Breast Cancer Stages / Staging

Making an educated treatment decision begins by learning the stage, or progression, of the disease. Using the results from your diagnostic tests, your care team at Cancer Treatment Centers of America (CTCA) will determine the location, type, size and stage (extent) of the breast cancer.

This information, along with factors such as your general health and personal preferences, will help your care team determine which treatments will be best suited to you.

Breast Cancer Staging

Breast cancer staging is a critical component of developing each individual’s personalized treatment plan. Below are the universally accepted descriptions of each breast cancer stage:

Stage 0 (noninvasive carcinoma, carcinoma in situ) Breast Cancer

In stage 0, there is no evidence of cancer cells breaking out of the part of the breast in which they started, or of getting through to or invading neighboring normal tissue. This very early breast cancer stage is sometimes interpreted as a precancerous condition.

Stage 1 Breast Cancer

Stage 1 is an early stage of the disease, in which the tumor measures up to two centimeters and no lymph nodes are involved.

Women with early stage breast cancer may have breast-sparing surgery (e.g., lumpectomy) followed by radiation therapy as their primary local treatment, or they may have a mastectomy (removal of the entire breast) with or without breast reconstruction to rebuild the breast. Sometimes radiation therapy is also given to the chest wall after surgery. In addition, chemotherapy and/or hormone therapy may also be given to try to destroy any remaining cancer cells and prevent the breast cancer from recurring. 

Stage 2 Breast Cancer

Stage 2  breast cancer describes invasive cancer in which the tumor measures between two to five centimeters, or the cancer has spread to the lymph nodes under the arm on the same side as the breast cancer. Stage 2 breast cancer is divided into subcategories known as stage 2A and stage 2B. 

Stage 2A – There are three ways this phase may manifest itself:

• There is no tumor found in the breast, but cancer is found in the underarm lymph nodes.
• Cancer in the breast spans two centimeters and also encompasses nearby lymph nodes.
• Cancer located within the breast is larger than two centimeters and smaller than five centimeters, but does not affect the lymph nodes.

Stage 2B – This stage may include one of the following:

• The tumor is between two and five centimeters and has spread to underarm lymph nodes.
• The breast cancer tumor is larger than five centimeters, but lymph nodes remain unharmed.

Women with stage 2 breast cancer may have breast-sparing surgery (e.g., lumpectomy) followed by radiation therapy, or a mastectomy (removal of the entire breast) with or without breast reconstruction to rebuild the breast. Women may also have lymph nodes under the arm removed. Sometimes, women have chemotherapy before surgery (neoadjuvant therapy) to shrink a tumor, or after surgery (adjuvant therapy) to destroy any remaining cancer cells and prevent the cancer from recurring. Women may also have a combination of other therapies, such as hormone therapy.

Stage 3 Breast Cancer

Also called locally advanced cancer, in stage 3 breast cancer, the tumor in the breast is more than two 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 divided into subcategories known as stage 3A, stage 3B, and stage 3C.

Stage 3A – This stage is defined by either of the following:

• The tumor measures larger than five centimeters.
• There is significant involvement of lymph nodes. The nodes clump together or stick to one another or surrounding tissue.

Stage 3B – This stage is defined by either of the following

• Cancer has spread to tissues near the breast, such as the skin or chest wall. The tumor may range in size.
• Underarm lymph nodes or those beneath the breast under the ribs may be affected.

Stage 3C – Cancer may or may not be in the breast and may have spread to the breast skin or chest wall. Cancer permeates lymph nodes around the collarbone and may also be in the lymph nodes surrounding the breast bone.

Women with stage 3 breast cancer may have chemotherapy and/or targeted therapies first in order to shrink the tumor to make surgery possible. After surgery, women may have chemotherapy, targeted therapy, hormone therapy or a combination of treatments to help prevent recurrence.

Stage 4 (Metastatic) Breast Cancer

In stage 4, the cancer has spread beyond the breast, underarm and internal mammary lymph nodes to other parts of the body near to or distant from the breast. The tumor may have spread to the supraclavicular lymph nodes (nodes located at the base of the neck, above the collarbone), bones, liver, lungs, skin or brain.

Women with metastatic breast cancer will receive treatment based on where the cancer has spread. The bone is the most common site of spread from breast cancer. Treatments for metastatic breast cancer to bone may include orthopedic oncology, hormone therapy, chemotherapy, targeted therapy, radiation therapy or a combination of treatments.

Recurrent Breast Cancer

Recurrent breast cancer means the disease has returned in spite of the initial treatment. Most recurrences appear within the first two or three years after treatment, but breast cancer can recur many years later. This type of breast cancer may come back in the breast, chest wall or in other parts of the body.

Breast cancer that returns locally (i.e., in the area of the surgery) is called a local recurrence. If the disease returns in another part of the body, it is called metastatic breast cancer. Women with recurrent breast cancer will receive treatment based on where the cancer returned.

Breast Cancer Stages Treatment Options at CTCA

No matter which breast cancer stage you are facing, it is important to remember that you have choices. The breast cancer experts at CTCA offer a number of innovative treatments and technologies for all stages of the disease, including metastatic and recurrent cancer.

At CTCA, your care team will take the time to listen to you and develop a personalized breast cancer treatment plan that is built around your unique needs and preferences.

When you're ready to learn more, call 1-800-615-3055 or Chat Now to talk with one of our Oncology Information Specialists. Our representatives are available 24 hours a day, every day of the week.

Next Topic: Breast Cancer Treatments