More Information About The Tnm Staging System
The T category describes the original tumor:
- TX means the tumor cant be assessed.
- T0 means there isnt any evidence of the primary tumor.
- Tis means the cancer is in situ .
- T1, T2, T3, T4: These numbers are based on the size of the tumor and the extent to which it has grown into neighboring breast tissue. The higher the T number, the larger the tumor and/or the more it may have grown into the breast tissue.
The N category describes whether or not the cancer has reached nearby lymph nodes:
- NX means the nearby lymph nodes cant be assessed, for example, if they were previously removed.
- N0 means nearby lymph nodes do not contain cancer.
- N1, N2, N3: These numbers are based on the number of lymph nodes involved and how much cancer is found in them. The higher the N number, the greater the extent of the lymph node involvement.
The M category tells whether or not there is evidence that the cancer has traveled to other parts of the body:
- MX means metastasis cant be assessed.
- M0 means there is no distant metastasis.
- M1 means that distant metastasis is present.
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What Are The Symptoms Of Stage 1 Breast Cancer
Because stage 1 breast cancer is the earliest stage, you may not notice or experience any symptoms.
However, if symptoms do develop, they may include:
- a lump in your breast tissue or under your arm
- redness, dimpling, or swelling in your breast
- an inverted nipple, which means that the nipple has pulled inward
- non-breast milk nipple discharge
Having these symptoms does not always mean that you have breast cancer, but it is important to let your doctor know so that they can evaluate you.
How Do Doctors Classify Breast Cancer Stages
TNM stands for:
- T: This indicates the size of the tumor and is followed by a 0, 1, 2, 3, or 4.
- N: This indicates whether or not lymph nodes are affected and is followed by a 0, 1, 2, or 3.
- M: This indicates whether or not the cancer has spread, or metastasized, and is followed by a 0 or 1.
Stage 1 breast cancer is T-0 or T-1, which means that the tumor size is 2 cm or less. It is N-0 or N-1, which means that there are no cancer cells in the lymph nodes or that it has only spread to the closest nodes. Finally, it is M-0, meaning that the cancer has not spread.
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Questions To Ask Your Doctor
Ask your doctor about their thoughts on your 1, 2, 5 and 10 year survival rates to get a personalized estimate. The numbers on this site are survival rates based upon cases of other people with this type of cancer. Use these numbers to ask your doctor what would make your outlook the same or different.
Tip: Use the drop-down at the top of the page to change the survival length from 5 year to 1, 2 or 10 year.
Reviewed by Aaron Simon M.D. Ph.D, Radiation Medicine, UC San Diego
What is Stage and why do I need to know it?
Cancer Stage is a number, typically from 1 to 4, measuring the size of the cancer tumor and if the cancer has spread. Stage 1 means the cancer hasnÃ¢t spread to other parts of the body, while stage 4 means that it has. Stages 2 and 3 are somewhere in between. Survival rates are typically lower for higher stages.
What is Grade and why do I need to know it?
Some cancers also have a grade. The grade indicates how fast the cancer is growing. Well differentiated means the cancer cells are more like normal cells and growing slower. Poorly differentiated means the cancer cells donÃ¢t look like normal cells and growing faster. Moderately differentiated grade means the cells are somewhere in between well and poorly differentiated.
What is Histology and why do I need to know it?
Bottom line, confirming stage and grade of cancer with your doctor is important for understanding prognosis and discussing treatment options.
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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Invasive Ductal Carcinoma Stages
Invasive ductal carcinoma stages provide physicians with a uniform way to describe how far a patients cancer may have spread beyond its original location in a milk duct. This information can be helpful when evaluating treatment options, but it is not a prognostic indicator in and of itself. Many factors can influence a patients outcome, so the best source of information for understanding a breast cancer prognosis is always a physician who is familiar with the patients case.
What Are The Treatment Options For Invasive Lobular Carcinoma
ILC can be more difficult to diagnose than other forms of breast cancer because it spreads in a unique pattern thats not always noticeable in imaging tests. The good news is that its a relatively slow-growing cancer, which gives you time to form a treatment plan with your cancer team.
There are several treatment options that can help increase your chances of a full recovery.
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What Are The Stages Of Breast Cancer And Their Treatment Options
Compared to most other cancers, staging breast cancer is more complex and that has to do with the number of breast cancer stages and differences in how breast cancer can develop.
How many stages of breast cancer are there? There are five stages, beginning at Stage 0 and going up to Stage 4. Within some stages there are additional categories based on the location and formation of the cancer.
So when it comes to treating breast cancer, there isnt a one-size-fits-all approach. Your treatment plan should be created especially for you and be coordinated across specialists and thats where your cancer care team comes in.
At HealthPartners, we believe cancer treatment and care is best managed by a group of doctors and specialists in whats known as multidisciplinary conferences. This is where breast surgeons, oncologists, radiologists, pathologists and other members of your care team gather to discuss the best treatment sequence for you.
Below we dive into the treatment options your care team might recommend at various breast cancer stages.
Life Expectancy By Stage
Even when divided by stage, its hard to determine life expectancy for someone with breast cancer because of the following:
- There are many types of breast cancer, and they vary in their level of aggressiveness. Some have targeted treatment, while others dont.
- Successful treatment may depend on age, other health problems, and treatments you choose.
- Survival rates are estimates based on people diagnosed years ago. Treatment is advancing quickly, so you may have a better life expectancy than people diagnosed even five years ago.
Thats why you shouldnt take general statistics to heart. Your doctor can give you a better idea of what to expect based on your personal health profile.
The Surveillance, Epidemiology, and End Results Program doesnt track breast cancer survival rates by type or in stages 0 to 4. A relative survival rate compares people with breast cancer to people in the general population.
Following are SEER based on women diagnosed between 2009 and 2015:
|Localized: Has not spread beyond the breast||98.8%|
Your doctor will consider all this when recommending treatment. Most people need a combination of therapies.
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Symptoms Of Lobular Breast Cancer
Lobular breast cancer sometimes begins without symptoms. It may show as an abnormal area on a mammogram, which leads to further examination.
Spotting ILC on a mammogram can be difficult because the cancer cells spread in a line rather than in a distinctive lump, as in IDC. Magnetic resonance imaging imaging is reported to provide more sensitive images that may show the cancer better.
The first symptom of ILC is sometimes a thickening or hardening of a portion of the breast. This thickening can be felt by touch, but it feels different from the classic lump associated with IDC, the more common breast cancer.
Other symptoms of ILC may include:
- swelling or fullness in a part of the breast, or in the whole breast
- a change in the skin texture in a part of the breast
- dimpling in the breast
The exact cause of ILC is currently unknown. But there are some risk factors that are associated with ILC. These can include:
- taking hormone replacements, for menopause for example
Although people can be diagnosed with lobular breast cancer at any age, its most common in women ages 55 years and older. Research suggests that hormone replacement therapy after menopause, especially with progesterone, may increase the risk of this type of cancer.
Factors Influencing Metastatic Breast Cancer Prognosis
There are several factors that can impact the prognosis of metastatic breast cancer, these include:
- Hormone receptors on cancer cells
- The type of tissue involved
- The number of tumors/extent of metastasis
- A persons overall attitude and outlook on the prognosis
Of course, no factors can accurately predict the exact prognosis for a person with metastatic breast cancer. These statistics are based on many clinical research studies, looking at survival rates for people diagnosed with breast cancer at all stages. But the prognosis of each person is different, regardless of what the statistics indicate.
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What Tumor Factors Threaten My Life More
There are important tumor biology factors not well reflected in survival statistics by breast cancer stage. Below we list a few important factors that carry a higher risk to life beyond just the stage of cancer. You must ask your surgeon or medical oncologist to explain your receptor status and give you a copy of your biopsy pathology report.
Triple Negative Receptor breast cancer
Triple negative breast cancer is considered a more aggressive breast cancer. Invariably it does require chemotherapy. If you have triple negative breast cancer the risk of dying is higher than the standard statistics usually quoted for a particular stage of breast cancer . Learn more about Triple Negative Breast Cancer with our video lesson
HER2-Positive breast cancer
HER2-positive breast cancers are also more aggressive tumors. But the good news is that we now have incredibly effective, targeted chemotherapy and immunotherapy for HER2-positive cancers. Our video lesson covers HER2-Positive Breast Cancer in more detail .
Breast Cancer at a Young Age
Women younger than 40 have a higher chance of being diagnosed with a more advanced stage breast cancer. Also, the specific cancer type younger women develop has a higher chance of being more aggressive . As a result, age is a relative risk factor for survival.
Untreated breast cancer
Teaching everyone to be an expert in their own breast cancer care.
Diagnosis Of Invasive Lobular Carcinoma
The earlier youre diagnosed with ILC and start treatment, the better your outlook. As with other types of cancer, early stages of ILC are likely to be treated more easily with fewer complications. This typically but not always leads to a complete recovery and low recurrence rates.
But compared with the much more common IDC, early diagnosis of ILC can be a challenge. Thats because the growth and spread patterns of ILC are more difficult to detect on routine mammograms and breast exams. ILC tumors are likely to have multiple origins, and they grow in single-file lines rather than a lump.
The first step in a diagnosis of ILC is a breast examination. Your doctor will feel your breast for a thickening or hardening of the tissue. Theyll also look for any swelling in the lymph nodes under your arms or around your collarbone.
Other diagnostic tests may include:
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What To Know In The Long
Stage 1A breast cancer is a generally favorable and treatable diagnosis, the experts said. But it does still involve long-term care and consideration.
Depending on the type of breast cancer, patients may need to take medication endocrine therapy, also called anti-hormone therapy for five to 10 years. For most stage 1 patients, though, it’s just five years, Mouabbi said.
People who’ve had stage 1 breast cancer also need to stay on top of screening in the future, the experts said.
“The highest risk factor for another breast cancer is a prior history of breast cancer,” Mouabbi said. That’s why it’s so important that, once a cancer patient is in remission, they continue regular breast cancer screening, including mammograms and physical exams.
“The most important thing is catching cancer in this early stage,” Ziedman agreed, adding that some people with a family history or genetic risks for cancer may need to start regular screenings much earlier.
Setting And Data Sources
We conducted a nationwide cohort study using population-based registries. Denmarks National Health Service provides tax-supported health care to Danish citizens and permanent residents, ensuring equal and free access to all medical care provided by hospitals and general practitioners . Using the civil personal registration number, a unique identification number assigned to all Danish residents at birth or immigration, we linked individual-level data from Danish administrative and population-based registries , namely the Danish Breast Cancer Group database , the Danish National Patient Registry , the Danish Pathology Registry , the Danish Cancer Registry , the Danish Register of Causes of Death , and the Danish Civil Registration System . In addition, we used data on contralateral breast cancer in a database initiated for a previous study .
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Want To Learn More About Your Breast Cancer Treatment Options Were Here For You
Whether you just received your diagnosis or youre looking for new treatment options, were here to help.
If youve just been diagnosed with breast cancer, your next stop will be to meet with a nurse navigator or breast surgeon, depending on your initial diagnosis, and start building your treatment plan. We offer cancer care clinic locations across the Twin Cities and western Wisconsin, so get started by selecting a location to make an appointment at.
What Is Invasive Ductal Carcinoma
Before discussing how invasive ductal carcinoma is staged and what those stages mean, it may be helpful to explain exactly what this malignancy is.Invasive ductal carcinoma involves the ducts that carry milk from the lobules to the nipples. The malignancy develops when cancerous cells form in one of these ducts and then spread to the surrounding tissues or lymph nodes. Invasive ductal carcinoma is the most common type of breast cancer, accounting for approximately 80% of the total number of cases.
Invasive ductal carcinoma can cause the following symptoms:
- A lump within the breast or the underarm area
- Pain or swelling in one breast
- Redness or a rash on a breast
- Dimpling around a nipple
- Inward turning of a nipple
- Discharge from a nipple
- Other changes in the size, shape or feel of a breast
These symptoms can be difficult to notice, especially when invasive ductal carcinoma hasnt yet progressed past its early stages, so its important to perform monthly breast examinations and consult with a physician about any noticeable changes, even if they appear minor.
Notably, many individuals with invasive ductal carcinoma also have ductal carcinoma in situ , a type of noninvasive breast cancer that occurs when cancerous cells remain confined to the milk duct rather than spreading to nearby tissues. Although DCIS is often considered to be precancerous and preinvasive, it can become invasive and begin spreading to surrounding tissues if left untreated.
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How Big Is A Stage 1b Breast Tumor
The tumor is less than 20 mm in size and there is no spread to lymph nodes. Stage 1B: T1N1miM0. The tumor is less than 20 mm in size and there are micrometastases in a nearby lymph node. Stage 1B: T0N1miM 0. There is no evidence of a primary tumor in the breast but there are micrometastases in a lymph node .
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.
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How Do Physicians Assign Breast Cancer Stages
In general, breast cancer stages are established based on three key variables: the size of a tumor, the extent of lymph node involvement and whether the cancer has spread to other areas of the body. This information may be obtained through a combination of clinical examinations, imaging studies, blood tests, lymph node removal and tissue samples . If, based on the initial test results, a physician believes that the cancer may have spread to other parts of the body, further testing may be ordered, such as a bone scan, positron emission tomography scan or liver function test.