Breast cancer staging
Once your health care team knows you have breast cancer, they will do more tests to stage it. Staging is a tool the team uses to find out how advanced the cancer is. The stage of the cancer depends on the size and location of a tumor, whether it has spread, and how far the cancer has spread.
Breast cancer
Breast cancer is cancer that starts in the tissues of the breast. There are two main types of breast cancer:Ductal carcinoma starts in the tubes (du...
Read Article Now Book Mark ArticleYour health care team uses staging to help:
- Decide the best treatment
- Know what kind of follow-up will be needed
- Determine your chance of recovery (prognosis)
- Find clinical trials you may be able to join
Two Types of Staging
There are two types of staging for breast cancer.
Clinical staging is based on tests done before surgery. These may include:
- Physical exam
- Mammogram
Mammogram
A mammogram is an x-ray picture of the breasts. It is used to evaluate some breast symptoms and to find breast cancer in women with no symptoms....
Read Article Now Book Mark Article - Breast MRI
Breast MRI
A breast MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the breast and sur...
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Breast Ultrasound
Breast ultrasound is a test that uses sound waves to examine the breasts.
Read Article Now Book Mark Article - Breast Biopsy, either ultrasound or stereotactic
Ultrasound
A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders. There are several types of breast biopsi...
Read Article Now Book Mark ArticleStereotactic
A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders. There are several types of breast biops...
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Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
Read Article Now Book Mark Article - CT scan
CT scan
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Bone scan
A bone scan is an imaging test used to diagnose bone diseases and find out how severe they are.
Read Article Now Book Mark Article - PET Scan
PET Scan
A positron emission tomography (PET) scan is an imaging test that uses a radioactive substance (called a tracer) to look for potential spread of brea...
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Pathological staging uses the results from lab tests done on breast tissue and lymph nodes removed during surgery. This type of staging will help determine additional treatment and help predict what to expect after treatment ends.
How Stages are Determined
Stages of breast cancer are defined by a system called TNM:
- T stands for tumor. It describes the size and location of the main tumor.
- N stands for lymph nodes. It describes whether cancer has spread to the nodes. It also tells how many nodes have cancer cells.
Lymph nodes
The lymph system is a network of organs, lymph nodes, lymph ducts, and lymph vessels that make and move lymph from tissues to the bloodstream. The l...
Read Article Now Book Mark Article - M stands for metastasis. It tells whether the cancer has spread to parts of the body away from the breast.
Metastasis
Metastasis is the movement or spreading of cancer cells from one organ or tissue to another. Cancer cells usually spread through the blood or the ly...
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What the Stages Mean
Doctors use seven main stages to describe breast cancer.
- Stage 0, also called carcinoma in situ. This is cancer that is confined to the lobules or ducts in the breast. It has not spread to surrounding tissue. Lobules are parts of the breast that produce milk. Ducts carry the milk to the nipple. Stage 0 cancer is called noninvasive. This means it has not spread. Some stage 0 cancers become invasive later. But doctors cannot tell which ones will and which will not.
Invasive
An invasive disease is one that spreads to surrounding tissues. An invasive procedure is one in which the body is "invaded", or entered by a needle,...
Read Article Now Book Mark Article - Stage I. The tumor is small (or may be too small to see) and invasive. It may or may not have spread to the lymph nodes close to the breast.
- Stage II. There may be no tumor found in the breast, but cancer can be found that has spread to axillary lymph nodes or nodes close to the breastbone. Axillary nodes are nodes found in a chain from under the arm to above the collarbone. There might also be a tumor between 2 and 5 centimeters in the breast with small cancers in some of the lymph nodes. Or, the tumor could be larger than 5 centimeters with no cancer in the nodes.
- Stage IIIA. Cancer has spread to 4 to 9 axillary nodes or to nodes near the breastbone but not to other parts of the body. Or, there could be a tumor larger than 5 centimeters and cancer that has spread to 3 axillary nodes or to nodes near the breastbone.
- Stage IIIB. The tumor has spread to the chest wall or to the skin of the breast causing an ulcer or swelling. It may also have spread to axillary nodes but not to other parts of the body.
- Stage IIIC. Cancer of any size has spread to at least 10 axillary nodes. It may also have spread to the skin of the breast or breast wall, but not to distant parts of the body.
- Stage IV. The cancer is metastatic, which means it has spread to other organs such as the bones, lungs, brain, or liver.
How Staging Guides Treatment
The type of cancer you have, along with the stage, will help determine your treatment. With stage I, II, or III breast cancer, the main goal is to cure the cancer by treating it and keeping it from coming back. With stage IV, the goal is to improve symptoms and prolong life. In almost all cases, stage IV breast cancer cannot be cured.
Recurrent Cancer
Cancer can come back after treatment ends. If it does, it can occur in the breast, in distant parts of the body, or in both places. If it does return, it may need to be restaged.
Cancer can come back
One of the most common fears for people who have had cancer is that it may return after initial treatment. When cancer comes back, it is called recu...
Read Article Now Book Mark ArticleReferences
Korourian S, Klimberg VS. Clinical prognosis and staging of breast cancer. In: Klimberg VS, Gradishar WJ, Bland KI, Korourian S, White J, Copeland EM, eds. Bland and Copeland's The Breast. 6th ed. Philadelphia, PA: Elsevier; 2024:chap 26.
National Cancer Institute website. Breast cancer treatment (adult) (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-treatment-pdq. Updated January 19, 2024. Accessed April 4, 2024.
Review Date: 12/31/2023
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.