What Is Stage Ii Breast Cancer
Stage II describes cancer that is in a limited region of the breast but has grown larger. It reflects how many lymph nodes may contain cancer cells. This stage is divided into two subcategories.
Stage IIA is based on one of the following:
- Either there is no tumor in the breast or there is a breast tumor up to 20 millimeters , plus cancer has spread to the lymph nodes under the arm.
- A tumor of 20 to 50 millimeters is present in the breast, but cancer has not spread to the lymph nodes.
Stage IIB is based on one of these criteria:
- A tumor of 20 to 50 millimeters is present in the breast, along with cancer that has spread to between one and three nearby lymph nodes.
- A tumor in the breast is larger than 50 millimeters, but cancer has not spread to any lymph nodes.
T1a Tnbc Had Worse Prognosis Than T1a And T1b Her2+/hor Cancer
Both univariate and multivariate analyses proved worse BCSS and OS of T1a TNBC tumors than T1a HER2+/HoR tumors , whereas T1b TNBC patients revealed no survival difference compared with T1b HER2+/HoR tumors in terms of BCSS or OS . For T1c tumor, T1c TNBC had poorer survival than T1c HER2+/HoR .
Figure 2Table 3
Since T1a TNBC had worse prognosis than T1a HER2+/HoR and showed a trend with poorer survival than T1b TNBC, it raised the concern that whether T1a TNBC had the worst prognosis among small tumors of TNBC and HER2-rich subtypes. To prove this hypothesis, further comparison was performed between T1a TNBC and T1b HER2+/HoR. BCSS of T1a TNBC was significantly worse than that of T1b HER2+/HoR in both univariate and multivariate analyses. Multivariate analyses for OS also drew the similar conclusion that T1a TNBC associated with increasing mortality . Both BCSS and OS data supported the notion that T1a TNBC without chemotherapy has the worst prognosis among all the small tumor of TNBC and HER2-rich subtypes.
Figure 3Table 4vs.
T Categories For Breast Cancer
T followed by a number from 0 to 4 describes the main tumor’s size and if it has spread to the skin or to the chest wall under the breast. Higher T numbers mean a larger tumor and/or wider spread to tissues near the breast.
TX: Primary tumor cannot be assessed.
T0: No evidence of primary tumor.
Tis: Carcinoma in situ
T1 : Tumor is 2 cm or less across.
T2: Tumor is more than 2 cm but not more than 5 cm across.
T3: Tumor is more than 5 cm across.
T4 : Tumor of any size growing into the chest wall or skin. This includes inflammatory breast cancer.
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Why Is Staging Important
During your initial diagnosis, you and your cancer team will work together to develop a treatment plan. Staging allows you to answer the following questions:
- How does this cancer typically progress?
- Which treatments may work?
Some of the staging may be even more in-depth, but in general, its designed to prepare a more tailored approach to your disease. Your care team will be able to explain any new terms and what they mean for you.
Expert cancer care
How Tumor Grade Affects Your Treatment Options
Your doctor uses tumor grade and other factors about your cancer to form a treatment plan and in some cases, to estimate your prognosis. Prognosis is an estimate of how the disease will likely go for you. Other factors that go into deciding on a treatment plan include cancer stage, genetic features of the tumor, your age, and your general health. Since a high-grade cancer may grow and spread more quickly, it may require more aggressive treatment right away.
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Special Invasive Breast Cancers And Carcinoma In Situ
Inflammatory breast cancer is an aggressive locally advanced breast cancer.
The main symptoms of IBC are swelling and redness in the breast. Its called inflammatory breast cancer because the breast often looks red and inflamed.
About 1-5 percent of breast cancers are IBC .
Learn more about IBC.
Paget disease of the breast is a rare carcinoma in situ in the skin of the nipple or in the skin closely surrounding the nipple. Its usually found with an underlying breast cancer.
About 1-4 percent of breast cancers also involve Paget disease of the breast .
Examples Using The Full Staging System
Because there are so many factors that go into stage grouping for breast cancer, it’s not possible to describe here every combination that might be included in each stage. The many different possible combinations mean that two women who have the same stage of breast cancer might have different factors that make up their stage.
Here are 3 examples of how all of the factors listed above are used to determine the pathologic breast cancer stage:
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What Is The Survival Outlook For Breast Cancer
According to the National Cancer Institute , the percentage of patients surviving five years after diagnosis is:
- 99 percent for breast cancer that is still local to the breast
- 86 percent for breast cancer that has spread just outside the breast
- 29 percent for breast cancer that has spread to more distant parts of the body
The NCI also lists the five-year survival rate for breast cancer overall as 90.6 percent for women and 83 percent for men.
Factors Influencing How Quickly Breast Cancer Tumors Grow
Several factors may influence how quickly breast cancer tumors grow. These factors include:
- Your age. People under 40 are likely to have more aggressive breast cancer.
- Menopause status. If you havent completed menopause, the hormones of menstruation may impact cancer growth.
- History of breast cancer. A family or personal history of this cancer may increase the risk of an aggressive type.
- The type of breast cancer. Some types are more aggressive than others.
- Hormone treatment. If you had hormone replacement therapy with menopause, the chances of an aggressive form of cancer are higher.
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Ductal Carcinoma In Situ
Ductal carcinoma in situ is a non-invasive breast cancer. In situ means in place. With DCIS, the abnormal cells are contained in the milk ducts of the breast and have not spread to nearby breast tissue.
Although DCIS is non-invasive, without treatment, the abnormal cells could progress to invasive breast cancer over time. You may also hear the terms pre-invasive or pre-cancerous to describe DCIS.
With treatment, prognosis for DCIS is usually excellent.
Learn about breast anatomy.
How Tumor Grade Is Determined
In most cases, doctors need to study a sample of tissue from the tumor to decide if it is cancer and, if it is, its grade. They obtain this tissue by doing a biopsy, a procedure in which they remove all or part of the tumor. A specialist called a pathologist determines the grade of your tumor by studying samples from the biopsy under a microscope. The pathologist describes the findings in a pathology report, which also contains other details about your diagnosis.
Cells that look more normal might be called well-differentiated in the pathology report. And cells that look less normal might be called poorly differentiated or undifferentiated. Based on these and other features of how cells look under the microscope, the pathologist will assign a number to describe the grade.
Different factors are used to decide the grade of different cancers. To learn about the factors that go into deciding the grade of your cancer, find your type of cancer in the PDQ® cancer treatment summaries for adult and childhood cancers.
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How Does Tumor Size And Location Affect Treatment
Its important for your doctor and entire healthcare team to know the cancers stage in order to plan treatment. Treatment for breast cancer takes into account the tumors size, location, and spread, if there is any.
For example, cancers that are considered early stage may be treated with localized treatments, like surgery and radiation. This cancer may have a better prognosis.
For advanced-stage cancers, a doctor may use systemic treatments. These include chemotherapy, hormone therapy, targeted therapy, and more. Radiation may also be used for advanced-stage cancer, but other treatments will likely be used in conjunction.
Research Related To Breast Cancer Classification And Implications For Clinical Practice
Researcher: Dr. Sunil Lakhani, University of Queensland
Dr Lakhani recently published practice-changing findings that contributed to a new classification of a rare breast cancer, called metaplastic breast tumours, by the World Health Organisation. Learn more about his research here.
Breast cancer staging is based on tumour size, the extent that cancer has spread to other parts of the body and other clinical factors. Your doctor will use diagnostic information such as medical imaging including mammogram and/or ultrasound, and other diagnostic tests, such as a biopsy of the breast tissue and draining lymph nodes to determine the stage of the cancer.
Once the stage of the cancer has been determined, it is expressed on a scale of 0 to IV. Stage 0 refers to pre-invasive breast cancers, including ductal carcinoma in situ . Stage I and II are referred to as early breast cancer. Stage III is referred to as locally advanced breast cancer. Stage IV is called advanced or metastatic breast cancer. See above for more information.
Stage 0 refers to pre-invasive breast cancers, including ductal carcinoma in situ . This means that there are abnormal cells present, but they are contained inside the milk duct in the case of DCIS, or lobule , in the case of lobular carcinoma in situ .
Invasive breast cancer occurs when cancer cells within the milk duct or lobules break or invade through normal breast tissue. It can be Stage I, II, III or IV.
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The Prognostic Role Of Tumor Size In Early Breast Cancer In The Era Of Molecular Biology
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Roles Conceptualization, Methodology, Writing original draft
Affiliation ASST Fatebenefratelli Sacco PO Fatebenefratelli Breast Surgery Unit, Milan, Italy
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Affiliation ASST Fatebenefratelli Sacco PO Fatebenefratelli Department of Pathology, Milan, Italy
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Roles Data curation, Software
Affiliation IRCCSMario Negri Institute for Pharmacological Research, Milan, Laboratory of Methodology for Biomedical Research, Milan, Italy
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Roles Data curation, Formal analysis, Software
Affiliation IRCCSMario Negri Institute for Pharmacological Research, Milan, Laboratory of Methodology for Biomedical Research, Milan, Italy
What Is Stage Iii Breast Cancer
In stage III breast cancer, the cancer has spread further into the breast or the tumor is a larger size than earlier stages. It is divided into three subcategories.
Stage IIIA is based on one of the following:
- With or without a tumor in the breast, cancer is found in four to nine nearby lymph nodes.
- A breast tumor is larger than 50 millimeters, and the cancer has spread to between one and three nearby lymph nodes.
In stage IIIB, a tumor has spread to the chest wall behind the breast. In addition, these factors contribute to assigning this stage:
- Cancer may also have spread to the skin, causing swelling or inflammation.
- It may have broken through the skin, causing an ulcerated area or wound.
- It may have spread to as many as nine underarm lymph nodes or to nodes near the breastbone.
In stage IIIC, there may be a tumor of any size in the breast, or no tumor present at all. But either way, the cancer has spread to one of the following places:
- ten or more underarm lymph nodes
- lymph nodes near the collarbone
- some underarm lymph nodes and lymph nodes near the breastbone
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Is Stage 3 Breast Cancer Curable
What does stage 3 mean? Because stage 3 breast cancer has spread outside the breast, it can be harder to treat than earlier stage breast cancer, though that depends on a few factors. With aggressive treatment, stage 3 breast cancer is curable however, the risk that the cancer will grow back after treatment is high.
How A Breast Cancers Stage Is Determined
Your pathology report will include information that is used to calculate the stage of the breast cancer that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.
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Study Population And Data Collection
Population-based data were extracted from SEER database founded by National Cancer Institute. SEER database is an open-access resource for cancer-based epidemiology and survival analyses . Data access was authorized by SEER Program and acquired via Account 11417-Nov2015. Relevant case list was generated from SEER 18 incidence database . SEER*Stat software from the National Cancer Institute was used to identify eligible patients.
T1a Tnbc Had Comparable Survival With T1b Tnbc And T1a/t1b Tnbc Had Better Survival Than T1c Tnbc
There was no survival difference between T1a and T1b TNBC in terms of BCSS and OS . However, Kaplan-Meier curves showed a trend of worse prognosis of T1a TNBC than T1b TNBC, which was contradictory to the common sense that large tumor usually had poor prognosis .
Figure 1Table 2
T1c tumors was strongly associated with poor BCSS and OS , compared with T1b tumors .
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Tumor Size And Next Steps
Biopsies and imaging studies give an approximate measurement of your tumor, but you need the actual tumor size in order to make the best treatment decisions.
After a lumpectomy or mastectomy, your excised breast tissue will be combined with your biopsy tissue, and a pathologist will examine the true size of the mass. The pathological measurement of your tumor is the gold standard for tumor size. Your postsurgical pathology report will summarize your comprehensive diagnosis of breast cancer.
With that in mind, it may seem counterintuitive to rely on the tumor size estimations used in TNM staging. But there is good reason for this: Imaging allows you and your surgeon to make the most conservative choice when it comes to breast surgery. Your surgeon will use the information from previous tests as guidance when removing your tumor.
If a lumpectomy will remove your cancer, you may be able to avoid a mastectomy. If neoadjuvant chemo is used to shrink the tumor before surgery, then you may need less tissue removed in a lumpectomy. However, in some cases, such as widely scattered invasive breast cancer, a mastectomy might be the only surgical option.
Having the most information and understanding the implications of your tests helps you make informed, intelligent treatment decisions.
Breast Cancer Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
Rfs And Efs In Women With Er
When the data from the groups of women in B-06, B-13, and B-19 who received no systemic therapy were combined, the 8-year RFS was 81%. When the data from women who received chemotherapy in the three studies were combined, the 8-year RFS was 90% . The cumulative probabilities of events comprising EFS were computed for each treatment group . In women treated with surgery alone, the cumulative incidence of all events was 30%. There was an 18% probability of recurrence at local-regional or distant sites through 8 years 10% of these events were distant recurrences, 3% were IBTR, and 5% were recurrences at other local-regional sites. The cumulative incidence of second cancer in the contralateral breast was 5% the cumulative incidence of other second primary cancers was 7%. There were no deaths before recurrence or second cancer as a first event . In patients who received postoperative chemotherapy, the cumulative incidence of all events was 18% through 8 years 9% of the total cumulative incidence was from local-regional recurrences or distant recurrences , 4% was from cancers in the contralateral breast, 3% was from second cancers other than breast cancer, and 2% was from deaths with no evidence of disease . The frequency of IBTR after lumpectomy and breast irradiation decreased from 8% to 3% as a result of chemotherapy .
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How Quickly Do Breast Cancer Tumors Grow
Breast cancer cells are mutated cells they dont grow the way healthy cells do. Instead, they grow at different rates than other cells in the body. Different types of cancers also grow at different rates. That makes predicting how quickly a breast cancer tumor will grow difficult.
Most breast cancer tumors have been growing for several years before theyre found. The cells will need to divide as many as 30 times before the tumor is detectable. With each division taking 1 to 2 months, a tumor could be growing 2 to 5 years before its found.
But there are things a healthcare professional can do to determine if the cancerous tumor is growing quickly. Some tumor gradings will include information that indicates how likely the tumor is to grow and spread.
This information is usually gathered with a biopsy. In this medical procedure, a professional will remove a tissue sample from the affected area. That tissue will be sent to a lab where a specialist will review it.
Cancerous cells that are highly aggressive will look very different from normal, healthy cells. The greater the difference between the two types of cells, the higher the chances the cancer is aggressive. But cancer cells that look more like the other cells may be less aggressive.
If the biopsy suggests the cancer is likely to spread, youll be monitored closely for metastases. Cancer cells can spread via the lymph system, bloodstream, or directly into nearby tissues and organs.