Making an educated treatment decision begins with 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 develop an appropriate treatment plan for you.
If you have been recently diagnosed, we will review your pathology to confirm you have received the correct diagnosis and staging information, and develop a personalized treatment plan. If you have a recurrence, we will perform comprehensive testing and identify a treatment approach tailored to your needs.
The stage of breast cancer is one of the most important factors in evaluating treatment options. Our cancer doctors use a variety of diagnostic tests to evaluate breast cancer and develop the appropriate treatment plan for you.
Stage 0 (noninvasive, carcinoma in situ): 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.
Also called carcinoma in situ, Stage 0 is the earliest breast cancer stage. This is sometimes interpreted as a precancerous condition. Many stage 0 breast cancers do not require treatment. When they do, the approach is generally very successful.
The five-year survival rate for stage 0 breast cancer is 93 percent. This means that almost all women diagnosed with stage 0 disease will live for at least five years after being diagnosed. In fact, women diagnosed with stage 0 breast cancer usually live long and healthy lives.
At stage 0, the breast mass is noninvasive. At this stage, there is no indication that the tumor cells have spread to other parts of the breast or other parts of the body. Often, stage 0 is considered a precancerous condition that requires close observation, but not treatment.
Stage 0 breast cancer is difficult to detect. There may not be a lump that can be felt during a self-examination, and there may be no other symptoms. However, breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable. Stage 0 disease is most often found by accident during a breast biopsy for another reason, such as to investigate an unrelated breast lump.
There are two types of stage 0 breast cancer:
Ductal carcinoma in situ (DCIS) occurs when breast cancer cells develop in the breast ducts. Today, stage 0 DCIS is being diagnosed more often because more women are having routine mammogram screenings. DCIS can become invasive, so early treatment can be important.
Lobular carcinoma in situ (LCIS) occurs when abnormal cells develop in the lobules. These cells are not cancerous and this condition rarely becomes invasive cancer. However, women who develop LCIS may be at increased risk for developing breast cancer in the future. For women who develop LCIS, the risk of getting an invasive cancer is 20 percent to 25 percent over 15 years after the initial diagnosis.
This breast cancer is the earliest stage of invasive breast cancer. In stage I, the tumor measures up to 2 cm and no lymph nodes are involved. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue.
Because a stage I tumor is small, it may be difficult to detect. However, breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.
Stage I breast cancer is divided into two categories:
The survival rate for stage IA breast cancer may be slightly higher than for stage IB. However, all women with stage I breast cancer are considered to have a good prognosis.
At stage I, TNM designations help describe the extent of the disease. For example, there may or may not be cancer cells in the lymph nodes, and the size of the tumor may range from 1 cm to 2 cm. Most commonly, stage I breast cancer is described as:
Also known as invasive breast cancer, the tumor in this stage measures between 2 cm to 5 cm, or the cancer has spread to the lymph nodes under the arm on the same side as the breast cancer. Stage II breast cancer indicates a slightly more advanced form of the disease. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue, and the tumor is larger than in stage I disease. However, stage II means the cancer has not spread to a distant part of the body.
At stage II, a tumor may be detected during a breast self-exam as a hard lump within the breast. Breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.
Stage II breast cancer is divided into two categories:
The survival rate for stage IIA breast cancer may be slightly higher than for stage IIB. However, all women with stage II breast cancer are considered to have a good prognosis.
At stage II, TNM designations help describe the extent of the disease. Most commonly, stage II breast cancer is described as:
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 III 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 (underarm) 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 III breast cancer is divided into three categories:
Stage IIIA: One of the following is true:
Stage IIIB: The tumor may be any size, and the cancer:
Stage IIIC:
Stage IIIC breast cancer may be operable or inoperable:
The survival rate for stage IIIA breast cancer may be slightly higher than for stage 3B, and the survival rate for stage IIIB may be slightly higher than for stage IIIC. However, all women diagnosed with stage III breast cancer have several promising treatment options.
At stage III, TNM designations help describe the extent of the disease. Higher numbers indicate more extensive disease. Most commonly, stage III breast cancer is described as:
Also known as metastatic breast cancer, the cancer in this stage 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 cancer has spread elsewhere in the body. The affected areas may include the bones, brain, lungs or liver and more than one part of the body may be involved.
At stage IV, TNM designations help describe the extent of the disease. Higher numbers indicate more extensive disease. Most commonly, stage IV breast cancer is described as:
Recurrent breast cancer: The disease has returned after initial treatment. Most recurrent cancers appear within the first two or three years after treatment, but breast cancer can recur many years later. Recurrent 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 treated with surgery) is called a local recurrence. If the disease appears in another part of the body, it is referred to as metastatic breast cancer or regional recurrence. Cancer cells may travel away from the original tumor in the breast to other parts of the body through the lymphatic system or bloodstream. Common metastatic areas include the bones, liver and lungs. Even when a metastatic breast tumor spreads to a different part of the body, it contains the same cancerous cells that developed in the breast.
It is important to report new signs or symptoms of breast cancer to your doctor. Symptoms of recurrent breast cancer vary from person to person.
Signs and symptoms of local breast cancer recurrence may include:
Signs and symptoms of metastatic breast cancer may include:
According to the Susan G. Komen® organization, women with early breast cancer most often develop local recurrence within the first five years after treatment. On average, 7 percent to 11 percent of women with early breast cancer experience a local recurrence during this time.
For patients with a family history of cancer, or a BRCA1 or BRCA2 gene mutation, the cancer recurrence rate is higher. The risk of finding new cancers, such as ovarian cancer, may also be higher. Cancer recurrence risk is based on many factors, including the cancer type and how it was treated.
Women should be familiar with how their breasts normally look and feel, and report any changes to a health care provider right away. They should also see their doctor for follow-up visits, so he or she may examine the breasts, discuss any new symptoms and order lab or imaging tests, if necessary. Continuing routine screenings and annual checkups is important in detecting breast cancer recurrence early.
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