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.
Stage 4 Breast Cancer
Stage 4 breast cancer can have a tumor of any size. Its cancer cells have spread to nearby and distant lymph nodes as well as distant organs.
The testing your doctor does will determine the stage of your breast cancer, which will affect your treatment.
Although they generally have less of it, men have breast tissue just like women do. Men can develop breast cancer too, but its much rarer.
According to the ACS , breast cancer is 70 times less common in Black men than in Black women. Its 100 times less common in white men than in white women.
That said, the breast cancer that men develop is just as serious as the breast cancer that women develop. It also has the same symptoms. If youre a man, follow the same monitoring instructions as women and report any changes to breast tissue or new lumps to your doctor.
Ductal Carcinoma In Situ
Ductal carcinoma in situ refers to an area of abnormal cells on one milk duct.
When a person receives this diagnosis, the cells have not invaded the surrounding breast tissue. However, having ductal carcinoma in situ can increase the risk of developing invasive breast cancer later.
This condition generally does not cause symptoms. Doctors find through mammography. Rarely, a person may notice a lump in the breast or some discharge from the nipple.
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What Are The Parts Of The Breast
A womans breast has three kinds of tissue
- Fibrous tissue holds the breast tissue in place.
- Glandular tissue is the part of the breast that makes milk, called the lobes. The tubes that carry milk to the nipple are called ducts. Together, fibrous and glandular tissue are called fibroglandular tissue.
- Fatty tissue fills the space between the fibrous tissue, lobes, and ducts. It gives the breasts their size and shape.
How Does Cancer Start In The Breast
To understand how cancer can originate, it can be helpful to understand how regular cells and tissues function and develop.
Healthy cells are the basic building blocks of all tissues and organs in the body. The body is constantly making new cells to replace worn out tissue or to heal injuries. Normal cells are programmed to grow and divide in an orderly and controlled manner, so that each new cell replaces ones that are lost.
Sometimes cells become abnormal and keep growing. As they grow, they can form a mass or lump called a tumour. However, not all tumours are cancer. Some tumours are benign , which means they tend to grow slowly and usually do not invade surrounding tissue or other parts of the body. Tumours that are malignant have the potential to invade and spread to other parts of the body.
Breast cancer starts when cells in the breast begin to grow abnormally. These cells have the potential to grow out of control and invade the surrounding tissue. When this occurs, this is called invasive breast cancer. If the cancer cells continue to grow, they may spread beyond the breast to other parts of body, which could become life-threatening.
There are different types of breast conditions which are named after the areas of the breast where they start:
Non-invasive breast conditions
Invasive breast cancers
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What Is Inflammatory Breast Cancer
Inflammatory breast cancer is a rare and very aggressive disease in which cancer cells block lymph vessels in the skin of the breast. This type of breast cancer is called inflammatory because the breast often looks swollen and red, or inflamed.
Inflammatory breast cancer is rare, accounting for 1 to 5 percent of all breast cancers diagnosed in the United States. Most inflammatory breast cancers are invasive ductal carcinomas, which means they developed from cells that line the milk ducts of the breast and then spread beyond the ducts.
Inflammatory breast cancer progresses rapidly, often in a matter of weeks or months. At diagnosis, inflammatory breast cancer is either stage III or IV disease, depending on whether cancer cells have spread only to nearby lymph nodes or to other tissues as well.
Additional features of inflammatory breast cancer include the following:
- Compared with other types of breast cancer, inflammatory breast cancer tends to be diagnosed at younger ages.
- Inflammatory breast cancer is more common and diagnosed at younger ages in African American women than in white women.
- Inflammatory breast tumors are frequently hormone receptor negative, which means they cannot be treated with hormone therapies, such as tamoxifen, that interfere with the growth of cancer cells fueled by estrogen.
- Inflammatory breast cancer is more common in obese women than in women of normal weight.
Signs And Symptoms Of Breast Cancer
In its early stages, breast cancer may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram.
If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.
Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:
- a breast lump or tissue thickening that feels different from surrounding tissue and is new
- changes to the appearance of the skin on your breasts
- a lump or swelling under your arm
If you have any of these symptoms, it doesnt necessarily mean you have breast cancer. For instance, pain in your breast or a breast lump can be caused by a benign cyst.
Still, if you find a lump in your breast or have other symptoms, contact your doctor for further examination and testing.
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What Are Symptoms Of Triple Negative Breast Cancer
TNBC symptoms are the same as other common breast cancers. And many breast cancer symptoms are similar to other less serious conditions. That means having certain symptom doesnt mean you have breast cancer. Possible breast cancer symptoms include:
- A new lump or mass.
- Swelling in all or part of a breast.
- Nipple retraction, when your nipple turns inward.
- Nipple or breast skin thats dry, flaking, thickened or red.
- Nipple discharge that is not breast milk.
- Swollen lymph nodes. This symptom happens when breast cancer spreads to the lymph nodes under your arm or near your collarbone.
Mammography: Screening For Breast Cancer
Breast tomosynthesis may be used with mammography to produce a clear, highly focused 3-dimensional picture of the breast. This technique makes it somewhat easier to detect cancer, especially in women with dense breast tissue. However, this type of mammography exposes women to more radiation as traditional mammography.
Recommendations for routine screening with mammography vary. Experts disagree about
When it should start
If changes in the breast are detected during a physical examination, ultrasonography is usually done. If results are inconclusive, mammography is done.
Mammography can also help identify tissue that should be removed and examined under a microscope .
Ultrasonography is sometimes used to help distinguish between a fluid-filled sac Breast cysts are common. In some women, cysts develop frequently, sometimes… read more ) and a solid lump. This distinction is important because cysts are usually not cancerous. Cysts may be monitored or drained with a small needle and syringe. The fluid from the cyst is examined to check for cancer cells only if any of the following occurs:
The fluid is bloody or cloudy.
Little fluid is obtained.
The lump remains after it is drained.
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Can Breast Cancer Be Prevented
You may be able to help prevent breast cancer by making healthy lifestyle changes such as:
- Staying at a healthy weight
- Limiting alcohol use
- Limiting your exposure to estrogen by
- Breastfeeding your babies if you can
- Limiting hormone therapy
If you are at high risk, your health care provider may suggest that you take certain medicines to lower the risk. Some women at very high risk may decide to get a mastectomy to prevent breast cancer.
It’s also important to get regular mammograms. They may be able to identify breast cancer in the early stages, when it is easier to treat.
NIH: National Cancer Institute
What Is Stage Iv Breast Cancer
Stage IV is the most advanced stage of breast cancer. It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs such as the lungs, liver, or brain or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread.
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Where Is The First Place Breast Cancer Spreads
The first place that breast cancer commonly spreads to outside the breast are the lymph nodes in the armpit . Surgery is usually needed to remove one or more lymph nodes to help check for breast cancer spread. This operation to remove lymph nodes in the armpit is known as axillary surgery.
Breast cancer found in the lymph nodes will impact the breast cancers staging, and the treatment plan will often be affected as well.
If cancer is found in the lymph nodes, there is a higher chance that cells have travelled through the lymphatic system and bloodstream to spread to other parts of the body. In this instance, treatment with systemic therapies, such as chemotherapy, is likely to be recommended.
If cancer is found in a large number of axillary nodes, radiotherapy may also be recommended to kill any breast cancer cells that remain in the armpit but cannot be removed by surgery.
What Can I Expect While Living With Metastatic Breast Cancer
Your care team will monitor you every few months to check if the cancer is responding to treatment, and also to see if you are having any side effects. The process of restaging the cancer includes:
- History/physical exam.
- Imaging tests, including CTs and bone scan or PET scan.
Before your scans or tests, its normal to feel anxiety. It may help to bring a friend or family member to the appointment with you.
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Where Breast Cancer Starts
Breast cancers can start from different parts of the breast. The breast is an organ that sits on top of the upper ribs and chest muscles. There is a left and right breast and each one has mainly glands, ducts, and fatty tissue. In women, the breast makes and delivers milk to feed newborns and infants. The amount of fatty tissue in the breast determines the size of each breast.
The breast has different parts:
- Lobules are the glands that make breast milk. Cancers that start here are called lobular cancers.
- Ducts are small canals that come out from the lobules and carry the milk to the nipple. This is the most common place for breast cancer to start. Cancers that start here are called ductal cancers.
- The nipple is the opening in the skin of the breast where the ducts come together and turn into larger ducts so the milk can leave the breast. The nipple is surrounded by slightly darker thicker skin called the areola. A less common type of breast cancer called Paget disease of the breast can start in the nipple.
- The fat and connective tissue surround the ducts and lobules and help keep them in place. A less common type of breast cancer called phyllodes tumor can start in the stroma.
- Blood vessels and lymph vessels are also found in each breast. Angiosarcoma is a less common type of breast cancer that can start in the lining of these vessels. The lymph system is described below.
To learn more, see Types of Breast Cancer.
Can Tnbc Be Prevented
Researchers dont know all the factors that cause triple negative breast cancer. They have identified the BRAC1 gene mutation as one potential cause for triple negative breast cancer. Unfortunately, you cant prevent BRAC1 because you inherit this gene mutation from your parents.
But there are steps that help prevent breast cancers, including TNBC:
- Maintain a healthy weight.
- Exercise on a regular basis.
- Know your family medical history.
- Monitor your breast health. Studies show 95% of women whose breast cancer was treated before it could spread were alive four years after diagnosis.
- Talk to your healthcare provider about genetic testing for the BRCA gene if you have a family history of breast cancer, ovarian cancer, pancreatic or prostate cancer. If you have the BRCA gene, there are steps you can take to prevent breast cancer.
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Health Disparities In Breast Cancer
There are ethnic disparities in the mortality rates for breast cancer as well as in breast cancer treatment. Breast cancer is the most prevalent cancer affecting women of every ethnic group in the United States. Breast cancer incidence among black women aged 45 and older is higher than that of white women in the same age group. White women aged 60â84 have higher incidence rates of breast cancer than Black women. Despite this, Black women at every age are more likely to succumb to breast cancer.
Breast cancer treatment has improved greatly in recent years, but black women are still less likely to obtain treatment compared to white women. Risk factors such as socioeconomic status, late-stage, or breast cancer at diagnosis, genetic differences in tumor subtypes, differences in health care access all contribute to these disparities. Socioeconomic determinants affecting the disparity in breast cancer illness include poverty, culture, as well as social injustice. In Hispanic women, the incidence of breast cancer is lower than in non-Hispanic women but is often diagnosed at a later stage than white women with larger tumors.
Poverty is a major driver for disparities related to breast cancer. Low-income women are less likely to undergo breast cancer screening and thus are more likely to have a late-stage diagnosis. Ensuring women of all ethnic groups receive equitable health care can positively affect these disparities.
I Have Triple Negative Breast Cancer What Can I Do To Help Myself
You already took the first step when you decided to help yourself. Many times cancer makes people feel as if theyve lost control of their lives. Committing to self-care is one way to overcome that feeling. Here are some things you can do during and after your treatment:
- Triple negative breast cancer is a rare and often misunderstood illness. Many people dont realize this cancer cant be treated the same as other breast cancers. As a result, you might feel isolated and alone with your cancer. If that happens, your healthcare provider can direct you to TNBC support groups and programs where you can talk to people who understand your experience.
- Youll probably need or want help while youre going through treatment. Your friends and family likely are anxious to do what they can. Let them know how they can help you.
- If you will need cancer surgery, ask your healthcare provider what to expect immediately after surgery and any follow-up treatment. Knowing what to expect will help you focus on what you can control rather than what you cant control.
- Cancer is stressful. You might find activities such as meditation, relaxation exercises or deep breathing exercises help to ease your stress.
- Chemotherapy treatments might affect your appetite. Try to eat a healthy diet, and talk to a nutritionist if you’re having trouble eating.
- Radiation treatment can leave you feeling exhausted. Plan to rest as much as possible during your treatment.
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What Is Stage Ii Breast Cancer
Stage II describes cancer that is in a limited region of the breast but has grown larger. It reflects how many lymph nodes may contain cancer cells. This stage is divided into two subcategories.
Stage IIA is based on one of the following:
- Either there is no tumor in the breast or there is a breast tumor up to 20 millimeters , plus cancer has spread to the lymph nodes under the arm.
- A tumor of 20 to 50 millimeters is present in the breast, but cancer has not spread to the lymph nodes.
Stage IIB is based on one of these criteria:
- A tumor of 20 to 50 millimeters is present in the breast, along with cancer that has spread to between one and three nearby lymph nodes.
- A tumor in the breast is larger than 50 millimeters, but cancer has not spread to any lymph nodes.
How Does Cancer Spread Beyond The Breast
Breast cancer can invade through nearby tissue, or spread through the body via the lymphatic system and blood.
- Tissue: the cancer spreads from the original site and grows into nearby areas .
- Lymphatic system: breast cancer cells break away from the original site and can enter nearby lymph tubes , grow in nearby lymph nodes or travel through lymph vessels to other parts of the body.
- Blood: breast cancer cells break away from the original site and can enter and travel through nearby blood vessels to other parts of the body.
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