Treatment For Stage 2 Breast Cancer
The most common type of treatment for stage 2 breast cancer is surgery.
Surgery
In most cases, treatment involves removing the cancer.
A person with stage 2A or 2B breast cancer may undergo a lumpectomy or mastectomy. The doctors and the individual can decide based on the size and location of the tumor.
Combination therapy
A doctor may recommend a combination of radiation therapy, chemotherapy, and hormone therapy to people with stage 2A or 2B breast cancer.
The subcategories for stage 3 breast cancer are 3A, 3B, and 3C.
3A breast cancer is an invasive breast cancer where:
- There is no tumor in the breast, or a tumor of any size is growing alongside cancer found in four to nine axillary lymph nodes or the lymph nodes by the breastbone.
- A person has a tumor greater than 5 cm, as well as clusters of breast cancer cells in the lymph nodes that are between 0.22 mm in diameter.
- The tumor is larger than 5 cm, and cancer has also spread to one to three axillary lymph nodes or the lymph nodes near the breastbone.
Stage 3B breast cancer is invasive breast cancer where:
- A tumor of any size has spread into the chest wall or skin of the breast, causing swelling or an ulcer to develop. It could also have spread to up to nine axillary lymph nodes or may have spread to lymph nodes by the breastbone.
If cancer spreads to the skin of the breast, a person may have inflammatory cancer.
Symptoms of inflammatory breast cancer include:
Stage 3C breast cancer is an invasive breast cancer where:
How Does Staging Relate To Types Of Breast Cancer
In addition to cancer stage, doctors will determine the tumor grade and subtype.
Tumors are graded on a scale of 1 to 3, based on how abnormal the cells appear compared to normal cells. The higher the grade, the more aggressive the cancer, meaning that it tends to be growing quickly.
The subtype is important because treatment and outlook will vary depending on which subtype of breast cancer that you have. Subtypes include:
What Is A Cancer Stage
While a grade describes the appearance of cancer cells and tissue, a cancers stage explains how large the primary tumor is and how far the cancer has spread in the patients body.
There are several different staging systems. Many of these have been created for specific kinds of cancers. Others can be used to describe several types of cancer.
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What Are The Symptoms Of Stage 1 Breast Cancer
Stage 1 breast cancer is cancer that is still confined in its primary location. Although its growing, the disease has not yet spread to other body parts. Stage 1 breast cancer occurs in different sub-stages known as 1A and 1B. If identified early, the disease can be treated effectively with excellent prognoses.
When breast tumors are identified as stage 1, they are still small, and if they have spread to lymph nodes at all, the spread is very microscopic. Stage 1A breast cancer means that the tumor is very small and hasnt spread to the lymph nodes. Stage 1B is when the disease is already in the lymph nodes, but still small, the size of a pinprick.
The stages of breast cancer are determined by the TNM system of classification. The system stages the disease by tumor size, if it has spread to any lymph nodes or if the cancer has progressed to other parts of the body.
Stage 1 breast cancer is very treatable since it is in a localized stage. Knowing your stage of tumor can help you get the best treatment option available to eliminate the disease completely.
Although uncommon, early breast cancer can cause signs and symptoms which may not be detected through a mammogram. Here are some of the stage 1 breast cancer symptoms to watch out for:
;Swelling in the breast or armpit
;Unusual discomfort or pain in the breast
;Breast tenderness that is very persistent
;Pitted or scaly skin
;A retracted nipple
;Pain in the nipple or change in its appearance
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Is Inoperable Breast Cancer Still Treatable
Although stage 3C breast cancer is defined as either operable or inoperable, an inoperable diagnosis doesnt necessarily mean that it cant be treated.
The term inoperable may mean that all the cancer in the breast and surrounding tissue cant be removed through simple surgery. When breast cancer is removed, a rim of healthy tissue around the tumor, called a margin, is also removed.
For breast cancer to be successfully removed, there needs to be healthy tissue in all margins of the breast, from your clavicle down to a few inches below the breast mound.
It is possible for inoperable breast cancer to become operable following a treatment to shrink the cancer.
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Breast Cancer Staging Guidelines
The TNM system is the most widely used cancer staging system and looks at the following cancer characteristics:
- Tumor The size of the tumor and whether it has grown into nearby tissue.
- Node Whether the cancer has spread to nearby lymph nodes. And if so, how many.
- Metastasis Indicates whether the cancer has spread to distant organs, like the lungs or liver.
But when it comes to breast cancer staging, the TNM system was expanded to include additional cancer characteristics, including:
- Estrogen-receptor status or progesterone-receptor status Whether the cancer has estrogen or progesterone receptors. A positive status means the cancer can use either hormone to grow.
- HER2 status Whether the cancer produces HER2, a protein that promotes the growth of cancer cells.
- Grade Indicates how much the cancer cells look like healthy cells.
- Oncotype DX recurrence score Indicates how likely a group of genes may respond to treatment, depending on ER, PR and HER2 status.
The Tnm System For Staging Breast Cancer
The AJCCs addition of the letters T, N, and M for anatomic breast cancer staging adds more information to a breast cancer diagnosis. Heres what they mean:
- T : The tumor grade shows a higher number for a larger size or density.
- N : Nodes refers to lymph nodes and uses the numerals 0 to 3 to give information about how many lymph nodes are involved in the cancer.
- M : This refers to how the cancer has spread beyond the breast and lymph nodes.
The AJCC also added clarifications in staging for ER, PR, and HER2 expression and also genetic information.
Ultimately, this means someone diagnosed with stage 3 breast cancer can receive more information from their breast cancer staging than ever before.
No matter the stage, the best source of information about your individual outlook is your own oncology team.
Make sure you understand your breast cancer stage and subtype so that you can better understand treatment options and individual outlook.
Getting the right treatment and the support you need can help you navigate the challenges of being diagnosed with stage 3 breast cancer.
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Precancer Or Noninvasive Cancer
Some physicians use the terms;precancer;and noninvasive cancer interchangeably when referring to stage 0 breast cancer, whereas others simply call it cancer. There is great debate over this, but generally, DCIS is considered cancer, while LCIS isn’t .
Aside from clinical perspectives that shape their opinion on the proper terminology to use, some physicians consider how hearing “cancer” will affect a patient.
Learning that your condition is “precancerous” may make you worry that it will inevitably progress to cancer and that it must be treated as such . On the other hand, people told that they have a “noninvasive cancer” often lump their condition in with more advanced cases of the disease. In fact, some doctors refer to LCIS as lobular neoplasia simply because it sounds less frightening.
Don’t be mistaken: Both DCIS and LCIS are concerning because they have the potential to invade beyond their well-contained sites. Both carcinomas have the cellular appearance of cancer and both might eventually grow and spread beyond their original clumps. But, they also might not. So far, doctors can’t say which direction any particular case will go.
While stage 0 breast cancer should be taken seriously, the lower the stage number, the easier the disease is to treat.
Remember that all of these names for stage 0 breast cancer are just different ways to refer to the same thing. Don’t get hung up on terms when deciding on treatment.
What Are Some Of The Cancer Type
Breast and prostate cancers are the most common types of cancer that have their own grading systems.
Breast cancer. Doctors most often use the Nottingham grading system for breast cancer . This system grades breast tumors based on the following features:
- Tubule formation: how much of the tumor tissue has normal breast duct structures
- Nuclear grade: an evaluation of the size and shape of the nucleus in the tumor cells
- Mitotic rate: how many dividing cells are present, which is a measure of how fast the tumor cells are growing and dividing
Each of the categories gets a score between 1 and 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 the three categories are then added, yielding a total score of 3 to 9. Three grades are possible:
- Total score = 35: G1
- Total score = 67: G2
- Total score = 89: G3
- Gleason X: Gleason score cannot be determined
- Gleason 26: The tumor tissue is well differentiated
- Gleason 7: The tumor tissue is moderately differentiated
- Gleason 810: The tumor tissue is poorly differentiated or undifferentiated
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How Can Hormones Affect The Growth Of Breast Cancer
Hormones like estrogen and progesterone are chemicals produced by glands in the body. Normally, these hormones help regulate body cycles, like menstruation. However, sometimes these same hormones can cause cancer to grow.
The pathologist will perform tests on the breast cancer cells to determine if they have receptors that feed on estrogen or progesterone, stimulating their growth. If the cancer cells have these receptors, your doctor may recommend hormone therapy drugs, such as blockers or inhibitors. Both types of drugs help to destroy cancer cells by cutting off their supply of hormones.
Stage 2 Breast Cancer
Stage 2 breast cancer is divided into two groups:
- Stage 2A
- Stage 2B
Stage 2A can mean:
No cancer is seen in the breast but cancer is found in one to three lymph nodes under the arm or near the breastbone
The cancer in the breast is 2cm or smaller and cancer is found in one to three lymph nodes under the arm or near the breastbone.
The cancer in the breast is larger than 2cm but smaller than 5cm and no cancer is found in the lymph nodes under the arm.
Stage 2B can mean:
The cancer in the breast is larger than 2cm but smaller than 5cm. Cancer is found in one to three lymph nodes under the arm or near the breastbone
The cancer in the breast is larger than 5cm and no cancer is found in the lymph nodes under the arm.
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Your Cancer Stage Can Help Identify Clinical Trials That May Be Right For You
There are eligibility criteria to meet before patients can join a clinical trial. That criteria often includes a particular cancer stage. Staging gives researchers a way to bring together many patients across many treatment centers in order to make reasonable conclusions based on the results of the study.
M Categories For Breast Cancer
M followed by a 0 or 1 indicates whether the cancer has spread to distant organs — for example, the lungs, liver, or bones.
M0: No distant spread is found on x-rays or by physical exam.
cM0: Small numbers of cancer cells are found in blood or bone marrow , or tiny areas of cancer spread are found in lymph nodes away from the underarm, collarbone, or internal mammary areas.
M1: Cancer has spread to distant organs .
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How Is Hormone Receptorpositive Breast Cancer Treated
Hormone therapy either blocks the bodyâs ability to produce estrogen or progesterone, or interferes with the effects of hormones on breast cancer cells, which helps to slow or stop the growth of hormone-sensitive tumors.
Ovarian Abation
Ovarian ablation, or treatment that stops or lowers the amount of estrogen made by the ovaries, can be done surgically, through radiation, or using drugs. With surgical treatment or radiation, the ovarian ablation is typically permanent. Suppressing ovarian function with drugs is temporary, and this group of medicines functions by interfering with signals from the pituitary gland stimulating the ovaries to produce estrogen. Side effects of ovarian suppression may include bone loss, mood swings, depression, and loss of libido.
SERMs
Selective estrogen receptor modulators bind to estrogen receptors, preventing estrogen from binding. In addition to blocking estrogen activity, SERMs can also mimic estrogen effects because of their ability to bind. A SERM called tamoxifen, for example, blocks the effects of estrogen in breast tissue but acts like estrogen in the uterus and bone. Tamoxifen is effective in treating early-stage breast cancer after surgery. Some SERMs can treat advanced or metastatic breast cancer. Side effects of tamoxifen may include risk of blood clots, stroke, cataracts, endometrial and uterine cancers, bone loss in premenopausal women, mood swings, depression, and loss of libido.
Aromatase Inhibitors
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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Stage 1b Breast Cancer Means One Of The Following Descriptions Applies:
Lymph nodes have cancer evidence with small clusters of cells between the approximate size of a pinprick to the approximate width of a grain of rice .
AND EITHER;No actual tumor is found in the breast.
OR;The tumor is smaller than the approximate size of a peanut .
Similar to stage 0, breast cancer at this stage is very treatable and survivable. When breast cancer is detected early, and is in the localized stage , the 5-year relative survival rate is 100%.
Treatment For Stage 3 Breast Cancer
Treatment for people with stage 3 breast cancer includes chemotherapy, surgery, and radiation. Typically, doctors administer the chemotherapy before performing the surgery in an attempt to shrink a tumor.
People with stage 3 breast cancer will probably need radiation therapy to kill off any remaining cancer cells. Doctors may also recommend hormone therapy, as well as additional targeted therapies, if necessary.
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Stages Of Breast Cancer
Stage I/ Stage 1
Stage I means that cancer has formed. In stage IA, cancer has not yet spread outside the breast, and the tumor is 2 centimeters or smaller. In stage IB, small clusters of breast cancer cells are found in the lymph nodes, and either no tumor is present, or the tumor is 2 centimeters or smaller.
Stage II/ Stage 2
Stage IIA is defined as either: a tumor between 2 and 5 centimeters without any cells having spread to the lymph nodes; or, no tumor is present in the breast, or the tumor is 2 centimeters or smaller, but there are cancer cells in 1 to 3 axillary lymph nodes or in the lymph nodes near the breastbone.
In stage IIB, the tumor is either: between 2 and 5 centimeters in size, and small clusters of breast cancer cells are found in the lymph nodes; the tumor is between 2 and 5 centimeters in size, and cancer has spread to 1 to 3 axillary lymph nodes or to the lymph nodes near the breastbone; or the tumor is larger than 5 centimeters, and cancer has not spread to the lymph nodes.
Stage III/ Stage 3
In stage IIIA, the tumor is either: larger than 5 centimeters, and small clusters of breast cells are found in the lymph nodes; larger than 5 centimeters, and cancer has spread to 1 to 3 axillary lymph nodes or to the lymph nodes near the breastbone; or, no tumor is present in the breast, or the tumor may be any size, and cancer cells are found in 4 to 9 axillary lymph nodes or in the lymph nodes near the breastbone.
Invasive Ductal Carcinoma: The Most Common Kind
The most common form of breast cancer is invasive ductal carcinoma , sometimes also called infiltrating ductal carcinoma. About 80 percent of all new breast cancer cases in women, and nearly all breast cancer in men, are IDC. The risk of IDC also increases as people grow older.
IDC starts in the ducts just as DCIS does, but the cancer then grows beyond the ducts and invades, or infiltrates, the fatty tissue surrounding the ducts. Without treatment, the cancer continues to metastasize, or spread, into the lymph nodes and bloodstream.
The options available to treat IDC depend on the type of breast cancer it is, what mutations it does or does not have, how aggressive it is, and other factors. One of the most important of those other factors is the cancer stage.
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