Women's Health

Facts About Breast Cancer

What Are the Stages of Breast Cancer?

• Early stage or stage 0 breast cancer is when the disease is localized to the breast with no evidence of spread to the lymph nodes (carcinoma in situ).
• Stage I breast cancer: The cancer is 2 centimeters or less in size and it hasn't spread anywhere.
• Stage IIA breast cancer is a tumor smaller than 2 centimeters across with lymph node involvement or a tumor that is larger than 2 but less than 5 centimeters across without underarm lymph node involvement.
• Stage IIB is a tumor that is greater than 5 centimeters across without underarm lymph nodes testing positive for cancer or a tumor that is larger than 2 but less than 5 centimeters across with lymph node involvement.
• Stage IIIA breast cancer is also called locally advanced breast cancer. The tumor is larger than 5 centimeters and has spread to the lymph nodes under the arm, or a tumor that is any size with cancerous lymph nodes that adhere to one another or surrounding tissue.
• Stage IIIB breast cancer is a tumor of any size that has spread to the skin, chest wall, or internal mammary lymph nodes (located beneath the breast and inside the chest).
• Stage IIIC breast cancer is a tumor of any size that has spread more extensively and involves more lymph node invasion.
• Stage IV breast cancer is defined as a tumor, regardless of size, that has spread to places far away from the breast, such as bones, lungs, liver, brain, or distant lymph nodes.

How Is Breast Cancer Diagnosed?

During your regular physical exam, your doctor will take a careful personal and family history and perform a breast exam and possibly order a mammogram or an ultrasound of the breasts. In certain women who are at increased risk for breast cancer, an MRI may be ordered.

Based on the results of these tests, your doctor may or may not request a biopsy to get a sample of the breast mass cells or tissue.

After the sample is removed, it is sent to a lab for testing. A pathologist -- a doctor who specializes in diagnosing abnormal tissue changes -- views the sample under a microscope and looks for abnormal cell shapes or growth patterns. When cancer is present, the pathologist can tell what kind of cancer it is (ductal or lobular carcinoma) and whether it has spread beyond the ducts or lobules (invasive).

Lab tests such as hormone receptor tests (estrogen and progesterone) can show whether the hormones help the cancer to grow. If the test results show that hormones help the cancer grow (a positive test), the cancer is likely to respond to hormonal treatment. This therapy deprives the cancer of the estrogen hormone.

Breast cancer diagnosis and treatment are best accomplished by a team of experts working together with the patient. Each patient needs to evaluate the advantages and limitations of each type of treatment, and work with her team of doctors to develop the best approach.