Regular breast exams help detect breast cancer in early stage. Here is important information on staging and grading of breast cancer. Read ahead…
Breast cancer is the most common cancer in women. Its symptoms are likely to be noticed when the cancer attains an advanced stage. Most of the time, the early signs of breast cancer are misinterpreted or neglected. Moreover, the symptoms may vary from woman to woman and they are not so specific that cancer can be diagnosed instantly. Lumps or swelling, skin changes in the breast are many times attributed to non-cancerous conditions like infection or a cyst. Doctors recommend regular self examination of breast. If you feel something abnormal, you should immediately see your doctor. Early detection of cancer helps remove the cancer completely.
Breast Cancer Diagnosis
Ductal Carcinoma in Situ (DCIS), Invasive Ductal Carcinoma (IDC), Invasive Lobular Carcinoma (ILC), inflammatory breast cancer, male breast cancer, recurrent breast cancer, metastatic breast cancer, etc. are some of the common types of breast cancer. Even males can develop this type of cancer. Staging of breast cancer helps understand the situation correctly and plan the correct treatment accordingly. Chest X-ray, mammograms, MRI scan, ultrasound tests, physical exam, biopsy, help diagnose breast cancer. At an early stage, surgical removal of cancer is possible.
A pathologist takes a look at the breast mass and also the nearby lymph nodes removed during surgery and describes the cancer with the help of TNM system. This helps the doctors to understand the correct nature and extent of the cancer. In the TNM system, the letters T (describes tumor) , N (nearby lymph nodes) and M (metastasis) are followed by certain numbers. A number from 0 to 4 is placed after T to show the size of the tumor and also the spread of the tumor into the skin or into the chest wall under the breast.
A larger number indicates larger tumor and wider spread to the nearby tissues. A number from 0 to 3 is placed after N to show whether the cancer has spread from its origin to the nearby lymph node and, if so, how many lymph nodes are invaded. Either 0 or 1 is placed after M to show metastasis (spread of the cancer to distant organs like bones or lungs). Tumors, nearby lymph nodes and metastasis are showed in the report as follow:
- TX: Doctors are unable to evaluate primary tumor.
- T0: No evidence of primary tumor
- Tis: Carcinoma in situ (abnormal cells found)
- T1: Tumor size 2 cm or less
- T2: Tumor size more than 2 cm but less than 5 cm
- T3: Tumor larger than 5 cm
- T4: Tumor spreading into chest wall or skin.
- NX: Nearby lymph nodes cannot be assessed
- N0: Cancer is confined to its original place and not spread to nearby lymph nodes.
- N1: Cancer has invaded 1 to 3 lymph nodes in the underarm, and/or small number of cancerous cells are present in internal mammary lymph nodes (those near the breast bone).
- N2: Cancer has invaded 4-9 lymph nodes under the arm. There can be enlargement of internal mammary lymph nodes.
- N3: Cancer has invaded 10 or more lymph nodes under the arm, or under the collarbone, with at least one area of cancer spread greater than 2 mm. Or if the cancer has invaded at least one axillary lymph node (size greater than 2 mm) and enlargement due to cancer is found in internal mammary lymph nodes.
- MX: Spread of cancer to distant organs cannot be assessed.
- M0: No distant spread of cancer.
- M1: Cancer has spread to distant organs.
Apart from these there are some more ways of describing breast cancer growth in the body. More detailed description is obtained from certain other extra combinations of these letters and numbers, like N0(i+), N0(mol+), N1mi, N1a, N1b, N1c, N2a, N2b, N3a, N3b, N3c, cM0(i+), etc.
Once the grading of breast cancer is done, stage grouping is done by combining the available information. The development of cancer is divided into four main stages. If the cancer is non-invasive, it is described as stage 0.
Stage 0: It is expressed as “Tis, N0, M0” which indicates ductal carcinoma in situ. This is the earliest stage of breast cancer.
Stage I: It is subdivided into 2 stages.
- Stage IA: T1, N0, M0: indicates the tumor is 2 cm large and it has not invaded lymph nodes and distant organs.
- Stage IB: T0 or T1, N1mi, M0: indicates that the tumor is not found or tumor of about 2 cm is found, 1 to 3 axillary lymph nodes are invaded, cancer has not spread to distant organs. N1mi indicates small areas (2 mm or less across but at least 200 cancer cells or 0.2mm across) of cancer spread in 1 to 3 lymph nodes under the arm.
Stage II: It is subdivided into IIA and IIB.
- Stage IIA can be expressed as “T0 or T1, N1 (but not N1mi), M0” or “T2, N0, M0”.
- Stage IIB can be expressed as “T2, N1, M0” or “T3, N0, M0”.
Stage III: It is subdivided into IIIA, IIIB, IIIC.
- Stage IIIA is expressed as “T0 to T2, N2, M0” or “T3, N1 or N2, M0”
- Stage IIIB is expressed as “T4, N0 to N2, M0”.
- Stage IIIC is expressed as “any T, N3, M0”
Stage IV: It is reported as “any T, any N, M1”.
During metastasis, breast cancer spreads mostly to bones, lungs, liver or brain. From the above description, it is clear that breast cancer detected in early stages is easy to remove and helps increase the life expectancy of the patient. Thanks to modern technology, new drugs and therapies like chemotherapy and radiation therapy that are administered according to staging. All this has resulted in higher survival rates of breast cancer. They are higher than survival rates for any other cancer.
Disclaimer: This HerHaleness article is for informative purposes only, and should not be used as a replacement for expert medical advice.