What Is Stage 0 Dcis
Stage 0 breast cancer, ductal carcinoma in situ is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. In Stage 0 breast cancer, the atypical cells have not spread outside of the ducts or lobules into the surrounding breast tissue. Ductal Carcinoma In Situ is very early cancer that is highly treatable, but if its left untreated or undetected, it can spread into the surrounding breast tissue.
What Is Stage 2 Breast Cancer
Stage 2 breast cancer has cancer cells in a breast and/or in the lymph nodes near a breast. This disease is further defined as stage 2A and stage 2B, depending on other factors. The two substages differ in key ways, but breast cancer survival rates are strong for both. The five-year survival rate of stage 2A breast cancer patients is 98 percent, and for 2B, its 95.6 percent, according to data published in the American Cancer Society journal CA: A Cancer Journal for Clinicians in 2017.
What Is Cancer Staging
Staging is a way of describing how extensive the breast cancer is, including the size of the tumor, whether it has spread to lymph nodes, whether it has spread to distant parts of the body, and what its biomarkers are.
Staging can be done either before or after a patient undergoes surgery. Staging done before surgery is called the clinical stage, and staging done after surgery is called the pathologic stage. Doctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor recommend the best kind of treatment and can help predict a patient’s prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.
This page provides detailed information about the system used to find the stage of breast cancer and the stage groups for breast cancer, such as stage IIA or stage IV.
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The Grading System Is Used To Describe How Quickly A Breast Tumor Is Likely To Grow And Spread
The grading system describes a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. Low-grade cancer cells look more like normal cells and tend to grow and spread more slowly than high-grade cancer cells. To describe how abnormal the cancer cells and tissue are, the pathologist will assess the following three features:
- How much of the tumor tissue has normal breast ducts.
- The size and shape of the nuclei in the tumor cells.
- How many dividing cells are present, which is a measure of how fast the tumor cells are growing and dividing.
For each feature, the pathologist assigns a score of 1 to 3 a score of 1 means the cells and tumor tissue look the most like normal cells and tissue, and a score of 3 means the cells and tissue look the most abnormal. The scores for each feature are added together to get a total score between 3 and 9.
Three grades are possible:
- Total score of 3 to 5: G1 .
- Total score of 6 to 7: G2 .
- Total score of 8 to 9: G3 .
Why Were New Measures Added To The Staging System
The new measures give information on the biology of the tumor that affects prognosis. Adding these measures improved staging.
For example, with breast cancer, a large tumor may have a better prognosis than a small tumor based on biological measures. In the same way, a small tumor may have a worse prognosis than a large tumor based on these measures.
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What Is Breast Cancer
Breast Cancer is a form of cancer that occurs in the breast cells of the human body. Typically, cancer is a disease that comes about when mutations occur in the genes responsible for cell growth. This causes cells to multiply uncontrollably.
Breast cancer usually forms in the ducts, lobules and/or connective tissue of the breasts .
How Staging Guides Treatment
The type of cancer you have, along with the stage, will help determine your treatment. With stage I, II, or III breast cancer, the main goal is to cure the cancer by treating it and keeping it from coming back. With stage IV, the goal is to improve symptoms and prolong life. In almost all cases, stage IV breast cancer cannot be cured.
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Stage 2 Breast Cancer Symptoms
Patients with stage 2 breast cancer may not experience any symptoms, and the cancer may be discovered during a routine mammogram. Possible breast cancer symptoms in stage 2 include:
- Dimpled skin on the breast
- Swelling or redness
- An inverted or flattened nipple
- Changes to the skin of the breast
- Changes to the size or shape of the breast
How Is Dcis Treated
DCIS may be treated with breast-conserving surgery, which is often followed by radiation therapy. With breast-conserving surgery, only the DCIS and some normal tissue around it is removed, and this type of surgery often does not alter the appearance of the breast significantly. Breast-conserving surgery may also be called a lumpectomy, a partial mastectomy, breast-sparing surgery, or segmental mastectomy.
DCIS can also be treated with single or double mastectomy, another type of surgery in which the whole breast is removed.
The goal of radiation therapy is to keep the DCIS from returning to the same breast, and research has shown that the risk of recurrence is substantially reduced by radiation therapy in some patients. Your radiation oncologist will take into account age, size of tumor, other medical problems and degree of differentiation in the cells before making a recommendation.. For patients with DCIS, radiation therapy would follow surgery. Radiation therapy can cause changes in the skin and increases the risk of developing secondary cancers in the future.
Patients may also have a recommendation for hormonal therapy. The goal is to decrease the likelihood of developing either further DCIS in or an invasive cancer.
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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.
Stage 3 Breast Cancer
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Stage 3A:The cancer cells have either enlarged the internal mammary glands or have invaded four to nine axillary lymph nodes. In this stage, the size of the tumour is not taken into consideration. Alternatively, this stage is diagnosed when the tumour size exceeds 5 cm and has advanced into one to three breastbone or axillary lymph nodes.
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Stage 3B: The cancer has spread to the chest wall or skin and may or may not have spread to around nine lymph nodes.
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Stage 3C: Cancerous cells are found in 10 or more axillary lymph nodes, internal mammary nodes or lymph nodes situated near the collarbone.
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Stage 2 Breast Cancer
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Stage 2A: This stage is diagnosed when the tumour is less than 2 cm but has invaded 1 to 3 nearby lymph nodes or has grown to 2 to 5 cm but has not affected any lymph nodes.
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Stage 2B: The tumour size is 2 to 5 cm and has also spread to one to three axillary lymph nodes. Or the tumour has grown larger than 5 cm but hasnt invaded any lymph nodes.
Stage 2a Breast Cancer
Stage 2A breast cancers are likely to have spread into the lymph nodes in the armpit. Lymph nodes are part of the lymphatic system, which circulates a fluid called lymph throughout the body. One of the first ways cancer starts to metastasize from its original location is by spreading into the lymph nodes.
The lymph nodes most likely to be affected are in the armpit . Stage 2 breast cancers typically spread to up to three lymph nodes.
Stage 2A breast cancer meets one of these criteria:
- No tumor has been found in the breast, but cancer has spread to the lymph nodes in the armpit.
- The tumor in the breast is 2 cm or smaller, and the cancer has spread to the armpit lymph nodes.
- The tumor in the breast measures 2 cm to 5 cm, but the cancer has not spread to the lymph nodes.
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Stage 1 Breast Cancer
At stage 1, breast cancer cells have spread from the milk ducts or lobes into the surrounding breast tissues but remain contained within a relatively small area. The cancer is classified as stage 1A if the breast tumor is smaller than 20 mm in diameter and has not spread to nearby lymph nodes.
The cancer is classified as stage 1B if small clusters of breast cancer cells are found in nearby lymph nodes and:
- The breast tumor is larger than 20 mm in diameter or
- There is no breast tumor, but cancerous cells in the breast tissues have formed clusters that are between 0.2 and 2 mm in diameter.
Treatment Of Ductal Carcinoma In Situ
For information about the treatments listed below, see the Treatment Option Overview section.
- Breast-conserving surgery and radiation therapy, with or without tamoxifen.
- Total mastectomy with or without tamoxifen. Radiation therapy may also be given.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
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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
Patients May Want To Think About Taking Part In A Clinical Trial
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today’s standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
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Tnm Staging Of Breast Cancer
After a breast cancerdiagnosis is confirmed, the staging process typically begins with a physical examination, imaging scans and a biopsy of a tumor tissue sample. The most common method of staging breast cancer uses the American Joint Committee on Cancer TNM system, which involves an analysis of three key measures:
- N Lymph node status
When using the TNM system for breast cancer staging, a physician will consider several additional factors, including:
Stages Of Breast Cancer
Breast cancer is classified by stages ranging from 0 to 4. The stages increase in severity with the number.
- Stage 0 involves only a small cluster of cancer cells in the duct or lobule.
- Stage 1 is a tumor smaller than 2 cm.
- Stage 2 is a tumor up to 5 cm that has not spread to the axillary lymph nodes.
- Stage 3 is a tumor of any size that may have spread to the axillary lymph nodes.
- Stage 4 is a tumor of any size that has metastasized and has gone to other tissues besides the breast and lymph nodes.
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Stage 2b Breast Cancer
With stage 2B breast cancers, the tumor is larger or cancer cells have spread further into the lymph nodes than with stage 2A.
Stage 2B breast cancer meets one of these criteria:
- The breast tumor measures 2 cm to 5 cm, and cancer cells have also been found in the armpit lymph nodes.
- The tumor is larger than 5 cm, but it hasnt spread to the lymph nodes.
Treatment Of Locally Advanced Or Inflammatory Breast Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
- Targeted therapy .
- Clinical trials testing new anticancer drugs, new drug combinations, and new ways of giving treatment.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
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Stage Groups For Breast Cancer
Doctors assign the stage of the cancer by combining the T, N, and M classifications , the tumor grade, and the results of ER/PR and HER2 testing. This information is used to help determine your prognosis . The simpler approach to explaining the stage of breast cancer is to use the T, N, and M classifications alone. This is the approach used below to describe the different stages.
Most patients are anxious to learn the exact stage of the cancer. If you have surgery as the first treatment for your cancer, your doctor will generally confirm the stage of the cancer when the testing after surgery is finalized, usually about 5 to 7 days after surgery. When systemic treatment is given before surgery, which is typically with medications and is called neoadjuvant therapy, the stage of the cancer is primarily determined clinically. Doctors may refer to stage I to stage IIA cancer as “early stage” and stage IIB to stage III as “locally advanced.” Stage 0: Stage zero describes disease that is only in the ducts of the breast tissue and has not spread to the surrounding tissue of the breast. It is also called non-invasive or in situ cancer . Stage IA: The tumor is small, invasive, and has not spread to the lymph nodes . Stage IB: Cancer has spread to the lymph nodes and the cancer in the lymph node is larger than 0.2 mm but less than 2 mm in size. There is either no evidence of a tumor in the breast or the tumor in the breast is 20 mm or smaller .
Stage IIA: Any 1 of these conditions:
Breast Exam By Your Doctor
The same guidelines for self-exams provided above are true for breast exams done by your doctor or other healthcare professional. They wont hurt you, and your doctor may do a breast exam during your annual visit.
If youre having symptoms that concern you, its a good idea to have your doctor do a breast exam. During the exam, your doctor will check both of your breasts for abnormal spots or signs of breast cancer.
Your doctor may also check other parts of your body to see if the symptoms youre having could be related to another condition.
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Types Of Breast Cancer
The types of Breast Cancer are broadly classified into two major categories, namely, invasive and non-invasive. Invasive cancer types usually spread to other body parts, whereas non-invasive cancer types are usually localised near the point of origin.
Under these two broad categories, the following are some of the most commonly diagnosed Breast Cancer types.
Biomarker Testing Is Used To Find Out Whether Breast Cancer Cells Have Certain Receptors
Healthy breast cells, and some breast cancer cells, have receptors that attach to the hormonesestrogen and progesterone. These hormones are needed for healthy cells, and some breast cancer cells, to grow and divide. To check for these biomarkers, samples of tissue containing breast cancer cells are removed during a biopsy or surgery. The samples are tested in a laboratory to see whether the breast cancer cells have estrogen or progesterone receptors.
Another type of receptor that is found on the surface of all breast cancer cells is called HER2. HER2 receptors are needed for the breast cancer cells to grow and divide.
For breast cancer, biomarker testing includes the following:
Sometimes the breast cancer cells will be described as triple negative or triple positive.
- Triple negative. If the breast cancer cells do not have estrogen receptors, progesterone receptors, or a larger than normal amount of HER2 receptors, the cancer cells are called triple negative.
- Triple positive. If the breast cancer cells do have estrogen receptors, progesterone receptors, and a larger than normal amount of HER2 receptors, the cancer cells are called triple positive.
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