Treatment Of Breast Cancer Stages I
The stage of your breast cancer is an important factor in making decisions about your treatment.
Most women with breast cancer in stages I, II, or III are treated with surgery, often followed by radiation therapy. Many women also get some kind of systemic drug therapy . In general, the more the breast cancer has spread, the more treatment you will likely need. But your treatment options are affected by your personal preferences and other information about your breast cancer, such as:
- If the cancer cells have hormone receptors. That is, if the cancer is estrogen receptor -positive or progesterone receptor -positive.
- If the cancer cells have large amounts of the HER2 protein
- How fast the cancer is growing
- Your overall health
- If you have gone through menopause or not
Talk with your doctor about how these factors can affect your treatment options.
Additional Markers For Breast Cancer Staging
Additional markers specific to breast cancer will further define your stage, which may be helpful in choosing targeted treatments to fight the cancer.
- ER: The cancer has an estrogen receptor. Estrogen is a hormone, and some cancers have receptors that respond to estrogen.
- PR: The cancer has a progesterone receptor. Progesterone is also a hormone.
- HER2: The cancer makes the protein HER2 .
- G: Grade of cancer refers to how different the cells look from normal. Grade 1 indicates that the cells look fairly normal, while grade 2 cells are growing a little faster, and grade 3 cells look markedly different than normal breast tissue.
These markers, along with the TNM measurements, define your stage.
A cancer recurrence refers to cancer that returns in the same breast, and it requires new staging. This new stage is marked by an R at the end to indicate restaging. If it develops in the other breast, its considered a new cancer.
Stage 1 Or 2 Early Breast Cancer
Stage 1 and 2 breast cancer refers to invasive breast cancer that is contained within the breast, and may or may not have spread to the lymph nodes in the armpit. These stages are also known as early stage breast cancer.
At Stage 1 and 2, some cancer cells may have spread outside the breast and armpit area, but at this stage these cannot be detected.
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In Historic First Woman Is Cured Of Stage 4 Breast Cancer
Across the globe, breast cancer is the most common cancer among women and it is ranked the fifth deadliest cancer. In the United States, around 155,000 women are living with metastatic breast cancer, also known as stage 4 breast cancer. This type of cancer means that the cancer has metastasized or spread to other areas of the body. According to the American Cancer Society, the 5-year survival rate for stage 4 breast cancer is 22%. Around 20-30% of women with stage 0 or stage 1 breast cancer the earliest stages of the cancer – go on to develop metastatic breast cancer.
Although treatable, the cancer cannot be cured that is, up until recently when, for the first time in history, a woman battling advanced stage breast cancer was considered cured by an experimental new therapy.
What Is A Breast Cancer Recurrence
Breast cancer recurrence means that the cancer was diagnosed when limited to the breast and/or armpit lymph nodes, then treated, and at some time later has come back.
This can occur in several ways:
- Local and/or regional recurrence: the breast cancer that was previously treated returns within the breast, chest wall or regional lymph nodes.
- New primary breast cancer: an unrelated new breast cancer occurs in one or the other breast. This actually isnt a local recurrence at allits a new cancer in the breast . This typically occurs many years after the original cancer and in an entirely different area of the breast. Its pathology is often different lobular instead of ductal, for example. Though they are often counted as recurrences in the statistics for breast conservation, they should be treated as completely new cancers, much as with new cancers in the opposite breast.
- Distant or systemic recurrence or metastasis is much more serious than local recurrence and is synonymous with stage 4 disease. For breast cancer patients, the most common areas of spread are the bone, liver, lungs and brain
Breast cancer recurrence occurs if:
- Cells from the original breast cancer diagnosis break away and hide nearby in the breast or spread elsewhere in the body
- Treatment, including surgery, chemotherapy, radiotherapy and/or hormone therapy have not gotten rid of all these cancer cells from the body.
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Should I Have Regular Routine Scans Or Blood Tests To Check For Distant Breast Cancer Recurrence
No. Routine scans to check for the presence of distant disease recurrence are not recommended in the absence of symptoms
Given the ominous nature of stage 4 disease, the obvious question is, why dont we scan for spread regularly after a first diagnosis, so that we can detect it early if it does return? The reason we dont scan or test for metastasis is that there really is no early stage 4 disease, and thus no real opportunity to intervene earlier and increase the chance of cure. Its also important to know that with recurrence, one does not progress from one stage to the next: a woman who was originally diagnosed with stage 1 breast cancer does not recur as stage 2, because once cells have taken up residence elsewhere, she is immediately considered to have stage 4 disease. And with stage 4 disease, either you respond well to treatment and the disease regresses, or you dont and it doesnt. Studies have shown that getting frequent scans after a first cancer diagnosis does not lead to improved survival, which is why we dont scan for stage 4even if we wish we could.
Current guidelines and evidence therefore recommend against routine CT or bone scans, or blood tests, to look for recurrence of cancer in patients who do not have any symptoms or other concerns that need to be followed up on.
If you do have concerning symptoms , then you should bring them to the attention of your healthcare team to be checked out.
What Causes Breast Cancer
Medical professionals generally attribute breast cancer to genetic factors and your lifestyle. In some cases, breast cancer could arise from exposure to harmful radiation. Breast cancer is best diagnosed early.
The symptoms of stage 2 breast cancer are difficult to miss. They include a lump in your breast, having an itch in your breast, and a bloody discharge from your nipple. You will also notice your lymph nodes in the armpit or neck are swollen. A sore nipple or inverted nipple should alert you to the possibility of having stage 2 aggressive breast cancer.A general observable change in the shape and size of your nipple or breast is an indicator of breast cancer in some cases. If it is accompanied by other symptoms or dimpling of your breasts skin with an orange peel texture developing, you should seek immediate medical attention.
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What Is Stage 0 Lcis
Lobular carcinoma in situ at Stage 0 generally is not considered cancer. Although it has carcinoma in the name, it really describes a growth of abnormal but non-invasive cells forming in the lobules. Some experts prefer the name lobular neoplasia for this reason because it accurately refers to the abnormal cells without naming them as cancer. LCIS, however, may indicate a woman has an increased risk of developing breast cancer.
If you have been diagnosed with LCIS, your doctor may recommend regular clinical breast exams and mammograms. He or she may also prescribe Tamoxifen, a hormone therapy medication that helps prevent cancer cells from growing.
Types Of Stage 1 And 2 Breast Cancer
The most common types of invasive breast cancers are named after the area of the breast where they begin. Types of early breast cancers include:
- Invasive ductal carcinoma IDC means that the cancer originated in the milk ducts of the breast, and has spread into the surrounding breast tissue. IDC is the most common type of breast cancer, accounting for 80% of all breast cancers.
- Invasive lobular carcinoma ILC means that the cancer originated in the milk-producing lobules of the breast, and has spread into the surrounding breast tissue. ILC is the second most common type of breast cancer, and accounts for 10% of breast cancers.
- There are also other less common forms of invasive breast cancer, such as inflammatory breast cancer and Pagets disease of the nipple. For more information on the various types of invasive breast cancer, including the less common forms, please visit Types of Breast Cancer page.
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Available Cancer Treatment Options
The current survival rate for cancer patients is about five years after that period, your cancer will either worsen. Five years is the typical survival rate for most cancer types, that doesnt mean that it cant come back after that period its just that the odds are very low.
To make a decisive decision, speak with your medical care professional to discuss what treatment options are available for your specific cancer.
People Also Ask
Q: What type of cancer is curable?A: several forms of cancer are curable, including lung cancer, prostate cancer, breast cancer, pancreatic cancer, and colon cancer. Curing depends heavily on early diagnosis, the earlier you catch cancer, the higher your survival odds are.
Q: How long can you live with cancer? A: the most common cancer survival rate period is five years once you reach this point, your cancer has pretty much reached its peak. If you have not experienced any fatal symptoms yet, you likely wont again. However, that doesnt mean that the odds of cancer growing back is completely gone.
Q: Can stage 1 cancer be cured?A: yes, stage 1 cancer is one of the most curable forms of cancer however, often, it doesnt require immediate treatment.
Radiation Therapy And Mastectomy
Most women who have a mastectomy dont need radiation therapy if theres no cancer in the lymph nodes.
In some cases, radiation therapy is used after mastectomy to treat the chest wall, the axillary lymph nodes and/or the lymph nodes around the collarbone.
For a summary of research studies on mastectomy versus lumpectomy plus radiation therapy and overall survival in early breast cancer, visit the Breast Cancer Research Studies section.
For a summary of research studies on radiation therapy following mastectomy for invasive breast cancer, visit the Breast Cancer Research Studies section.
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What Are The Signs Of Distant Breast Cancer Recurrence
If your breast cancer has spread to other parts to the body, known as distant recurrence, there are a number of possible symptoms, including:
- Unexpected weight loss or change in appetite
- Severe or ongoing headaches
However, symptoms will vary depending on where the secondary cancer presents. Sometimes recurrence is identified on a scan or blood test that was done for a reason other than breast cancer.
Studies have shown that doctors are sometimes reluctant to mention the symptoms of metastatic disease. In medical school it was suggested that we shouldnt tell people who had been treated for cancer what to look for if they were worried about recurrences because theyd start imagining that they had every symptom we told them about, but that doesnt reassure people at all it just means theyll be afraid of everything instead of a few specific things. When youve had cancer, youre acutely aware of your body, and any symptom thats newor that you never noticed beforecan take on terrifying significance as you worry that your cancer may be back. Inevitably this will mean a lot of fear over symptoms that turn out to be harmless.
As I explain to my patients, there are good reasons these days to remain optimistic, even after cancer comes back. Newer, better treatments are becoming available all the time. And for women who were treated a long time ago, the options for treatment may have changed and improved significantly since the first time they were treated
Mortality Rates Versus Number Of Breast Cancer Deaths
Sometimes its useful to have an estimate of the number of people expected to die from breast cancer in a year. This numbers helps show the burden of breast cancer in a group of people.
Numbers, however, can be hard to compare to each other. To compare mortality rates in different populations, we need to look at mortality rates rather than the number of breast cancer deaths.
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Most Women Diagnosed With Early
- Tags:Tumor Between 1 cm and 1.9 cm, Tumor Between 2 cm and 2.9 cm, Tumor Between 3 cm and 3.9 cm, Tumor Between 4 cm and 4.9 cm, Tumor Smaller than 1 cm, Early-stage: Stage 0 — DCIS , Early-stage: Stage IA, Early-stage: Stage IB, Early-stage: Stage IIA, Early-stage: Stage IIB, Lymph Nodes Removed, 1-9 Involved, Lymph Node Removal, Sentinel Lymph Node Removal/Dissection, After Surgery, Planning/Considering Surgery, and Preparing for/Undergoing Surgery
When early-stage breast cancer is removed, the lymph node closest to the cancer called the sentinel node often is removed and sent to a pathologist for evaluation. Removing just this one node is called sentinel node biopsy or sentinel node dissection.
If cancer cells are in the sentinel node, it means the cancer has spread beyond the breast. Until recently, doctors thought that more treatment was necessary to reduce the risk of the cancer coming back , including removing other underarm lymph nodes .
But a practice-changing study, called the ACOSOG Z-11 trial, found that women diagnosed with early-stage disease with one or two positive sentinel nodes who have lumpectomy and radiation do just as well as women who have axillary node surgery.
Among other directives, the new guidelines say:
The researchers found that women who had only sentinel lymph surgery more than doubled, from 23% in 2009 to 56% in 2011, the year after publication.
Myth #: When Breast Cancer Travels To The Bone Brain Or Lungs It Then Becomes Bone Cancer Brain Cancer Or Lung Cancer
Not true. Breast cancer is still breast cancer, wherever it travels in the body. However, the characteristics of the cells can change over time. For example, a breast cancer that tested negative for hormone receptors or an abnormal HER2 gene might test positive when it moves to another part of the body, or vice versa . Keep in mind that the cancer cells are trying to survive in the body, so they can change, says Dr. Gupta. We always emphasize rechecking the biology.
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What Can You Do At The Breast Centre
Breast Centre offers one-stop comprehensive breast service in breast cancer screening, assessment, diagnosis and treatment of all breast conditions. Staffed by dedicated doctors and nurses, the clinic and radiology suites at the Breast Centre are equipped with state of the art advanced technology and equipment.
How Does Breast Cancer Spread
Breast cancer can spread through the lymphatic system, the bloodstream, or uncommonly, by local invasionwhich is when cancer cells actually invade nearby tissues, such as the chest wall or ribs.
When breast cancers spread and enter the lymphatic system, they usually first arrive at nearby lymph nodes and may still be early-stage. The spread of breast cancer to lymph nodes does not necessarily mean that its metastatic, even though pathology reports often somewhat confusingly state breast cancer metastatic to lymph nodes.
A growing cancer may shed a cell or a clump of cells, and It can use your blood or lymph system as a network of highways for traveling. So, if a loose cancer cell makes it via the lymphatic system to your lymph nodes, its also possible that it may spread via the bloodstream to other parts of your body.
When cancer recurs in a lymph node near the breast, it is considered a regional recurrence and not a distant recurrence.
When breast cancer spreads to lymph nodes it has essentially declared its intent to metastasize. Breast cancer reaching the lymph nodes is in effect a declaration that its working to spread further.
In women with negative nodes, its trickier. What we want is a way to identify the 20 to 30 percent who have microscopic cells elsewhere and not over-treat the other 70 percent. At present we dont have a perfect way to do this.
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Risk Factors For Distant Recurrence
There are several risk factors that raise the risk of recurrence overall . These include:
- Tumour size: Larger tumours are more likely to recur than smaller ones both early and late.
- Positive lymph nodes: Tumours that have spread to lymph nodes are more likely to recur at any time than those that have not.
- Age at diagnosis: Breast cancer recurrence is more common in younger women.
- Treatments received and response to treatments: Both chemotherapy and hormonal therapy reduce the risk of recurrence
- Tumour Characteristics: More aggressive cancers are more likely to recur than less aggressive tumours , especially in the first five years. We also take into account the receptor status and an estimate of proliferation .
There are also factors that do not appear to affect the risk of recurrence. Recurrence rates are the same for women who have a mastectomy or lumpectomy with radiation and are also the same for women who have a single vs. double mastectomy.