Breast cancer staging

The stage of a cancer is an expression of the tumor's size and the extent to which it has spread to the lymph nodes and other sites in the body. Stages range from 0 to 4. Staging helps determine treatment options and provides some sense of a patient's overall prognosis. As a general rule, the lower the stage, the better the prognosis.

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Breast cancer staging is complicated, and treatment options by stage as well as prognosis are constantly changing, so it is best to review staging information with your doctor.

Stage 0: These cancers are described as noninvasive or in situ (in place). There are abnormal or precancerous cells in the lining of a lobule or duct, but the cells have not spread into normal breast tissue.

Stage I: Cancer cells have spread into tissue beyond the ducts or lobules, although not to the lymph nodes or other parts of the body. The tumor is 2 centimeters (approximately an inch) or less in diameter.

Stage IIA: A tumor has a diameter of 2 centimeters or less and has spread to a small number of lymph nodes, or it is 2 to 5 centimeters in diameter but has not reached the nodes.

Stage IIB: A tumor of 2 to 5 centimeters has spread to the nodes, or a tumor exceeds 5 centimeters in size but has not reached the lymph nodes.

Stage IIIA: Either the tumor's diameter is larger than 5 centimeters or it is smaller than that, but the cancer cells have spread to lymph nodes, and the nodes are sticking to each other or to surrounding tissue.

Stage IIIB: Regardless of the tumor's size, cancer cells have spread out of the breast to the chest wall, the skin, the lymph nodes in the chest wall, or other nearby tissue. There is no evidence of spread to distant sites.

Stage IIIC: Regardless of the tumor's size, cancer cells have spread to lymph nodes under the arm and breastbone or under and above the collarbone. There is no evidence of spread to distant sites.

Stage IV: Regardless of tumor size, cancer cells have reached the lungs, liver, brain, bones, or other sites distant from the breast.

Healthcare professionals also use the following letters when characterizing individual cancers:

• T refers to tumor size
• N (for nodes) refers to the number of lymph nodes with cancer
• M (for metastasis) refers to cancer that has spread to distant sites