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How Fast Does Breast Cancer Spread Lymph Nodes

Where Do These Numbers Come From

What does it mean if breast cancer spreads to the lymph nodes? | Norton Cancer Institute

The American Cancer Society relies on information from the Surveillance, Epidemiology, and End Results database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.

The SEER database tracks 5-year relative survival rates for breast cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:

  • Localized: There is no sign that the cancer has spread outside of the breast.
  • Regional: The cancer has spread outside the breast to nearby structures or lymph nodes.
  • Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.

Breast Cancer Cell Growth

Cancer begins when there are genetic changes, called mutations, in a normal breast cell. These changes happen in genes that control the growth of the cell. These changes may occur over a long period of time, even decades, before a cancer cell forms.

These tumor cells multiply and divide exponentially, meaning that one cell becomes two, two cells become four, and so on. That’s why a tumor size will increase more rapidly, the larger it becomes.

That said, not all cells are dividing at the same time. The cancer’s growth can change at different stages as a tumor forms. Compared with many types of cancer, breast cancer has a “low growth fraction.” This means that the proportion of cancer cells that are in an active cell cycle is low.

Some tumors, such as lymphomas and some leukemias, have much higher growth fractions. They may be active for a much shorter period of time before they are detected, even in children.

If Cancer Is Found Tests Are Done To Study The Cancer Cells

  • how quickly the cancer may grow.
  • how likely it is that the cancer will spread through the body.
  • how well certain treatments might work.
  • how likely the cancer is to recur .

Tests include the following:

Based on these tests, breast cancer is described as one of the following types:

  • TX: Primary tumor cannot be assessed.
  • T0: No sign of a primary tumor in the breast.
  • Tis: Carcinoma in situ. There are 2 types of breast carcinoma in situ:
  • Tis : DCIS is a condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive breast cancer that is able to spread to other tissues. At this time, there is no way to know which lesions can become invasive.
  • Tis : Paget disease of the nipple is a condition in which abnormal cells are found in the skin cells of the nipple and may spread to the areola. It is not staged according to the TNM system. If Paget disease AND an invasive breast cancer are present, the TNM system is used to stage the invasive breast cancer.
  • T1: The tumor is 20 millimeters or smaller. There are 4 subtypes of a T1 tumor depending on the size of the tumor:
  • T1mi: the tumor is 1 millimeter or smaller.
  • T1a: the tumor is larger than 1 millimeter but not larger than 5 millimeters.
  • T1b: the tumor is larger than 5 millimeters but not larger than 10 millimeters.
  • T1c: the tumor is larger than 10 millimeters but not larger than 20 millimeters.
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    Mammographic And Ultrasound Features Of Inflammatory Breast Cancer

    The typical findings on screening for inflammatory breast cancers are thickening of the skin and connective tissues and an increase in breast density.

    In around 30% of inflammatory breast cancers cases there is no lump . Rather IBC usually presents as a diffuse infiltration of cancer cells, so it is not as easily detected on mammogram or ultrasound.

    So, the absence of a true breast mass on mammography does not always rule out cancer.

    In addition, the high density of the breast might hide an actual tumor deeper within the breast.

    Ultrasound can be helpful in the diagnostic process, as it may be able to detect masses hidden at mammography and on clinical examination.

    Ultrasound is also useful to detect axillary adenopathy and this can help with taking more accurate biopsy samples. With inflammatory breast cancer, ultrasound images might show edema and skin thickening along with an ill-defined mass of some kind.

    Stage Iv Breast Cancers May Be Recurrences Following Initial Treatment

    Metastatic Cancer: When Cancer Spreads

    Up to 5% of initial breast cancer diagnoses are of the most advanced or metastatic stage. However, this number has significantly reduced with the implementation of widespread breast cancer screening programs.

    Metastatic breast cancer can appear to be a rapid deterioration of a disease that has been present for some time undetected.

    But metastatic breast cancer can also be the result of a recurrence of breast cancer after successful initial treatment. Sometimes the terms local and regional recurrence indicate a return of breast cancer to the original tumor site or elsewhere in the breast or contralateral breast.

    If the cancer returns in other areas of the body it is a distant metastasis or distant recurrence.

    For more detail on Stage IV survival rates, recurrence rates and treatment please see our new post HERE.

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    Signs And Symptoms Of Inflammatory Breast Cancer

    Inflammatory breast cancer causes a number of signs and symptoms, most of which develop quickly , including:

    • Swelling of the skin of the breast
    • Redness involving more than one-third of the breast
    • Pitting or thickening of the skin of the breast so that it may look and feel like an orange peel
    • A retracted or inverted nipple
    • One breast looking larger than the other because of swelling
    • One breast feeling warmer and heavier than the other
    • A breast that may be tender, painful or itchy
    • Swelling of the lymph nodes under the arms or near the collarbone

    If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away. Tenderness, redness, warmth, and itching are also common symptoms of a breast infection or inflammation, such as mastitis if youre pregnant or breastfeeding. Because these problems are much more common than IBC, your doctor might suspect infection at first as a cause and treat you with antibiotics.

    Treatment with antibiotics may be a good first step, but if your symptoms dont get better in 7 to 10 days, more tests need to be done to look for cancer. Let your doctor know if it doesn’t help, especially if the symptoms get worse or the affected area gets larger. The possibility of IBC should be considered more strongly if you have these symptoms and are not pregnant or breastfeeding, or have been through menopause. Ask to see a specialist if youre concerned.

    If Your Breast Cancer Has Spread

    Even if your breast cancer has spread to other parts of your body, it does not necessarily mean its not treatable. If the cancer cannot be removed, the goal of treatment is to improve symptoms, improve quality of life and extend survival.

    Some women live with breast cancer for several years as they learn to adjust and accept that theyll be on treatment for an indefinite period of time, explains Dr. Roesch. Your cancer team will help you learn and cope with what you can expect on this journey.

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    Symptoms If Cancer Has Spread To The Lymph Nodes

    Lymph nodes are part of a system of tubes and glands in the body that filters body fluids and fights infection.

    The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen. You might have any of the following symptoms if your cancer has spread to the lymph nodes:

    • a lump or swelling under your armpit
    • swelling in your arm or hand
    • a lump or swelling in your breast bone or collar bone area

    One of the first places breast cancer can spread to is the lymph nodes under the arm on the same side as the breast cancer. This is not a secondary cancer.

    What Is Stage 3 Breast Cancer

    Lymph nodes and breast cancer

    Also known as locally advanced breast cancer, the tumor in this stage of breast cancer is more than 2 inches in diameter across and the cancer is extensive in the underarm lymph nodes or has spread to other lymph nodes or tissues near the breast. Stage 3 breast cancer is a more advanced form of invasive breast cancer. At this stage, the cancer cells have usually not spread to more distant sites in the body, but they are present in several axillary lymph nodes. The tumor may also be quite large at this stage, possibly extending to the chest wall or the skin of the breast.

    Stage 3 breast cancer is divided into three categories:

    Stage 3A: One of the following is true:

    • No tumor is found in the breast, but cancer is present in axillary lymph nodes that are attached to either other or other structures, or cancer may be found in the lymph nodes near the breast bone, or
    • The tumor is 2 cm or smaller. Cancer has spread to axillary lymph nodes that are attached to each other or other structures, or cancer may have spread to lymph nodes near the breastbone, or
    • The tumor is 2 cm to 4 cm in size. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breast bone, or
    • The tumor is larger than 5 cm. Cancer has spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.

    Stage 3C:

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    Clinical Trials Are A Promising Treatment Option

    For people with advanced stages of cancer, clinical trials can be considered the gold standard of treatment. I recommend clinical trials highly, says Rosen. You get access to medication and treatment that you normally wouldnt have.

    A clinical trial could even have positive results on your cancer. We are living in an exciting time for cancer treatment, says Kimmick. There are myriad new drugs coming out that will improve the lives of all women with breast cancer, both metastatic and early stage.

    However, its important to be realistic about the potential outcome of your trial. Rosen was recently enrolled in a clinical trial in which the medication proved toxic for her. But she has no regrets about participating. It feels like Im helping researchers who are working on cures for cancer, she says. When I had a bad reaction to the drug, they were able to put my side effects in their study. I feel like I did help, and that makes me happy.

    People interested in joining a clinical trial for treatment should talk to their doctor about options that might be good for them.

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    Sentinel Lymph Node Biopsy

    In a sentinel lymph node biopsy , the surgeon finds and removes the first lymph node to which acancer is likely to spread . A radioactive substance and/or a blue dye is injected into the tumor, the area around it, or the area around the nipple. Lymph vessels will carry these substances along the same path that the cancer would likely take. The first lymph node the dye or radioactive substance travels to will be the sentinel node.

    After the substance has been injected, the sentinel node can be found either by using a special machine to detect radioactivity in the nodes, or by looking for nodes that have turned blue. Sometimes, both methods are used. The surgeon cuts the skin over the lymph node area and removes the node containing the dye or radioactivity.

    The few removed lymph nodes are then checked closely in the lab for cancer cells by a pathologist. Sometimes, this is done during the surgery. Because there is a chance that other lymph nodes in the same area will also have cancer if cancer is found in the sentinel lymph node, the surgeon may go ahead with an axillary dissection to remove more lymph nodes while you are still on the operating table. If no cancer cells are seen in the node at the time of the surgery, or if they are not checked by a pathologist at the time of the surgery, they will be examined more closely over the next several days.

    Based on the studies that have looked at this, skipping the ALND may be an option for:

    Where Does Breast Cancer Spread To

    Lymph Node Removal in Early

    Breast cancer cells seem to prefer to settle into:-

    • long bones in the arms and legs
    • ribs
    • skull

    With an osteolytic metastasis, the cancer kind of eats away at the bone, creating holes.

    With an osteoblastic bone metastasis, the bone mineral density actually increases, but this can cause the bones to fracture more easily. This requires a little more explanation. Breast cancer metastases tend to be lytic when they are untreated, and then they become densely sclerotic as they respond to treatment.

    Even if no treatment is given yet, an osteoblastic metastasis from breast cancer generally indicates that the persons own body is trying to fight cancer with some success.

    A CT scan may also be used to check for metastasis to the lungs or liver. A CT scan is essentially an X-ray linked to a computer. The breast cancer doctor injects a contrast dye agent into the bloodstream and this makes any cancer cells in the liver and chest easier to see.

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    How Quickly Breast Cancer Spreads

    Metastasis, the spread of breast cancer to other parts of the body, is responsible for the majority of breast cancer deaths. This makes it important to know how fast a breast cancer spreads.

    Breast cancer usually spreads first to lymph nodes under the arm. This is called lymph node-positive breast cancer. Breast cancer is considered early-stage and potentially curable even with the involvement of lymph nodes.

    When a cancer spreads to regions such as the bones, brain, lungs, or liver, it is considered stage IV or metastatic breast cancer. This means it is no longer curable.

    Most breast cancers have the potential to spread. Carcinoma in situ or stage 0 breast cancer is considered non-invasive because of its limited spread. It is potentially 100% curable with surgery.

    All other stages of breast cancer are considered invasive and have the potential to spread. Spread to lymph nodes, even when early stage, is very important because it indicates the cancer’s potential to spread beyond the breasts.

    What Does It Mean If Theres Cancer In My Lymph Node

    If cancer is found in one or more lymph nodes, it could mean that more tests are needed to know how far the cancer has spread. This information is used to determine the stage of your cancer and the best treatment options.

    For more information on staging, see Cancer Staging, or find your cancer type for more detailed information.

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    Breast Cancer With Possible Spread To Lymph Nodes In Neck

    Hi, I have been really worried. Last year I was diagnosed with BC Her2+ and I had chemo Fec-T and radiotherapy. I started zolendronic acid on Friday and I am still on Herceptin. Yesterday I went for an ultrasound to my neck. The radiologist spoke of finding 3 enlarged lymph nodes I think at the base of my neck. I am so worried it has come back and that prognosis will be poor. Has anyone had anything similar? IN other ways I am feeling well. Thank you. Xx

    Hi Sunny-day

    Im sorry to hear that the radiologist found some enlarge lymph nodes on your recent ultrasound. Its understandable that youre cconcerned about what these may be and what they may mean given that youve had breast cancer.

    I would say that we seem to have a lot of posts here on the forum at the moment from people who have swollen lymph nodes so try to stay positive and remember that there could be a number of reasons other than cancer for this problem.

    Have you spoken to your GP or Consultant about these findings? Its certainly worth giving them a call to talk things through and see if they feel further investigation is needed.

    Keep in touch and let us know how you get on.

    Best wishes,

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    Types Of Mammary Tumors

    Breast cancer spread to the lymph nodes

    The diagnostic process of possible mammary cancer can identify the type of tumor your pet has. Some of the most well-known include:

    • Inflammatory carcinoma: This is the most malignant type and could rapidly spread throughout the dogs body.
    • Adenocarcinoma: One of the most common types of tumors
    • Fibroadenoma: A type of benign tumor that is typically painless
    • Mixed mammary tumor: The most frequently occurring tumor in dogs

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    Stages Of Breast Cancer: Stage Iiic

    Stage IIIc breast cancers basically involve tumors of any size with significant metastases to:-

    • the lymph nodes behind the sternum
    • lymph nodes under the arm
    • the lymph nodes above or below the collarbone

    The extent and depth of lymph node involvement make these patients unsuitable candidates for surgical treatment as a primary mode of therapy. Chemotherapy is the treatment of choice for women with stage IIIb and IIIc breast cancers.

    However, up to 70% of patients with stage III breast cancers who have chemotherapy remain alive and disease-free after 7 years.

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