October is
"Breast Cancer Awareness" Month

The Stages of Breast Cancer

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If breast cancer is found, more tests will be done to find out if the cancer has spread from the breast to other parts of the body. This is called staging. To plan treatment, your healthcare professional needs to know the stage of the disease.

The following stages are used for breast cancer:

• Carcinoma in situ: Up to 20 percent of breast cancers are very early cancers, sometimes called ductal carcinoma in situ (DCIS).

• Another condition that may be discovered early is atypical lobular neoplasia (ALN), which is not cancer. Sometimes ALN is found when a biopsy is done for another lump or abnormality found on the mammogram. Women with this condition have a 25 percent chance of developing breast cancer in either breast in the next 25 years.

• Stage I:  The cancer is no larger than 2 centimeters and cannot be detected outside the breast. Systemic treatment is usually given as insurance against the chance that it would recur.

• Stage II:  Any of the following may be true:
  
  
  • The cancer is no larger than 2 centimeters but has spread to the lymph nodes under the arm (the axillary lymph nodes).
    
    
  • The cancer is between 2 and 5 centimeters.
    
    
  • The cancer may or may not have spread to the lymph nodes under the arm.
    
    
  • The cancer is larger than 5 centimeters but has not spread to the axillary (underarm) lymph nodes.

• Stage III:  Stage III is divided into stages IIIa and IIIb:
  
  
  • Stage IIIa is defined by either of the following: The cancer is smaller than 5 centimeters and has spread to the lymph nodes under the arm, and the lymph nodes are attached to each other or to other structures. The cancer is larger than 5 centimeters and has spread to the lymph nodes under the arm.
    
    
  • Stage IIIb is defined by either of the following: The cancer has spread to tissues near the breast (skin or chest wall, including the ribs and the muscles in the chest). The cancer has spread to lymph nodes inside the chest wall along the breastbone.

• Inflammatory breast cancer:  This is a special class of breast cancer because it is rare. The breast looks as if it's inflamed because of its red appearance and warmth. The skin may show signs of ridges or it may have a pitted appearance. Also, a biopsy of skin will show tumor cells. This type of breast cancer tends to be more aggressive. Inflammatory breast cancer that is not detected outside of the breast and underarm lymph nodes is Stage IIIb.

• Stage IV:  The cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain. Or, tumor has spread locally to the skin and lymph nodes inside the neck, near the collarbone.

• Recurrent:  Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the breast, in the soft tissues of the chest (the chest wall), or in another part of the body.