Stages of Breast Cancer

Cancer is a life-altering disease that can affect any person. Often the damage caused by cancer is described in stages to provide an accurate prognosis to the patients. This bifurcation in stages helps the patients and the doctors to understand how extensive or evolved the cancer is in the breast tissue & other parts of the body. Determining the stage allows the doctors to perform the right treatment plan, including surgery, if needed.

Based on the physical exams and results from the patients’ mammogram/other diagnostic imaging tests, the doctor assigns the stage to cancer. The stage can be later altered based on the lab reports from the breast surgery. ‘TNM’ stands for T – tumor size, N – involvement of lymph nodes, and M – metastasized – are the scales that are taken into consideration to determine the stage of cancer.

Stages of Breast Cancer

Breast cancer is segregated into five stages, starting from zero to four (represented in roman numerals 0, I, II, III, IV with variables in some stages). The tumors are measured in mm or cm based on their size.

Stage 0 –

Stage 0 is the earliest stage on the scale. It is called as non-invasive breast cancer or precancers. Ductal Carcinoma in Situ (DCIS) is the most common non-invasive cancer in this stage. Here there is no evidence that the cancerous cells have spread to the nearby normal tissues.

Stage I –

In stage I, the cancer cells have spread to the nearby breast tissues although it is still held up in a small area. This is the early stage of invasive cancer. This stage is divided into two sub-categories:

Stage I A:

Tumor of 2 cms (nearly the size of a grape).
Cancer still held up within the breast, with no cancer detected in the lymph nodes.

Stage I B:

A small tumor less than 2 cms along with a group of cancer cells found in the lymph nodes.
There is no tumor in the breast, a group of cancer cells found in the lymph nodes.

Stage II –

In stage II, the cancer is still in the breast region but has grown larger. Here the cancer cells spread to the lymph nodes. Stage II is divided into the following categories:

Stage II A:

Tumor of 2 cms may or may not be in the breast, plus it has spread to the lymph nodes under the arm.
A breast tumor of 2 to 5 cms is present but hasn’t spread to the lymph nodes.

Stage II B:

Cancer cells have spread to a nearby 1 and 3 lymph nodes and a tumor of 2 to 5 cms is present in the breast.
Tumor larger than 5 cms is present in the breast but hasn’t spread to any lymph nodes.

Stage III –

Stage III breast cancer denotes that the tumor has grown larger than the other stages and cancer has spread further into the breast. Stage III is divided into three sub-categories:

Stage III A:

Cancer cells are found in 4 to 9 lymph nodes, a tumor may or may not be present in the breast.
Cancer cells have spread between nearby 1 and 3 lymph nodes and the tumor size in the breast is larger than 5 cms.

Stage III B:

The appearance of swelling/inflammation due to the spread of cancer to the skin.
Ulcerated area/wound caused by the breaking of cancer through the skin.
Cancer cells may have spread to as many as 9 lymph nodes in the underarm or the nodes in the nearby breastbone.

Stage III C:

In this stage, the tumor/lump could be of any size or there might be no tumor present at all. Here the cancer cells have spread to the below places:

10 or more lymph nodes in the underarm.
Lymph nodes near the collarbone.
Lymph nodes near the breastbone and some near the underarm.
The skin.

Stage IV –

This is the advanced stage of breast cancer. In this stage, cancer has expanded to vital organs like lungs, liver or brain. This could mean that it could be stage IV when first diagnosed or it is an upturn of the previous breast cancer spread.

Early diagnosis plays a crucial part in curing breast cancer. Due to the recent advancement in technology, getting accurate care for cancer is available to all. Make sure to get yourself routinely checked for any signs or symptoms of breast cancer.

Dr. Mekhala Swethadri, Associate Consultant, Radiation Oncology, Narayana Multispeciality Hospital, Mysore

Narayana Health