Stage 1 Breast Cancer
What is Stage 1 breast cancer?
Stage 1 breast cancers are still relatively small, and theyve either not yet spread to the lymph nodes or theres only been a tiny bit of spread in the sentinel lymph node which is where the cancer is most likely to spread first. There are two types of Stage 1 breast cancer:
- Stage 1A Stage 1A breast cancer means the tumor is no larger than 2 centimeters, and the cancer has not spread outside the breast or to lymph nodes.
- Stage 1B Stage 1B breast cancer means there are small groups of cancer cells in the lymph nodes. There may or may not be a tumor smaller than 2 centimeters in the breast.
What are the treatment options for Stage 1 breast cancer?
- Surgery Like with Stage 0, a lumpectomy and mastectomy are both options at this stage:
- Lumpectomy This kind of breast conservation surgery is a viable option when the cancerous cells are confined to one area of the breast.
- Mastectomy A mastectomy may be recommended if cancer is found throughout the breast.
Stage 1 breast cancer treatment timeline
Living With Stage : The Breast Cancer No One Understands
Editor’s note: We’re bringing back this piece from October 2014 for Metastatic Breast Cancer Awareness Day and to honor Jody Schoger, featured in the story. Schoger died of metastatic breast cancer in May. Want to learn more about MBC? Look for our tweets at the Northwest Metastatic Breast Cancer Conference this Saturday at Fred Hutch.
A no-nonsense Texan of 60 years, Jody Schoger* has a very no-nonsense way of educating people about her metastatic breast cancer.
âSomeone will say, âWhen are you done with treatment?â and Iâll tell them, âWhen Iâm dead,ââ said Schoger, a writer and cancer advocate who lives near Houston. âSo many people interpret survivorship as going across the board. That everybody survives cancer now. But everybody does not survive cancer.â
An estimated 155,000-plus women in the U.S. currently live with âmets,â or metastatic breast cancer. This type of cancer, also called stage 4 breast cancer, means the cancer has metastasized, or traveled, through the bloodstream to create tumors in the liver, lungs, brain, bones and/or other parts of the body. Between 20 and 30 percent of women with early stage breast cancer go on to develop metastatic disease. While treatable, metastatic breast cancer cannot be cured. The five-year survival rate for stage 4 breast cancer is 22 percent median survival is three years. Annually, the disease takes 40,000 lives.
Is Stage 1a Breast Cancer Curable
Although the majority of women with Stage I breast cancer are cured following treatment with surgery and radiation, some patients may benefit from additional treatment with chemotherapy and/or hormonal therapy. Treatment after surgery is called adjuvant therapy and it may further decrease the risk of cancer recurrence.
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Myth #: Metastatic Breast Cancer Is A Single Type Of Cancer That Will Be Treated The Same Way For Every Person
The label metastatic contributes to the myth that it is one kind of breast cancer. But like earlier-stage breast cancers, stage IV cancers can have different characteristics that will guide treatment choices. They can test positive or negative for hormone receptors and/or an abnormal HER2 gene the gene that causes the cells to make too many copies of HER2 proteins that can fuel cancer growth. These test results guide treatment choices.
For triple-negative stage IV cancers meaning they test negative for hormone receptors and an abnormal HER2 gene testing for PD-L1 is becoming more common. PD-L1 is a checkpoint protein found on the surface of healthy cells that prevents the bodys immune system T-cells from attacking them. Some breast cancer cells also have large amounts of PD-L1 on their surfaces, which helps shield them from the bodys immune response. Newer immunotherapies are being used to treat PD-L1-positive MBC.
Furthermore, treatment choices can depend on a persons age, overall health, and whether there are other medical conditions present.
The bottom line? Treatments vary. DivineMrsM of Ohio says it well: There is the misconception that there is one standardized treatment for every case of MBC, like a one size fits all. But there are different approaches and it cant always be said that one approach is better than another. Most people dont realize different subcategories of this disease.
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What Is Stage 3 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.
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What Causes Breast Cancer Recurrence
The goal of cancer treatments is to kill cancer cells. But, cancer cells are tricky. Treatments can reduce tumors so much that tests dont detect their presence. These weakened cells can remain in the body after treatment. Over time, the cells get stronger. They start to grow and multiply again.
Even surgery to remove a cancerous tumor isnt always 100% effective. Cancer cells can move into nearby tissue, lymph nodes or the bloodstream before surgery takes place.
How Long Does It Take Breast Cancer To Grow
Every type of breast cancer varies based on individual factors and subtypes, says Dr. Roesch.
Different types of breast cancer tend to behave differently, and because every cancer is different and every person is too its hard to say exactly how quickly breast cancer can grow and spread. Still, experts understand that some types of breast cancer tend to be more aggressive and fast moving, while other types typically move slower.
Speed of breast cancer growth can be influenced by these factors:
Your cancer team will determine how likely or fast your breast cancer may spread based on your breast cancer subtype, stage and individual factors. Although breast cancer experts can hypothesis and estimate the speed of cancer growth, every breast cancer is different and distinctive to that person.
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How The Breast Cancer Staging Process Starts
The breast cancer staging process begins with diagnostic testing. Depending on previous screening results, if any breast cancer symptoms are present, and other factors, your doctor may recommend one of the following tests:
- Diagnostic mammogram A mammogram involves using an X-ray to take photos of your breast tissue at different angles. To do this, your breasts are gently compressed between two plates so the X-ray can be taken.
- Ultrasound An ultrasound is a non-invasive imaging test that bounces soundwaves of your breast tissue to create a picture of the inside of your breast.
- MRI An MRI is another non-invasive imaging test that uses radio waves and a magnetic field to create an image of your breast tissue. This can help doctors determine the size and placement of tumors.
- Biopsy A biopsy removes small masses and growths from your breast so they can be examined under a microscope by a pathologist and determine if theyre cancerous.
If cancer is detected, a CT scan may be ordered to look for any distant metastasis or local invasion to other organs. And youll likely be connected with a breast surgeon right away, either through a nurse navigator or your doctor.
Difficulty Swallowing Or Not Wanting To Eat Or Drink At All
There will come a time when the dying person won’t want to eat or drink anything. It is important not to try and force them to eat or drink. This will make them uncomfortable.
You can give them small pieces of ice to suck or sips of fluid, if they are still awake. This will keep their mouth moist. You can put lip balm on their lips to help stop them getting dry and sore.
Even if they cant take anything into their mouth, you can moisten their lips and mouth every 1 to 2 hours with lemon and glycerine swabs or water. Your GP or district nurse can get you the swabs.
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What Are The Types Of Breast Cancer Recurrence
If you develop cancer in the opposite, untreated breast , you receive a new breast cancer diagnosis. This isnt the same as breast cancer recurrence.
When breast cancer returns, it may be:
- Local: Cancer returns in the same breast or chest area as the original tumor.
- Regional: Cancer comes back near the original tumor, in lymph nodes in the armpit or collarbone area.
- Distant: Breast cancer spreads away from the original tumor to the lungs, bones, brain or other parts of the body. This is metastatic cancer, often referred to as stage 4 breast cancer.
Stage 2 Breast Cancer
What is Stage 2 breast cancer?
Stage 2 breast cancer cells or tumors are larger than Stage 1 cancers, and may have spread to nearby lymph nodes. There are two types of Stage 2 breast cancer:
- Stage 2A Generally speaking, Stage 2A breast cancer can indicate one of the following:
- No tumor can be found in your breast, but cancer larger than 2 millimeters can be found in one to three underarm lymph nodes or near the breastbone.
- The tumor measures 2 centimeters or smaller, and has spread the nearby axillary lymph nodes.
- The cancer has not spread to area lymph nodes, however, the tumor measures between 2 and 5 centimeters.
What are the treatment options for Stage 2 breast cancer?
Stage 2 breast cancer treatment timeline
Again, it depends on what treatments or follow-up therapies are needed. Generally, the treatment timeline for Stage 2 breast cancer can last three to six months. Again, certain treatments like hormone therapies designed to stop the cancer from coming back can last for one to 10 years.
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Complete Loss Of Consciousness
At the end of life, the chemical balance of the body becomes completely upset. The dying person then slips into unconsciousness. This is usually right towards the end, maybe only a few hours or days before death.
The persons breathing becomes irregular and may become noisy. You wont be able to wake them at all. Their breathing will stay irregular for some time and will stop at some point.
What Is The Life Expectancy For Stage 3 Breast Cancer
The life expectancy for people with breast cancer is improving, according to the American Cancer Society. It points out that current survival rates are based on people who were diagnosed and treated at least 5 years ago and treatments have advanced over that time.
Your life expectancy with stage 3 breast cancer depends on several factors, such as:
- your age
- the size of the tumors
You should talk with your doctor about how these factors may apply to you.
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What To Know About Breast Cancer Growth
Breast cancer occurs when normal cells mutate and multiply faster than usual. One cell divides to become two cells, then each of those cells divides to become four cells, and so on. The uncontrolled multiplication of cancer cells creates tumors within the breast tissue.
The speed at which a cancer progresses depends on the growth rate of the cancer cells. It is hard to estimate cancer growth because not all cancer cells multiply and divide at the same speed.
In most cases, breast cancer initially develops in either the milk ducts or the lobules, which are the glands that produce milk, before expanding into the breast tissue.
Breast cancer that develops in ducts or lobules can spread to the connective tissue. From there, it can spread to the surrounding lymph nodes.
Once in the lymph nodes, the cancer cells can enter the lymphatic system or the bloodstream, where they can move to other areas of the body.
Emotional And Spiritual Changes
Everyone will feel different emotions when they are dying. A lot depends on:
- the type of person they are
- their age
- how much support they have
- their religious and spiritual beliefs
- the experiences they have had in life
Someone dying in their 20s is likely to feel very differently from someone who is 80. And someone leaving behind young children will have different worries from someone whose children are grown up and able to take care of themselves.
As death gets closer they might begin to let go and seem more at peace with things. Others might become very anxious, fearful or angry. Some people could appear to withdraw, even from the people they love and care about. But this doesnt mean that they dont care anymore.
These events are all very normal and are a natural part of dying.
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Neoadjuvant Chemotherapy And Neoadjuvant Her2
With neoadjuvant chemotherapy, all the chemotherapy to treat the breast cancer is usually given before surgery . If the tumor doesnt get smaller with the first combination of chemotherapy drugs, other combinations can be tried.
If your tumor is HER2-positive, you may get neoadjuvant trastuzumab and neoadjuvant pertuzumab , but not at the same time as the chemotherapy drug doxorubicin .
Clinical Manifestations Of Stage 4
The main classification signs of breast cancer stage 4 are its spread to remote organs or lymph nodes. The size of the tumor at this stage is no longer important moreover, it may no longer be detected at the primary site.
It is the metastases that most often develop in the liver, lungs, and bones that give information about the development of the oncological process. They are painful and cause vivid symptoms. Metastases in the liver give jaundice and increase abdominal size. Metastases in the lungs give shortness of breath, and in the bones severe pain and frequent fractures.
- severe intoxication
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How Often Does Stage 1 Breast Cancer Come Back After Treatment
If stage 1 cancer is treated comprehensively, it rarely comes back. A new, unrelated breast cancer is more likely to emerge after stage 1 breast cancer is treated than a recurrence. Your healthcare provider will recommend a surveillance schedule for you so that new breast cancer or a recurrence can be identified and treated as quickly as possible.
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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How Long Does It Take For Stage 1 Breast Cancer To Develop Into Stage 2
It is not possible to determine exactly how long it will take for newly diagnosed breast cancer to progress from stage 1 to stage 2. It can happen within months if it is an aggressive high-grade tumor, or it can take longer. It’s important to know that stage 1 breast cancer could have already been present for a while before being detected, so it may progress quickly.
Treatment For Stage 4 Breast Cancer
Typically, treatment for stage 4 breast cancer includes a combination of chemotherapy, radiation therapy, and hormone therapy .
Targeted therapy is a treatment that targets the protein that allows cancer cells to grow and this type of therapy may also be an option for people with stage 4 breast cancer.
Sometimes, surgeons will operate to try and remove tumors though this is not usually the first option for treatment.
Doctors, however, may recommend surgery to help with pain relief by treating some of the issues that may develop as a result of having stage 4 breast cancer. These include spinal cord compression, removing single masses caused by metastasis, and fixing any broken bones.
A doctor may also prescribe medication to treat related symptoms such as:
- antidepressants to help mood
- anticonvulsants to manage pain or neurologic conditions
- local anesthetics to manage pain
New treatments and therapies are emerging all the time, and anyone who has breast cancer at any stage can volunteer to try out these new treatments. People considering this should talk to their doctor to see whether any trials are available in their area.
Trials for a new treatment called immunotherapy are currently taking place. Immunotherapy works by raising the bodys natural ability to fight off cancer and has fewer side effects than chemotherapy.
As well as numbers, a zero or an X often follow the letters T, N, and M. According to the AJCC, the meanings are as follows:
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