Stages

If breast cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body.

The Spreading of Cancer


There are three ways that cancer spreads in the body:

Through tissue.
Cancer invades the surrounding normal tissue.

Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.

Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary tumor and travel through the lymph or blood to other places in the body, another, or secondary tumor, may form. This process is called metastasis. The secondary, or metastatic, tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

Stages of Breast Cancer


Stage 0 is carcinoma in situ.

Lobular carcinoma in situ (LCIS), abnormal cells in the lining of a lobule, seldom becomes invasive cancer. However, having LCIS in one breast increases the risk of cancer for both breasts.

Ductal carcinoma in situ (DCIS), abnormal cells lining a duct, is also called intraductal carcinoma. The abnormal cells have not spread outside the duct. They have not invaded the nearby breast tissue. DCIS sometimes becomes invasive cancer if not treated.

Stage I is an early stage of invasive breast cancer. The tumor is no more than 2 centimeters (three-quarters of an inch) across. Cancer cells have not spread beyond the breast.

Stage II is one of the following:

  • The tumor is no more than 2 centimeters (three-quarters of an inch) across. The cancer has spread to the lymph nodes under the arm. 

  • The tumor is between 2 and 5 centimeters (three-quarters of an inch to 2 inches). The cancer has not spread to the lymph nodes under the arm. 

  • The tumor is between 2 and 5 centimeters (three-quarters of an inch to 2 inches). The cancer has spread to the lymph nodes under the arm 

  • The tumor is larger than 5 centimeters (2 inches). The cancer has not spread to the lymph nodes under the arm. 

Stage III is locally advanced cancer. It is divided into Stage IIIA, IIIB, and IIIC.

Stage IIIA is one of the following:

  • The tumor is no more than 5 centimeters (2 inches) across. The cancer has spread to underarm lymph nodes that are attached to each other or to other structures. Or the cancer may have spread to lymph nodes behind the breastbone. 

  • The tumor is more than 5 centimeters across. The cancer has spread to underarm lymph nodes that are either alone or attached to each other or to other structures. 

  • Or the cancer may have spread to lymph nodes behind the breastbone. 

Stage IIIB is a tumor of any size that has grown into the chest wall or the skin of the breast. It may be associated with swelling of the breast or with nodules (lumps) in the breast skin.

  • The cancer may have spread to lymph nodes under the arm. 

  • The cancer may have spread to underarm lymph nodes that are attached to each other or other structures. Or the cancer may have spread to lymph nodes behind the breastbone. 

  • Inflammatory breast cancer is a rare type of breast cancer. The breast looks red and swollen because cancer cells block the lymph vessels in the skin of the breast. When a doctor diagnoses inflammatory breast cancer, it is at least Stage IIIB, but it could be more advanced. 

Stage IIIC is a tumor of any size. It has spread in one of the following ways:

  • The cancer has spread to the lymph nodes behind the breastbone and under the arm. 

  • The cancer has spread to the lymph nodes above or below the collarbone. 

Stage IV is distant metastatic cancer. The cancer has spread to other parts of the body.

Recurrent Cancer is cancer that has come back (recurred) after a period of time when it could not be detected. It may recur locally in the breast or chest wall. Or it may recur in any other part of the body, such as the bone, liver, or lungs.

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