Breast Cancer Stages
Description of Stages of Breast Cancer and Treatment
Note: Treatment options included here are only for stage II and the more advanced
stages, as described by PDQ, a computer system
operated as a service of the National Cancer Institute.
Please see the information resources
section to learn how to contact PDQ.
Stage 0: Breast cancer stages
A contained cancer with no evidence of invasion and therefore no spread to the lymph
nodes, other organs, or tissue. Doctors call this carcinoma in situ.
Stage I: Breast cancer stages
The primary cancer is 2
cm (about 3/4 inch) or less in diameter without any spread to the lymph nodes.
Stage IIA: Breast cancer stages
The primary tumor is between 2 and 5 cm in
diameter and has not spread to the lymph nodes.
Stage IIB: Breast cancer stages
The primary tumor is between 2 and 5 cm in diameter and has spread to underarm lymph
nodes, or the primary tumor is over 5 cm and has not spread to the lymph nodes.
Treatment: Surgery followed by radiation therapy. The surgical options are as
follows: lumpectomy (removing the cancer and some surrounding tissue with axillary node
dissection), partial or segmental mastectomy (removing part of the breast and armpit lymph
nodes), total mastectomy (removing the entire breast and armpit area lymph nodes) or
modified radical mastectomy (removing entire breast, the lining over the chest muscles,
and armpit lymph nodes), and radical mastectomy (removing entire breast, chest muscles,
and armpit lymph nodes). Radical mastectomy is rarely used now, except in situations in
which the cancer has spread to the chest muscles. The specific surgical recommendation is
based on tumor size and location and its appearance on the mammogram.
Adjuvant therapy:This
follows the primary surgical treatment when all known tumor is removed. It includes
chemotherapy with or without hormonal therapy, hormonal therapy or entry into one of
several clinical trials that are evaluating chemotherapy before surgery and chemotherapy
and/or hormone therapy after surgery, or no postsurgery adjuvant therapy for patients with
a good chance of recovery. Patients with more than 10 cancerous lymph nodes may be
candidates for a National Cancer Institute-approved CLINICAL TRIALcomparing HDC
with ABMT/BCT to standard-dose chemotherapy. (Please see What kinds of studies are going on now?)
Stage IIIA: Breast cancer stages
The differences between stages IIB and IIIA are subtle and related to the lymph nodes
involved. Stage IIIA is a primary breast cancer of any size that has spread to underarm
and other nearby lymph nodes and surrounding armpit tissues.
Treatment: Surgical options are modified radical mastectomy or radical
mastectomy. Radiation therapy is given before or after surgery. Chemotherapy with or
without hormone therapy is given with surgery and radiation therapy. Clinical trials are
evaluating the following treatments: new standard-dose chemotherapy regimens with or
without hormonal drugs, chemotherapy before surgery, and HDC with ABMT/BCT compared to
conventional chemotherapy.
Stage IIIB: Breast cancer stages
Primary cancer of any size attached to the chest wall. It can involve the skin, ribs,
and muscles in the chest. The cancer may have spread to the lymph nodes inside the chest
near the breast bone.
Treatment:The patient undergoes a biopsy of the tumor, but in a
majority of cases, the cancer found cannot be removed during the surgery. Some patients
may undergo a mastectomy after radiation therapy if the cancer has markedly shrunk.
Patients are offered:
- chemotherapy;
- hormonal therapy with or without surgery to remove ovaries; and/or
- entry into a clinical trial that is testing new chemotherapy drugs, biological therapy,
or new drug combinations. HDC with ABMT/BCT may be discussed.
Stage IV (metastatic):
Breast cancer stages
Primary cancer of any size that has spread to other sites of the body, most often the
bone, lungs, liver, or brain, or the tumor has spread to the breast skin and other lymph
nodes along the side of the neck or near the collarbone.
Treatment:Options at this stage are usually considered to be palliative-that is,
they focus on relieving symptoms, extending the patient's survival time, and improving the
patient's quality of life. Unfortunately, the medical and surgical treatments available at
this time cannot offer a cure for this stage of cancer. However, the cancer in some
patients does respondto
therapy, and therapy may offer some time without progression of the cancer or some time
with no detectable cancer. Treatment usually begins with a BIOPSYfollowed by one or more of
these options: chemotherapy, radiation (and perhaps mastectomy to relieve symptoms),
hormonal therapy with or without removal of the ovaries and/or entry into a clinical trial to test HDC with
ABMT/BCT, hormonal drugs, or biological therapy.
Inflammatory breast cancer: Breast cancer stages
This is a primary breast
cancer in which the breast appears inflamed because it is red and warm. The breast is
generally quite firm and may or may not be associated with a breast mass. The skin may
appear dimpled or have ridges. This type of cancer tends to spread quickly unless treated
appropriately.
Treatment: Similar to the options for patients with stage IIIB or IV breast
cancer. Patients are usually given neoadjuvant treatment, which is a combination of
chemotherapy, hormonal therapy, and radiation therapy. Patients whose cancer shows a good
partial or complete response undergo mastectomy.
Recurrent breast cancer: Breast cancer stages
This is breast cancer (at any stage) that returns after a time during which no tumor
was detectable. It can return in the original breast site or in another part of the body.
A small number of patients with recurrent cancer can be cured, especially if it has
returned in the breast in which lumpectomy and axillary lymph node dissection was done,
and all can be treated. But, if the recurrent breast cancer appears in another part of the
body, these patients usually cannot be cured.
Treatment: Options include one or more of the following:
- hormonal therapy and possibly removal of ovaries;
- surgery and/or radiation therapy if the recurrence is in one place only and is operable;
- radiation to relieve pain if the recurrence is in the bones and other places; and/or
- entry into a clinical trial testing new chemotherapy drugs, new hormonal drugs,
biological therapy, or HDC with ABMT/BCT.
|