A diagnosis of breast cancer It usually involves various emotions, and also many questions related to the stages of this condition in human cells.
“Breast cancer staging is a critical process that helps us determine the extent of the cancer, whether it is located in the breast tissue or has spread beyond,” explains Dr. Hahn Mai, breast medical oncologist. from Houston Methodist Hospital. “This information is important for several reasons; it even helps plan treatment accordingly“.
Knowing the stage of breast cancer also provides a roadmap that will help you list the most relevant questions to discuss with your doctor and thus find the appropriate support resources.
The positive news: Less than 3% of women diagnosed with new or recurrent breast cancer succumb to it.
How is breast cancer staged?
Staging involves a comprehensive evaluation of the cancer. The following key factors are analyzed:
- Tumor size
- If the cancer has spread to nearby lymph nodes
- If the cancer has spread to distant organs
- The molecular subtype of the tumor. That is, if certain proteins (estrogen receptor, progesterone receptor or HER2) are produced by cancer cells.
- The grade of the cancer (how aggressive the cancer cells look under a microscope)
Several tests may be used to gather this information, including a mammogram, ultrasound, breast biopsy, lymph node biopsy, PET scan, and MRI. Not everyone will need all of these tests, but your care team will help you understand which ones are helpful for your specific case.
Based on the results of these tests, your doctor will assign you a stage, with which you can discuss new steps, prognosis and treatment.
How many stages of breast cancer are there?
Breast cancer has five stages. The earliest is stage 0, which is called carcinoma in situ. It is the only form of breast cancer that is considered non-invasive. The most advanced is stage IV, which is also called metastatic breast cancer.
The lower the stage number, the less the cancer has spread. The higher the number, the more it has spread, which usually also means more aggressive treatment will be needed.
What stages of breast cancer require a mastectomy?
Surgery is almost always necessary to treat breast cancer. The exception is stage IV breast cancer, in which there is very rarely a role for surgery, as it is a metastatic state.
“In particular, surgery is essential for early-stage breast cancer: stages I and II, because it can eliminate the disease,” explains the oncology specialist.
Small, early-stage tumors can often be removed with a breast-conserving procedure called a lumpectomy, where the tumor and only a small amount of healthy breast tissue are removed. The amount removed depends on the size of the tumor.
A mastectomy, on the other hand, is when the entire breast is removed. It can be used to treat stage 0 to stage III breast cancer. There are several reasons why your doctor may recommend a mastectomy instead of a lumpectomy, even in early-stage cancer.
“If a lumpectomy is not feasible due to the large size of a tumor or when the cancer encompasses two or more quadrants of the breast, a mastectomy is required,” explains Dr. Mai.
After a mastectomy, breast reconstruction can be performed, either with an implant or with your own tissue (usually from the abdomen). Newer techniques can also help preserve nipple and breast skin in some cases, improving appearance after mastectomy and reconstruction.
What stages of breast cancer require chemotherapy and radiation?
In addition to surgerymost stages of breast cancer require or benefit from chemotherapy and/or radiation. The goal of these treatments is to destroy cancer cells or stop them from growing within the breast tissue. Chemotherapy is administered using medications, while radiation therapy uses high-energy beams (particles or light rays).
These treatments may be used to help shrink the tumor before surgery or to destroy any persistent cancer cells that may remain after surgery, helping to ensure that the cancer does not come back.
“If an early-stage cancer is aggressive, we may recommend chemotherapy“says the specialist at Houston Methodist Hospital. “Whether chemotherapy or radiation is useful for the other stages of breast cancer depends on some factors, such as the molecular subtype of the cancer and the type of breast surgery used to treat it. remove the tumor.”
For example, HER2-positive (HER2+) breast cancer often requires chemotherapy. The same is true for triple-negative breast cancer, a less common but aggressive type that lacks the molecular features that breast cancer treatment often targets: estrogen receptor, progesterone receptor and HER2.
“Radiation therapy is indicated when a patient undergoes a lumpectomy, although patients also need radiation therapy after mastectomy in certain cases,” adds Dr. Mai.
For stage IV breast cancer, chemotherapy is used (if tolerated) to help control the spread and relieve symptoms. It is usually combined with other therapies, such as hormone therapy, targeted therapy, and immunotherapy.
Is the stage of breast cancer related to the cure of the cancer or its probability of recurrence?
Staging not only helps determine breast cancer treatment plans; It can also help you better understand the prognosis. However, the results are also based on other factors, such as the type of breast cancer.
“Stages 0 to III are potentially curable,” Dr. Mai clarifies. “By definition, stage IV breast cancer is not curable.”
That said, cutting-edge treatments are helping people with metastatic breast cancer live longer. The average life expectancy of people diagnosed with metastatic breast cancer can vary significantly and depends on factors such as the type of breast cancer, its response to treatment, the person’s general health, and other factors such as lifestyle.
Staging can also help measure the likelihood that breast cancer will return after treatment. As a general rule, the more advanced the stage, the more likely the tumor will come back.
“Patients with stage II and III have a higher chance of recurrence compared to those with stage 0 or I,” says Dr. Mai. “Recurrence is also influenced by the type of breast cancer.”
For example, triple negative breast cancer and inflammatory breast cancer are more likely to recur than other types.
It is important to note that treatment outcomes are also influenced by compliance with the treatment and care plan. While a diagnosis cannot be changed, following your doctor’s guidance can influence treatment outcomes and risk of recurrence.
That’s key because when detected early, most breast cancers are curable. And although some patients recur, most do very well during initial treatment.
More information for patients:
Houston Methodist Global Healthcare Services | Houston Methodist
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