You may want to know the stage and grade of breast cancer after you or a loved one has discovered a lump and been diagnosed with the disease. The answers are essential for your breast cancer treatment plan to decide on the best approach for your cancer type.
Your doctor can utilize any option to determine the stage of breast cancer. Clues can come from biopsies, X-rays, blood tests, physical tests, and specific imaging techniques. A pathologist (specialist doctor) can examine samples from your lymph nodes or breasts to establish the presence and extent of breast cancer.
The treatment team often generates a code from the tests showing the extent of the cancer. The string of letters and numbers helps doctors to identify the available treatment options.
You wonder what the stages of breast cancer are. This article will tell you everything you need to know about how each breast cancer stage is determined, your health at that point, and the best treatment options.
Breast cancer grades
Your doctor may want to know the grade of your breast cancer after knowing its stage. The process involves measuring cancer cells’ appearance and growth rate relative to normal ones. Your treatment team can then predict whether they can spread to other body parts. Grading complements staging when identifying suitable treatment options and possible outcomes.
Cancer cells’ grades can be determined by checking how different they are from normal cells. After careful observation, cancer cells may be assigned letters between 1 and 3, as illustrated below:
- Grade 1 (well differentiated): The cancerous cells are similar to normal breast tissue, and their growth is slow.
- Grade 2 (moderately differentiated): Doctors notice slight differences between the cancerous cells and normal ones. Their growth is faster than in stage 1.
- Grade 3 (poorly differentiated): Cancer cells differ from normal ones. Their growth is rapid, and they are likely to spread to other areas.
Doctors can also assess for abnormal cells in milk ducts within the breast—ductal carcinoma in situ (DCIS). DCIS is often limited to the milk duct, with a low risk of spreading cancer cells to other tissues.
What is cancer staging?
Staging[1] determines the extent of breast cancer. The description indicates the tumor size and the parts to which the cancer has spread. Lymph nodes are a primary area where doctors check for carcinogenic cells. Staging also states the biomarkers in the specific case.
Your doctor can conduct specific tests (for staging) either before or after breast cancer surgery. The clinical stage refers to the cancer staging done before breast cancer surgery, while the one done after is called the pathological (stage). Several diagnostic tests may be necessary for complete staging. Your breast cancer treatment team can anticipate the outcome based on the assessment and the available intervention options.
Let us consider the most common staging approaches used by doctors:
- TNM staging system
- Stage groups for breast cancer
TNM staging system
Your doctor can use the TNM system when analyzing your case and breast cancer type. The aim is to answer the following questions using specific diagnostic tests:
- Tumor (T)- Doctors first check the size of the primary tumor in the breast. They also establish the biomarkers (the indicators that you have breast cancer).
- Node (N)- doctors check whether cancer has spread to the lymph nodes. The tests also establish the size, location, and the number of infected cells.
- Metastasis (M)- The team checks whether cancer has spread to other body parts.
There are five main stages of cancer, as discussed here. Stage 0 is non-invasive DCIS. Invasive cancer has four stages—stages I to IV.
Let us consider a few specific aspects of the TNM staging system.
Tumor
“T” is placed alongside another letter or number to indicate the tumor’s presence, size, and location. The tumor size is measured in centimeters.
Dividing a stage into smaller groups enables doctors to describe the tumor in more detail. Tumor stage information can be expressed as follows:
TX: It is impossible to evaluate the primary tumor at this stage.
T0: doctors are unable to establish the presence of breast cancer.
Tis: the cancer is confined to the milk ducts—carcinoma in situ. This stage has two stages:
- Tis (DCIS): DCIS is non-invasive. But, late and poor treatment could lead to the spread of cancer cells to other body parts. The cancer is still within the breast at this breast cancer stage.
- Tis (Paget’s disease): The cancer is only on the skin on the nipple. Paget’s disease can sometimes occur with invasive cancer types.
T1: The tumor is less than 20 millimeters in width. T1 has four substages to denote the nature of the tumor.
- T1mi is where the tumor is 1 millimeter wide or less.
- T1a- the tumor is less than 5 mm in width, but above 1 mm.
- T1b- the tumor is above 5 mm wide but smaller than 10 mm,
- T1c- the width of the tumor is up to 20 mm (from 10 mm)
T2: the tumor is above 20 mm in width, but less than 50 mm in its widest area.
T3: the tumor is larger than 50 mm.
T4: the stage has the following subgroups:
- T4a- the tumor has extended to the chest wall.
- T4b- the tumor has reached the skin.
- T4c- cancer cells are in both the skin and the chest wall.
- T4d is inflammatory breast cancer[2]. This type can manifest through redness, swelling, and pain in the breast.
Node (N)
The “N” in the TNM system denotes lymph nodes. It is crucial to note that lymph nodes are involved in fighting infections. Regional lymph nodes are the ones located near the area with cancer cells. When one has breast cancer, they include:
- Axillary lymph nodes—located under the arm.
- The lymph nodes are located around the collarbone (above and below).
- Mammary lymph nodes – located under the breastbone.
“Distant lymph nodes” is the term that refers to ones located further away from the cancer cells. The following abbreviations indicate how cancer staging is done:
NX: This is where the lymph nodes have not been evaluated.
N0: the abbreviation can indicate either of the following:
- The absence of cancer cells in the lymph nodes.
- The cancer cells in the lymph nodes are less than 0.2 mm wide.
N1 indicates that cancer has spread to up to 3 axillary lymph nodes.
N2: Cancer cells were found in up to 9 axillary lymph nodes.
N3: Cancer has reached up to 10 lymph nodes.
Breast cancer stages
Doctors can use major stages (0-IV) to help you understand the state of your breast cancer[3]. They can include abbreviations from stating systems such as the TNM (discussed above) to give an accurate review.
Stage 0
The disease is only in the milk ducts—it has not spread to surrounding tissues. Your doctor may call it in situ (non-invasive) cancer.
Stage I
Stage IA: The tumor is still within the breast, outside the milk ducts. But, it has not reached the lymph nodes (T1, N0, M0).
Stage IB: Cancer has reached the lymph nodes. The tumors are less than 2 mm wide (T0 or T1, N1, M0).
Stage II
Stage IIA: The stage could involve the following:
- There is no tumor in the breast. Cancer cells have spread to up to 3 axillary nodes but not distant body parts (T0, N1, M0)
- The tumor is less than 20 mm wide and is present in up to 3 axillary nodes (T1, N1, M0).
- The tumor is up to 50 mm wide but not present in axillary nodes (T2, N1, M0)
Stage IIB: the stage could involve the following:
- The tumor is up to 50 mm wide but has not spread to up to 3 axillary nodes (T1, N1, M0).
- The tumor is wider than 50 mm but in less than 3 axillary nodes (T2, N1, M0).
Stage III
Stage IIIA: The tumor can be of any size and present in up to 9 axillary nodes. Cancer has not spread to other body parts (T0, T1, T2, OR T3; N2; M0). Stage IIIA is also when a tumor in 3 axillary nodes is more than 50 mm wide (T3, N1, M0).
Stage IIIB: The tumor has spread to the chest wall. It comes as inflammatory breast cancer. It has not spread to other body parts (T4; N0, N1, or N2; M0).
Stage IIIC: A tumor of any size is in up to 10 axillary nodes but not other body parts (T, N3, M0).
Stage IV (metastatic)
The tumor has spread to other body parts (any T, any N, M1). It is uncommon to get a stage IV diagnosis without a history of cancer.
Metastasis (M)
The “M” in TNM stands for metastasis. It refers to cancer that has spread across the body. The following abbreviations indicate the actual state:
MX: Doctors did not find cancer cells in other body parts.
M0: there is no evidence of cancer cells in other body parts.
M0 (i+): There are traces of cancer cells in the blood, bone marrow, and other lymph nodes.
M1: Cancer cells from the breast are growing in other body parts.
About Alternative/Natural Treatment of Breast Cancer
Medical treatment for breast cancer can involve one or several surgeries—such as lumpectomy and mastectomy. Your doctor can also recommend chemotherapy, specific medications, and radiation therapy for breast cancer prevention or recurrence. While medications and invasive procedures can help, they may have intense side effects. For instance, they can bring fatigue and reduce your ability to fight off illness effectively. Thus, alternative treatment can help you to fight early breast cancer while minimizing the side effects of traditional medications.
Curious about how to treat breast cancer without surgery? Immunity Therapy Center offers many alternative treatment options for breast cancer. Our dedicated team offers a personalized breast cancer treatment plan based on your cancer progression and health.
Contact us today, and schedule a free consultation to learn more about alternative treatments. Call our team at any time for assistance.
Written By: Dr. Pablo Orozco
Dr. Pablo Orozco is a Board Certified Medical Doctor from Universidad Autónoma de Baja California.
Dr. Orozco has been a treating physician at the Immunity Therapy Center for more than 3 years providing daily on site patient care. He works with patients on a daily basis and guides them through the treatment process. Dr. Orozco’s passion for Alternative Cancer Treatments along with his commitment to patient care is key to insure that our patients have the best experience and results possible.
Sources:
- Johns Hopkins University. Staging and Grade. https://pathology.jhu.edu/breast/staging-grade/
- Cancer.net. Breast Cancer- Inflammatory. https://www.cancer.net/cancer-types/breast-cancer-inflammatory
- American Cancer Society. Stages of Breast Cancer. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/stages-of-breast-cancer.html
At Immunity Therapy Center, our goal is to provide objective, updated, and research-based information on all health-related topics. This article is based on scientific research and/or other scientific articles. All information has been fact-checked and reviewed by Dr. Carlos Bautista, a Board Certified Medical Doctor at Immunity Therapy Center. All information published on the site must undergo an extensive review process to ensure accuracy. This article contains trusted sources with all references hyperlinked for the reader's visibility.