancer has not yet spread to any other organs or to the bones. However, it is considered to be at an advanced stage, and it is now considered more challenging to fight and treat.(10, 11)
- Stage IIIA: This means that the cancer has been diagnosed in up to nine lymph nodes that create a chain right from the underarm all the way to your collarbone. It could also mean that the cancer has spread to or it has enlarged the lymph nodes that are located deep in the breast. In some cases, there can be no tumor present, but in others, there could be a large tumor already present in the breast.
- Stage IIIB: This stage means that the tumor has properly grown into the skin or chest wall around the breast. It might not have spread to the lymph nodes yet.
- Stage IIIC: This means that your cancer has been discovered in at least ten or more lymph nodes in the body, or it might even have spread below or above the collarbone. It is also considered to be at stage IIIC if fewer lymph nodes located outside the breast have been impacted, but the lymph nodes inside the breast are already cancerous or enlarged.
Stage IV: By stage four, the breast cancer cells have already spread significantly further away from the breast, and the lymph nodes present right around the breast area. The most commonly affected sites include the bones, brain, liver, and lungs. This stage is often referred to as metastatic, which means that the cancer has spread beyond the part of the body where it first originated.(12, 13, 14)
What Do Breast Cancer Grades Mean?
Apart from determining the exact stage of your breast cancer, it is also necessary to find out the grade of the breast cancer. Grading of breast cancer is used to measure how the cancer cells look and how rapidly they are growing as compared to the normal, healthy cells of the body. Grading of breast cancer also tells you the likelihood of the cancer spreading to other parts of the body. The grade and stage of breast cancer together help doctors decide on the potential outcome of the cancer and also determine the best form of treatment.
Doctors figure out the grade of a cancer cell on how different it appears from the normal cells. Doctors analyze at three different features of the cells by looking at them under a microscope and then assign a score to each one. These scores are then added together to assign a grade between one and three. Here are the different grades of breast cancer and what they mean:
- Grade 1 (meaning the cells are well differentiated): In grade 1 breast cancer, the cells appear quite similar to healthy breast tissue, and they are also growing at a slow rate.(15, 16)
- Grade 2 (means the cells are moderately differentiated): In grade 2, the cancer cells appear to be slightly different from normal cells, and they also grow a bit faster.(17, 18)
- Grade 3 (means the cells are poorly differentiated): At grade 3, the breast cancer cells appear very different than the normal cells. They are rapidly growing and most likely to spread to other parts of the body.(19)
If, for example, you have Stage 0 ductal carcinoma in situ, your doctors are going to grade the cancer cells depending on how they look under the microscope. They are also going to check if there are any dead or dying cancer cells present. If there are any dead or dying cancer cells present, this means that the cancer cells are growing rapidly. If there are several dead or dying cancer cells, this means that your breast cancer is of a higher grade.
What is the TNM System for Classifying Breast Cancer?
Doctors also have a grouping system for cancer by using the letter T, N, or M. Each one of these letters let you know some specific information about your cancer.(20, 21)
- The letter ‘T’ stands for the tumor. The higher is the number assigned after the T, the wider or bigger is the mass of cancer that is found in the breast.
- The letter ‘N’ stands for nodes or lymph nodes. These are small filters that are present throughout the body. The lymph nodes are particularly dense in and around the breast.
- The lymph nodes work to catch the cancer cells before they reach other parts of the body as well. Again, same as before, a number (usually 0 to III) lets you know whether the cancer has spread to the lymph nodes located near the breast. In such a case, it also lets you know to how many lymph nodes the cancer has spread to.
And finally, the letter ‘M’ stands for metastasis, which means that the cancer has already spread to beyond the lymph nodes and breast.
What is the 5-Year Survival Rate Based on the Breast Cancer Stage?
The five-year survival rate of breast cancer indicates how many people tend to survive for at least five years after getting diagnosed with breast cancer. The survival rate depends on the stage of the cancer you are diagnosed with. However, it is essential to note that this is only an estimate, and many people go on to live for a much longer time. The lower the stage of breast cancer at the time of diagnosis, the higher are the chances of surviving longer. Your doctor will help you understand your survival rate based n the staging of your cancer and what it means for you.
According to estimates calculated by the National Cancer Institute, the five-year survival rates for breast cancer are as follows:(22, 23, 24)
- Stage 0: 100 percent
- Stage I: 100 percent
- Stage II: 90-93 percent
- Stage III: 70-72 percent
- Stage IV: 22 percent
Conclusion
Being handed a diagnosis of breast cancer is no doubt a life-changing experience. It is natural to have many questions and feel confused about the entire staging process. Your doctor is the best companion to have in this journey, and you should let them know about your doubts and confusion so that you have access to accurate answers. Finding about more about the stages of breast cancer will help you understand just what you can expect in the months to come and also make educated decisions on your treatment plan along with your doctor.
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