Breast cancer is becoming more common around the world. However, apart from women, it is rarely seen in men as well. The size of the tumor has spread to the lymph nodes when carried to other areas of the body. Its treatment depends on the stage of the cancer, which helps to know its severity. Some treatments include chemotherapy, radiation, Surgery, hormone balancing, and treatment.

Breast Cancer: An Overview

Breast cancer is a condition in which breast cells grow uncontrollably. There are many types of breast cancer. Cancer cells in the breast determine the type of breast cancer.

Breast cancer can develop in different places in the breast. Lobules, ducts, and connective tissue are the three primary components of the breast. The glands responsible for making milk are called lobules. Ducts refer to the tubelike structures that carry milk from the breast to the nipple. It is all held together by connective tissue made up of fibrous and fatty tissue. It usually begins within the tubules or lobules.

breast cancer staging

There are five stages of breast cancer:

  • Stage 0 (zero), which refers to non-invasive ductal carcinoma in situ (DCIS);
  • Stages I to IV (1–4) are used to diagnose invasive breast cancer.

Based on the stage of the cancer, specialists find the best treatment for the patient. Doctors can staging a patient before or after surgery. They use the diagnosis to determine the stage of the cancer. Physical examination, image scanning and other tests help determine staging. Therefore, doctors cannot do staging until they have the results of all tests. Identifying the stage helps the doctor to estimate the chances or prognosis of a patient’s recovery.

There are two types of staging: clinical and pathological. Physical examination, mammogram, ultrasound and MRI scan techniques determine the clinical staging prior to surgery. Surgery removes breast tissue, and the lymph node determines the stage of the disease. The pathology report contains information for calculating the stage of breast cancer. For example, it determines whether the cancer is confined to one area of ​​the breast or has moved into healthy breast tissue. The doctor may also recommend blood tests or imaging tests if the cancer is likely to spread.

breast cancer symptoms

Symptoms of breast cancer vary from person to person. Even some women do not show any signs or symptoms at all. The most common symptom of breast cancer is a new lump or swelling in the breast. However, not every lump means the occurrence of breast cancer. Breast cancer can be smooth, circular, sensitive or painful. They may also be painless and may be hard lumps with uneven edges.

Some other symptoms are:

  • Mastitis (in whole or in part)
  • Skin peeling (sometimes referred to as an orange peel)
  • pain in the breasts or nipples
  • nipple retraction (inward turning)
  • Red, dry, flaky, or thickened nipple or breast skin
  • nipple discharge
  • swollen lymph nodes under the arm or toward the collar bone

TNM System

TNM stands for Tumor, Node and Metastasis. Doctors use the TNM system to identify the stage of your cancer. However, knowing about the same cancer stage can be difficult until you have surgery.

Tumor (T)

The term ‘tumour’ refers to the size of the tumor (the area of ​​cancer). This is a simplified version of the T phase description.

  • TX: TX indicates that physicians cannot determine the size of the tumor.
  • TIS (DCIS) is an abbreviation for ductal carcinoma in situ. This is a type of breast cancer that has not yet become aggressive. Cancer cells are contained within the breast ducts and have not yet spread to adjacent tissue.
  • T1: Breast tumors are 20 millimeters (mm) or less in diameter. There are four substages, depending on the size of the tumor. T1mi refers to cancer that is less than 1 mm in diameter. T1a refers to a tumor greater than 1 mm but less than 5 mm. T1b indicates that the cancer is more significant than 5 mm but smaller than 10 mm. T1c means tumor greater than 10 mm but smaller than 20 mm.
  • T2: Tumor is greater than 20 mm but less than 50 mm in diameter.
  • T3: Tumor is greater than 50 mm in diameter.
  • T4: Tumor is of one of four types. T4a indicates that the cancer has reached the chest wall. If cancer has developed in the skin, it is T4b. T4c cancer spreads to the chest wall and skin. T4d is inflammatory breast cancer.

node (n)

The ‘N’ in the TNM staging system refers to lymph nodes. These small, bean-shaped organs help prevent infection. Regional lymph nodes are located near the site of cancer origin. such as:

  • The axillary lymph nodes are on the underside of the arm.
  • lymph nodes above and below the collarbone
  • internal breast lymph nodes under the breastbone
  • Distant lymph nodes are in other areas of the body

The staging is described as:

  • NX: no lymph nodes examined
  • N0: First, there is no cancer in the lymph nodes. Second, cancerous spots smaller than 0.2 mm are present.
  • N1: Tumor has spread to 1 to 3 axillary lymph nodes and 1 to 3 internal mammary lymph nodes. Micrometastatic cancer is cancer in a lymph node larger than 0.2 mm but less than 2 mm (N1mi).
  • N2: Cancer has grown to 4 to 9 lymph nodes in the axilla. Alternatively, it may extend into the internal mammary lymph nodes rather than the axillary lymph nodes.
  • N3: Cancer has spread to 10 or more axillary lymph nodes and to lymph nodes below the clavicle or collarbone. It is also possible for it to spread to the lymph nodes inside the mammary gland.

Metastasis (M)

The letter ‘M’ in the TNM system indicates whether the cancer has spread to other areas of the body, a condition known as distant metastasis. This tumor then ceases to be classified as early stage or locally developed.

  • MX: It is impossible to assess distant dispersion
  • M0: no sign of distant metastases
  • M0 (i+): No sign of distant metastases on clinical or radiographic examination. Tumor cells no larger than 0.2 mm may be in the blood, bone marrow, or other lymph nodes.
  • M1: Signs of metastasis to other areas of the body, indicating that breast cancer cells have spread to other organs.


Other tests for breast cancer cells

The doctor also uses other information related to your breast cancer. This data helps determine your stage, prognosis and treatment outlook. Here are some of them:

  • Hormone receptors for female hormones (estrogen and progesterone)
  • HER2 status (human epidermal growth factor receptor 2)
  • cancer grade

Physicians also examine protein levels in the human epidermal growth factor receptor 2 (HER2). In some breast tumours, it is more likely to be a HER2-positive cancer. However, it causes cancer cells to multiply and grow and spread rapidly.


Depending on the stage of your cancer, doctors select the appropriate treatment after considering various factors.

Treatment depends on:

  • your type of cancer
  • cancer site
  • Additional health problems you’re dealing with
  • breast cancer stage

Additional factors that may affect treatment include:

  • the extent to which your cancer cells have progressed
  • whether you have gone through menopause

Therapists may use the following treatments:

  • Surgery
  • radiotherapy
  • chemotherapy
  • hormone replacement therapy


Bisphosphonates are drugs used to treat osteoporosis. In the case of early breast cancer and menopause, you can take post-menopausal bisphosphonates. They help prevent the spread of cancer to the bones. Bisphosphonates drugs may also reduce symptoms such as bone pain in patients with secondary breast cancer.


Breast cancer staging is a complex task. First, your doctor will check for any development of a lump or other abnormality in the breasts to determine the cause and, if necessary, treat it. Before a doctor can determine your exact stage, they consider a variety of possibilities and are narrowed down to the exact type. In case of any concerns regarding your stage, speak to your doctor or gynecologist. Early detection of breast cancer increases your chances of successful treatment.

Frequently Asked Questions (FAQs)

Q:What stage of breast cancer requires a mastectomy?

A: If you have more than two tumors in your breast, a doctor may prescribe a mastectomy instead of a lumpectomy and radiotherapy. Mastectomy is performed in the early stages of breast cancer. It helps to remove cancerous tissue and lymph nodes.

Q: How many rounds of chemo are normal?

A: Chemotherapy consists of 4 to 8 cycles of treatment. A cycle is the period between one round of therapy and the beginning of the next. A break is taken after each therapy session to enable your body to recover. This break lets the body deal with side effects like nausea and hair loss.

Q: At what stage does a 1.2 cm breast tumor occur?

A:Tumor size is an important element of breast cancer staging. This has an impact on a person’s treatment and prognosis options. Tumors are usually small and easy to treat in the early stages. For example, under T1 stage (including T1a, T1b and T1c), the cancer is 2 cm or smaller (3/4 inch) in diameter.

Q:How fast do breast tumors grow?

A:Breast cancer cells divide to grow. However, since cancer cells continue to mutate, predicting their growth rates can be challenging. Each division requires approximately 1 to 2 months, and a noticeable tumor develops in the body for 2 to 5 years. The more the cancer grows, the more likely it is to infect adjacent tissues, the lymphatic system, or the circulatory system and move to other organs.

Q:What are the signs that you have a cancerous lymph node?

A:There are several symptoms of a cancerous lymph node. These include lumps under the skin in the neck, under the arms or near the groin area, fever without infection, excessive sweating at night, weight loss, itchy skin, etc.

Q:How are the stages of cancer determined?

A:Tests will be done by your health care professional to evaluate the degree and severity of your cancer. A physician will then issue an assessment number. The higher the value, the wider the spread of cancer. Image scanning, physical examination, and other tests can determine the stage of cancer.

Q:Where does breast cancer usually first spread?

A:Breast cancer is more likely to initially move to the lymph nodes under your arm. It can also spread to the tissues around your breast, including the chest, collarbone, or lower back.

Q: What size is a small breast tumor?

A:At its widest point, the breast tumor is 20 millimeters (mm) or less. It is about one and a half inches.

Q:What is the survival rate of breast cancer?

A: According to studies, women with non-metastatic invasive breast cancer had a survival rate of 84%, that is, ten years. When invasive breast cancer is in the breast, the chance of survival for 5 years is 99%. This stage of breast cancer occurs in 65% of women.

Q: When is a mastectomy needed?

A: Stage I or II (early stage) breast cancer requires a mastectomy. It removes cancerous tissue and lymph nodes. If more than two tumors are present in the breast, doctors recommend mastectomy.

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