Medical News Today: What Happens at Each Stage of Breast Cancer?

The stages of breast cancer range from 0 to 4. Each stage has different symptoms and treatment options.

has four steps and a doctor uses the TNM classification system to identify which of these four stages breast cancer has reached.

The letters TNM mean the following:

• T represents and indicates the amount of breast tissue involved.
• N represents nodes and indicates that it has spread to the lymph nodes.
• M means metastasis and indicates whether the cancer has spread to other parts of the body.

The TNM staging system also. The numbers from 0 to 4 determine the degree of cancer progression.

The system is overseen by the Joint US Committee on Cancer (AJCC). This means that all cancer doctors describe and classify cancer stages in the same way.

To determine at what stage a person's breast cancer has reached, a doctor will perform tests. The tests include blood tests, CT scans and x-rays, including a mammogram.

Stage 0 breast cancer

The TNM classification system helps to identify the stage of breast cancer and the appropriate treatment.

A person with a type of non-invasive cancer.

This means that the cancer has not spread elsewhere in the body and that the cancer cells remain in the breast where they started to grow.

Non-invasive breast cancer is also known as In Situ Ductus (DCIS). This means that the cancer stays in the milk ducts.

An early diagnosis of stage 0 breast cancer means that a person can receive prompt treatment.

This could prevent cancer from turning into a type of invasive breast cancer.

Treatment for stage 0 breast cancer

There are a variety of stage 0 breast cancers, including:

Surgery

A lumpectomy involves removing breast cancer cells. This is an option when the cells remain in an area. It is a relatively short and simple procedure, and a person should be able to return home after the operation the same day.

If cancer cells appear throughout the breast, the doctor may recommend a, which involves removing all the breast. Plastic surgeons can rebuild the breast at the same time or at a later date.

Radiotherapy

can help kill cancer cells and prevent them from spreading. A person will usually undergo radiation therapy once the breast surgery site has healed. This is usually 4-6 weeks after the surgery.

Hormonal treatment

The hormone, naturally present in the body, can impact certain types of breast cancer. If a person has estrogen receptor (ER +) or receptor (PR +) positive breast cancer, a doctor may suggest hormone therapy in addition to surgery.

The person may also need a radiation therapy to manage the levels of these hormones in the body.

Stage 1 breast cancer

means that the cancer cells invade the surrounding breast tissue. Stage 1 breast cancer has two subcategories -.

People with Stage 1A breast cancer have breast cancer with:

• A tumor less than 2 centimeters (cm) in diameter that did not extend to the outside of the breast.

People with Stage 1B breast cancer have invasive breast cancer that can come in the form of:

• No tumors in the breast, but the cancer cells have formed clusters of diameter between 0.2 and 2 mm and can also be found in the lymph nodes.
• A tumor whose size does not exceed 2 cm grows in the breast next to small groups of cancer cells measuring between 0.2 and 2 mm and developing in the lymph nodes.

If this is the case and the cancer is ER + or PR +, a doctor is still likely to classify it as Stage 1A.

The microscopic invasion is where the cancer cells began to spread outside the lining of the milk duct or lobule. In case of microscopic invasion, doctors can still classify cancer as stage 1 breast cancer, provided that these cells do not measure more than 1 mm.

Treatment for stage 1 breast cancer

Doctors can offer a variety of stage 1 breast cancer, although surgery is the main treatment.

Surgery

A lumpectomy or mastectomy are two viable surgical options for people with stage 1 breast cancer. A doctor will decide which surgery is most appropriate depending on the location of the primary tumor, its size, breast size, family history, genetics, and individual preferences.

Radiotherapy

Radiation therapy is a standard treatment for stage 1 breast cancer. However, a doctor may not recommend radiation therapy for people over the age of 70, especially if hormone therapy is appropriate.

Hormone

If breast cancer is ER + or PR +, hormone therapy can be effective. Hormone therapy works by inhibiting the growth of estrogen, which promotes cancer growth. Hormone therapy can reach breast cancer cells and other parts of the body and reduces the risk of cancer recurrence.

Chemotherapy

Before recommending, a doctor will test if the cancer is receptive to hormones.

If the test results show that the cancer is not receptive to estrogen and progesterone or another protein called human epidermal growth factor receptor 2 (HER2), it is called triple negative breast cancer.

Hormone therapy is ineffective against this type of cancer and people with it usually need chemotherapy.

However, some people with ER + or PR + breast cancer may still undergo chemotherapy. A doctor may need to perform a tumor test to determine if chemotherapy is appropriate.

Sometimes doctors recommend that people with HER2 + breast cancer use Herceptin, a targeted therapy, alongside chemotherapy.

Stage 2 breast cancer

also has subcategories known as.

Stage 2A breast cancer is an invasive cancer where:

• There is no tumor growth in the breast itself, but cancerous masses larger than 2 mm in diameter develop in up to three axillary nodes (in and around the armpit) or lymph nodes located near the sternum.
• There is a tumor in the breast less than 2 cm in diameter that has spread to the axillary lymph nodes.
• The tumor has a diameter of 2-5 cm but has not spread to the axillary lymph nodes.

Stage 2B breast cancer is an invasive breast cancer where:

• A tumor 2 to 5 cm in diameter develops in the lymph nodes next to groups of cancer cells. These cancerous cells form groups of size between 0.2 mm and 2 mm.
• There is a tumor 2 to 5 cm in diameter and the cancer cells have spread to one to three axillary lymph nodes or lymph nodes through the sternum.
• The tumor is larger than 5 cm, but the cancer cells did not spread to axillary nodes.

Treatment for stage 2 breast cancer

Surgery is the most common form of stage 2 breast cancer.

Surgery

In most cases, the treatment consists of eliminating the cancer.

A person with stage 2A or 2B breast cancer can undergo a lumpectomy or mastectomy. Doctors and the individual can decide according to the size and location of the tumor.

Combined therapy

A doctor may recommend a combination of radiation therapy, chemotherapy, and hormone therapy (if the cancer is receptive to hormones) to people with stage 2A or 2B breast cancer.

Stage 3 breast cancer

Chemotherapy will generally be the first phase of treatment for stage 3 breast cancer.

The subcategories are 3A, 3B and 3C.

Breast cancer 3A is an invasive breast cancer where:

• There is no tumor in the breast or a tumor of any size grows with cancer found in four to nine axillary nodes or in the lymphatic glands of the sternum.
• A person has a tumor larger than 5 cm, as well as clusters of breast cancer cells located in the ganglia whose diameter is between 0.2 and 2 mm.
• The tumor is larger than 5 cm and the cancer has spread to one to three axillary nodes or to the lymph nodes located near the sternum.

Stage 3B breast cancer is an invasive breast cancer where:

• A tumor of any size has spread into the chest wall or breast skin, causing swelling or ulceration. It could also extend to nine axillary nodes or spread to the lymph nodes through the sternum.

If the cancer spreads to the breast skin, a person may have an inflammatory cancer.

Symptoms include:

• the breast skin turns red
• breast swelling
• the chest feels abnormally hot

Stage 3C breast cancer is an invasive breast cancer where:

• There is no real tumor in the breast or the tumor can be of any size and spread to the breast wall or breast skin. The cancer may also be present in 10 or more axillary nodes.
• The cancer has spread to ganglia above or below the clavicle or to axillary nodes or lymph nodes near the sternum.

Treatment for stage 3 breast cancer

For people with Stage 3, breast cancer includes chemotherapy, surgery and radiation therapy. As a rule, doctors administer chemotherapy before performing the surgical operation in order to reduce the size of a tumor.

People with stage 3 breast cancer will likely need radiation therapy to remove the remaining cancer cells. Doctors can also recommend hormone therapy, as well as additional targeted therapies, if needed.

Stage 4 breast cancer

A person with cancer has spread not only to nearby lymph nodes but also to more distant lymph nodes and other organs of the body.

Stage 4 breast cancer is the most advanced stage. It is also called secondary or metastatic breast cancer. Stage 4 breast cancer may be a recurrent breast cancer that has now spread to other parts of the body.

Treatment for stage 4 breast cancer

Generally, the treatment includes a combination of chemotherapy, radiation therapy and hormone therapy (if any).

Targeted therapy is a treatment targeting the protein that allows cancer cells to grow and this type of therapy could also be an option for people with stage 4 breast cancer.

Sometimes surgeons operate to try to remove the tumors, although this is usually not the first treatment option.

However, physicians may recommend surgery to relieve pain by treating some of the problems that may occur as a result of stage 4 breast cancer. These include spinal cord compression, elimination unique masses caused by metastasis and fixation of broken bones.

A doctor may also prescribe medications to treat related symptoms such as:

• to help the mood
• anticonvulsants to manage pain or neurological conditions
• local anesthetics to manage pain

New treatments and therapies are emerging all the time and anyone with breast cancer at any stage can volunteer to try these new treatments. People considering this should consult with their doctor to see if trials are available in their area.

The trials for a new treatment called immunotherapy are. Immunotherapy works by increasing the body's natural ability to fight cancer and has fewer side effects than chemotherapy.

The US Food and Drug Administration (FDA) has not yet approved immunotherapy, but anyone wishing to attend these tests should discuss it with their doctor.

Learn more about the TNM storage system

In addition to numbers, a zero or an "X" often follows the letters T, N, and M. Depending on, the meanings are:

• TX means that doctors do not have information about the presence or size of the tumor
• T0 means that no evidence of an invasive primary tumor is present. This indicates that the cancer is "in situ" (which means that the tumor has not yet become a healthy breast tissue).
• NX means that doctors do not have information about lymph nodes
• N0 means that there is no evidence of cancer in the neighboring lymph nodes
• MX means that doctors do not have information about metastases
• M0 means that no evidence of distant metastasis is present

Considerations on breast cancer treatment

There is an increased risk of breast cancer if a close family member suffers.

Stages of breast cancer give a doctor an indication of the development of breast cancer and the type of treatment options available.

There are, however, other factors that the physician considers in determining the success of a specific treatment for breast cancer.

These included:

• Age: People under 40 tend to have more aggressive breast cancers.
• Pregnancy: Doctors can postpone chemotherapy until the second or third trimester and delay the hormone and radiation therapy until the baby is born.
• How fast cancer grows and spreadsMore aggressive cancers require more aggressive treatments.
• Family historyPeople whose close relatives have had breast cancer should experience it themselves.
• Genetic mutation status: If someone tests positive for the breast cancer genes known as BRCA1 (BReast CAncer One gene) and BRCA2 (BReast CAnener Two gene), their risk of developing breast cancer. Some people may need tests for other genes associated with breast cancer.

Perspective

The prospects of a person depend on an early diagnosis and stage of his cancer. The earlier a person receives treatment, the better the prognosis.

People should routinely check for any signs of breast cancer by performing monthly breast exams and should talk to their doctor about the possibility of having a regular mammogram.

Some people may need to start screening sooner than others based on their risk factors. Discuss with the doctor. Other people may be candidates to start screening later, but it's a good idea to share the decision-making with a doctor who can advise you on the best course of action.

Treatment depends on many factors, including the stage of breast cancer, family history, genetics, and the person's personal preferences. Physicians will tailor the treatment to each individual and adjust it according to the initial response of a person.