Stage 2b Breast Cancer
With stage 2B breast cancers, the tumor is larger or cancer cells have spread further into the lymph nodes than with stage 2A.
Stage 2B breast cancer meets one of these criteria:
- The breast tumor measures 2 cm to 5 cm, and cancer cells have also been found in the armpit lymph nodes.
- The tumor is larger than 5 cm, but it hasnt spread to the lymph nodes.
How Is The Stage Determined
The staging system most often used for breast cancer is the American Joint Committee on Cancer TNM system. The most recent AJCC system, effective January 2018, has both clinical and pathologic staging systems for breast cancer:
- The pathologic stage is determined by examining tissue removed during an operation.
- Sometimes, if surgery is not possible right away or at all, the cancer will be given a clinical stage instead. This is based on the results of a physical exam, biopsy, and imaging tests. The clinical stage is used to help plan treatment. Sometimes, though, the cancer has spread further than the clinical stage estimates, and may not predict the patients outlook as accurately as a pathologic stage.
In both staging systems, 7 key pieces of information are used:
- The extent of the tumor : How large is the cancer? Has it grown into nearby areas?
- The spread to nearby lymph nodes : Has the cancer spread to nearby lymph nodes? If so, how many?
- The spread to distant sites : Has the cancer spread to distant organs such as the lungs or liver?
- Estrogen Receptor status: Does the cancer have the protein called an estrogen receptor?
- Progesterone Receptor status: Does the cancer have the protein called a progesterone receptor?
- HER2 status: Does the cancer make too much of a protein called HER2?
- Grade of the cancer : How much do the cancer cells look like normal cells?
In addition, Oncotype Dx® Recurrence Score results may also be considered in the stage in certain situations.
T Categories For Breast Cancer
T followed by a number from 0 to 4 describes the main tumor’s size and if it has spread to the skin or to the chest wall under the breast. Higher T numbers mean a larger tumor and/or wider spread to tissues near the breast.
TX: Primary tumor cannot be assessed.
T0: No evidence of primary tumor.
Tis: Carcinoma in situ
T1 : Tumor is 2 cm or less across.
T2: Tumor is more than 2 cm but not more than 5 cm across.
T3: Tumor is more than 5 cm across.
T4 : Tumor of any size growing into the chest wall or skin. This includes inflammatory breast cancer.
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Diagnosing Invasive Breast Cancer
In many people the cancer is found during breast screening.
Its important that you see your GP if you have any symptoms. They may refer you to a specialist breast clinic. At the breast clinic the doctor or specialist nurse takes your medical history and examines your breasts. They also feel for any swollen lymph nodes under your arms and at the base of your neck.
You may have some or all of the following tests:
- a biopsy a small sample of cells or tissue is taken from your breast and looked at under a microscope
Changes seen on the mammogram or ultrasound could be due to cancer, so you may have a biopsy of the breast. You might also have an ultrasound of the lymph nodes under your arm. You may also have lymph node biopsies if they look abnormal.
You should get your results within 1 or 2 weeks at a follow up appointment.
- drugs that help prevent or slow down bone thinning or bone damage
- a combination of these treatments
You may have surgery to your armpit called a sentinel lymph node biopsy. This means having about 3-5 lymph nodes removed. Sometimes surgeons have to remove more lymph nodes. Your doctor will let you know whether you need this.
You might have chemotherapy or hormone therapy before surgery called neoadjuvant therapy. The aim is to shrink the cancer down. This means that some people may be able to have breast conserving surgery, who might have needed removal of the breast .
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.
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Treatment For Early And Locally Advanced Invasive Breast Cancers
Treatment for early and locally advanced invasive breast cancer includes some combination of surgery, radiation therapy, chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies.
The specific treatments depend on the cancer stage and the characteristics of the tumor, such as hormone receptor status and HER2 status.
Stage 0 Vs Stage 1 Breast Cancer
In stage 1 breast cancer, the cancer is invasive, though its small and contained to breast tissue , or a small amount of cancer cells are found in your nearest lymph nodes .
As we explore stage 0 breast cancer, were talking about DCIS, not stage 1 invasive breast cancer or lobular carcinoma in situ .
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Breast Cancer Support And Resources
There are many resources and support groups for breast cancer survivors. Theres no obligation to stick with a group. You can try it out and move on whenever youre ready. You might be surprised to learn that you have a lot to offer others as well.
The American Cancer Society has a variety of support services and programs. You can call the 24/7 helpline at 800-227-2345, visit the
Invasive Ductal Carcinoma Diagnosis
IDC is usually found as the result of an abnormal mammogram. To diagnose cancer, youâll get a biopsy to collect cells for analysis. The doctor will remove a bit of tissue to look at under a microscope. They can make a diagnosis from the biopsy results.
If the biopsy confirms you have cancer, youâll likely have more tests to see how large the tumor is and if it has spread:
- CT scan. It’s a powerful X-ray that makes detailed pictures inside your body.
- PET scan. The doctor injects a radioactive substance called a tracer into your arm. It travels through your body and gets absorbed into the cancer cells. Together with a CT scan, this test can help find cancer in lymph nodes and other areas.
- MRI. It uses strong magnets and radio waves to make pictures of the breast and other structures inside your body.
- Bone scan. The doctor injects a tracer into your arm. They take pictures to find out if cancer has traveled to your bones.
- Chest X-ray. It uses low doses of radiation to make pictures of the inside of your chest.
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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 Symptoms Of Invasive Ductal Carcinoma
In the early stages, invasive ductal carcinoma may not cause any obvious symptoms. Some people may develop certain warning signs, including:
- A new lump in the breast.
- Swelling of the breast.
- Prior radiation to the chest.
- Early start of menstrual periods.
- Late menopause.
- Never being pregnant or having children later in life.
In approximately 5% to 10% of breast cancer cases, invasive ductal carcinoma has been linked to hereditary factors. These include mutations of the breast cancer gene 1 , breast cancer gene 2 and other genes such as PALB2, CHEK2 and ATM.
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Treatment For Invasive Breast Cancer
Treatment for invasive breast cancer usually involves some combination of surgery, radiation therapy, chemotherapy, hormone therapy and/or HER2-targeted therapy.
The order of therapies and the specific treatments depend on the cancer stage and the characteristics of the tumor .
Learn more about treatment.
Quality Of Life For Women Who Choose Breast
Fourteen papers on quality of life, using data from randomized trials of breast-conserving surgery versus mastectomy, have been published.31,32,33,34,35,36,37,38,39,40,41,42,43,44
Poulsen and colleagues31 reported on 184 women who participated in the Danish Breast Cancer Cooperative Group trial. Over an average follow-up of 31 months, no significant differences were found between the 2 types of surgery on measures of physical state, emotional state, social activity, work activity, body image, marital and sexual life or level of anxiety.
Curran and associates32 analyzed data from 278 women who participated in the European Organization for the Treatment of Cancer trial. Two years postoperatively, women in the breast-conserving therapy group had better body image and were more satisfied with treatment than those in the mastectomy group there was no significant difference between the 2 groups with respect to fear of cancer recurrence .
Although survival results are not yet forthcoming, quality-of-life data from the EORTC 10850 trial have been published.44 In 136 women aged 70 years and older, women who underwent breast-conserving and tamoxifen therapy did not differ from those receiving mastectomy in terms of treatment preference, fatigue, emotional function, fear of recurrence, social support, physical functioning and leisure-time activities. Women who underwent breast-conserving therapy did, however, report fewer arm problems and a trend toward improved body image .
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Stage 2 Breast Cancer Symptoms
Patients with stage 2 breast cancer may not experience any symptoms, and the cancer may be discovered during a routine mammogram. Possible breast cancer symptoms in stage 2 include:
- Dimpled skin on the breast
- Swelling or redness
- An inverted or flattened nipple
- Changes to the skin of the breast
- Changes to the size or shape of the breast
What Does It Mean To Have Stage 3 Breast Cancer
Stage 3 cancer means the breast cancer has extended to beyond the immediate region of the tumor and may have invaded nearby lymph nodes and muscles, but has not spread to distant organs. Although this stage is considered to be advanced, there are a growing number of effective treatment options.
This stage is divided into three groups: Stage 3A, Stage 3B, and Stage 3C. The difference is determined by the size of the tumor and whether cancer has spread to the lymph nodes and surrounding tissue.
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Survival Rates Of Stage 1 And Stage 2 Breast Cancer
According to data from the Australian Institute of Health and Welfare, the earlier breast cancer is first diagnosed, the better the outcome. The survival rates of people diagnosed with breast cancer have also improved over time due to earlier detection and improvements in treatment. Most people with early stage breast cancer can be treated successfully.
You may wish to discuss your prognosis and treatment options with your doctors. However, it is not possible to predict the exact course of your cancer and how long you will live. The length of survival can vary from person to person. Factors that influence this include:
- Response to treatment
- The type of breast cancer that you have
- The rate of tumour growth
- Other factors such as your age, medical history and overall health.
What Is The Survival Outlook For Breast Cancer
According to the National Cancer Institute , the percentage of patients surviving five years after diagnosis is:
- 99 percent for breast cancer that is still local to the breast
- 86 percent for breast cancer that has spread just outside the breast
- 29 percent for breast cancer that has spread to more distant parts of the body
The NCI also lists the five-year survival rate for breast cancer overall as 90.6 percent for women and 83 percent for men.
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How Is Ductal Carcinoma In Situ Treated
No two patients are the same. Your doctor will customize your treatment plan based on your test results and medical history. Among other things, your doctor will consider:
- Aggressiveness of the cancer cells
- Your family history of breast cancer
- Results of tests for a gene mutation that would increase the risk of breast cancer
Most women with DCIS don’t have the breast removed with a mastectomy. Instead, they have a lumpectomy.
Most common is a lumpectomy followed by radiation. The surgeon removes the cancer and a small area of healthy tissue around it. Lymph nodes under the arm donât need to be removed as they are with other types of breast cancer.
After a lumpectomy, radiation cuts the chances that the cancer will come back. If cancer does return, itâs called recurrence.
Some women may opt to have a lumpectomy only. Discuss the risks of not having radiation with your doctor before deciding against it.
You and your doctors may decide that a mastectomy to remove the breast is the best course of treatment if you have any of the following:
- A strong family history of breast cancer
- A gene mutation that makes having breast cancer more likely
- Very large areas of DCIS
- DCIS lesions in multiple areas throughout your breast
- Not being able tolerate radiation therapy
You and your treatment team may also consider the use of hormone therapy if the cancer tests positive for hormone receptors. It can cut the chance of getting another breast cancer.
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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.
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Causes Of Invasive Ductal Carcinoma
Unfortunately, doctors have yet to figure out the exact cause of invasive ductal carcinoma. When you get this type of cancer, it means something damaged your cells DNA and caused it to change. The result is that the cells grow abnormally and uncontrollably in your breast tissue.
Doctors are still looking for genetic and environmental factors that damage the DNA. They have determined that caffeine, deodorant, microwaves and cell phone use do not lead to this type of cancer.
What Does It Mean If My Report Mentions Estrogen Receptor Or Progesterone Receptor
Receptors are proteins on cells that can attach to certain substances, such as hormones, that circulate in the blood. Normal breast cells and some breast cancer cells have receptors that attach to the hormones estrogen and progesterone. These 2 hormones often fuel the growth of breast cancer cells.
An important step in evaluating a breast cancer is to test a portion of the cancer removed during the biopsy to see if they have estrogen and progesterone receptors. Cancer cells may contain neither, one, or both of these receptors. Breast cancers that contain estrogen receptors are often referred to as ER-positive cancers, while those containing progesterone receptors are called PR-positive cancers. Women with hormone receptor-positive cancers tend to have a better prognosis and are much more likely to respond to hormone therapy than women with cancers without these receptors.
All breast cancers and pre-cancers, with the exception of lobular carcinoma in situ , should be tested for these hormone receptors when they have the breast biopsy or surgery.
Results for ER and PR are reported separately and can be reported in different ways:
- Negative, weakly positive, positive
- Percent positive
- Percent positive and whether the staining is weak, moderate, or strong.
How the results of your tests will affect your therapy is best discussed with your doctor.
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Survival For All Stages Of Breast Cancer
Generally for women with breast cancer in England:
- Around 95 out of every 100 women survive their cancer for 1 year or more after diagnosis
- Around 85 out of every 100 women will survive their cancer for 5 years or more after diagnosis
- Around 75 out of every 100 women will survive their cancer for 10 years or more after diagnosis
Cancer survival by stage at diagnosis for England, 2019Office for National Statistics
These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer.
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