Cancer

Understanding how Breast Cancer is staged and graded

Understanding how Breast Cancer is staged and graded

Your specialist doctor needs certain information about the cancer to advise you on the best treatment for you. This includes:

  • The stage of the cancer
  • The grade of the cancer
  • Whether the cancer has receptors (proteins) for hormones or a protein called HER2.

This information comes from the results of all the tests you have had, including:

  • The biopsy, when the tissue was examined
  • Other tests that were done on the cells.

At Shree Mahavir Jain Hospital, our specialist doctor and nurse will talk to you about this. They will explain how it helps you and your doctor decide on your treatment plan. Being one of the best cancer hospitals in Thane, this is the place you’ll be treated with highly experienced professional doctors. 

The stage of a cancer describes its size and whether it has spread from where it started. There are different systems for describing the stage of a cancer. The most commonly used ones are the TNM staging system and the number staging system.

The TNM staging system gives the complete stage of the cancer:

  • T describes the size of the tumour.
  • N describes whether the cancer has spread to the lymph nodes and which nodes are involved. For example, N0 means no lymph nodes are affected. N1 means there are cancer cells in 1 to 3 of the lymph nodes.
  • M describes whether the cancer has spread to another part of the body. For example, M0 means the cancer has not spread (metastasised) to other parts of the body.

The stages are the number zero and the Roman numerals I, II, III, or IV (often followed by A, B, or C). In general, the higher the number, the more advanced the cancer. But there’s more to it than that.

Stage 0

The cancer has been diagnosed early. It started in the breast ducts or milk glands and has stayed there. You’re likely to hear or see the words in situ, meaning “in the original place.” Get more details about stage 0 breast cancer types and treatment options.

Stage I

Starting at this level, breast cancer is called invasive, meaning it has broken free to attack healthy tissue.

Stage 1A

Means the cancer has spread into the fatty breast tissue. The tumor itself is no larger than a shelled peanut, or there may be no tumor.

Stage IB

Means some cancer cells, but just tiny amounts, have been found in a few lymph nodes.

Stage II

The cancer has grown, spread, or both.

IIA means the tumor in the breast is still small, if there’s one at all. There may be no cancer in the lymph nodes, or it may have spread to as many as three.

Stage IIB

Breast tumor is bigger — it may be the size of a walnut or as big as a lime. It may or may not be in any lymph nodes.

Stage III

The cancer has not spread to bones or organs, but it’s considered advanced, and it’s harder to fight.

IIIA means the cancer has been found in up to nine of the lymph nodes that form a chain from your underarm to your collarbone. Or it has spread to or enlarged the lymph nodes deep in your breast. In some cases there is a large tumor in the breast, but other times there’s no tumor.

IIIB means the tumor has grown into the chest wall or skin around your breast, even if it hasn’t spread to the lymph nodes.

IIIC means cancer has been found in 10 or more lymph nodes, or has spread above or below your collarbone. It’s also IIIC if fewer lymph nodes outside the breast are affected but those inside it are enlarged or cancerous.

Stage IV

Breast cancer cells have spread far away from the breast and lymph nodes right around it. The most common sites are the bones, lungs, liver, and brain. This stage is described as “metastatic,” meaning it has spread beyond the region of the body where it was first found

The grade of a cancer gives an idea of how slowly or quickly it might grow. The grade is based on how the cancer cells look under a microscope compared with normal cells. The cells are examined by a doctor called a pathologist, who studies tissue samples and is an expert in cell types.

Grade 1 (low grade cancer)

The cancer cells look similar to normal cells (they are well differentiated). They usually grow slowly. These cancer cells are less likely to spread.

Grade 2 (moderate or intermediate-grade cancer)

The cancer cells look more abnormal and grow slightly faster than grade 1 cells.

Grade 3 (high-grade cancer)

The cancer cells look very different from normal cells (they are poorly differentiated). They may grow more quickly than grade 1 or 2 cells.

Low grade cancers tend to grow more slowly than high grade cancers. High grade cancers are more likely to come back after they have first been treated. But the grade can only give a guide to how any individual cancer will behave and individual cancers may behave differently.

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