Stages of Breast Cancer

Staging Your Cancer

Tumor size,lymph node involvement, and whether the cancer has spread to the other parts of your body will determine the stage of your cancer. A key part of staging breast cancer is to determine whether an invasive tumor has spread to regional lymph nodes. To accomplish this, a test called sentinel node biopsy has become the gold standard. The sentinel nodes are the lymph nodes in the underarm area that are usually the one closest to the area of the breast invovled in the cancer. Using the result of the sentinel node biospy, doctors can determine whether additional lymph nodes need to be removed.

A surgeon may use any of the several methods to locate sentinel nodes. These include injecting a blue dye in the area of the breast where the tumor has been indentified, the use of radioactive tracer injected into the breast, or both. Once identified, the surgeon removes the sentinel nodes and a pathologist examines them for cancer cells. If no cancer is seen, then further lymph nodes need to be removed. If the sentinel nodes does not contain cancer, the surgeon will remove additional lymph nodes from the armpit (axillary lymph node dissection) to determine how many lymph nodes are involved as well as to remove the cancer in the area. Properly done. a sentinel node biopsy canaccurately identify the lymph node involvement of the cancer 97 percent of the time.

Sentinel node biopsy has spared many women from the axillary node dissection and its complications, such as swelling (lymphedema).

Additional information important to determine treatment includes identifying the cancer's :

• Grade. This is determined with tissue taken at the time of the core biopsy or surgical biopsy. The grade is based on how aggressive individual cancer cells appear under a microscope. There are different systems to grade cells, but a higher number typically means a more aggressive cancer.
• Stage. This refers to the cancer's size and whether it has spread(metastasized) to lymph nodes or other parts of the body. To further determine the stage, a history, physical exam, blood tesr and a bone scan, computerized tomography(CT) imaging position emission tomography (PET) scans, may be obtained.

The various stages are:

• Stage 0: The cancer is contained within the duct- ductal carcinoma in situ(DCIS).

• Stage I: The invasive cancer is two centimeters or kess and is only on the breast.

• Stage II: The invasive cancer is greater than two but less than five centimeters or has spread to the lymph nodes.

• Stage III: Advanced cancer that's 5 centimeters or more in size and has spread to the lymph nodes or has involved the lymph channels and skin of the breast(inflammatory breast changes.) It hasn't spread beyond to the distant organs of the body.

• Stage IV: Advanced cancer that has spread to othre parts of the body such as lungs, liver, bones or brain.