Breast cancer staging A breast cancer staging test can show if the cancer has spread to other parts of the body. When breast cancer spreads, it can often be found in the axillary lymph nodes (lymph nodes in the armpit). Breast cancer cells can spread from the breast to almost any other part of the body, such as the lungs, liver, bones or brain. Your doctor will need to know the stage of your breast cancer to help you choose the best treatment. Tests to help with tumor staging may include.
▪ Lymph node biopsy: If cancer cells are found in a lymph node, the cancer may have spread to other lymph nodes or to other parts of the body. Surgeons use a method called sentinel lymph node biopsy to remove the lymph nodes that are most likely to have breast cancer cells. If no cancer cells are found in the sentinel lymph nodes, the patient may be able to avoid having more lymph nodes removed. Removing more lymph nodes to check for cancer cells is called axillary dissection.
axillary dissection.
CT scan: An x-ray machine connected to a computer to get a series of detailed pictures of the chest or abdomen. You may have to drink or inject contrast material. The contrast material makes it easier to find abnormal tissue. CT scan (CT scan) pictures can show if cancer cells have spread to the lungs or liver.
■MRI (magnetic resonance imaging): A strong magnet attached to a computer is used to help draw detailed pictures of the chest, abdomen, or brain. The MRI can show if the cancer has spread to these areas. Sometimes a contrast agent is used to make the abnormal tissue show up more clearly on the picture.
■ Bone scan: The doctor injects a small amount of radioactive material into the blood vessels. This material collects on the bones through the blood. A scanner detects and measures the amount of radiation and takes a picture of the bone. Where there is cancer, there will be a large amount of radioactive material collecting. Such pictures can show if the cancer has spread to the bones.
PET scan: Before the test, you will be given a small amount of radioactive sugar and the PET scanner will pick up the signal from the sugar and take a picture of which part of your body is absorbing the sugar. The PET scan can show if the cancer has spread to other parts of the body.
Cancer Staging
The stage of breast cancer is determined by the size of the tumor and whether it has spread to lymph nodes or other parts of the body. Doctors use the Roman numerals 0, I, II, III, IV and the letters A, B and C to stage breast cancer.
Stage I cancer is early-stage breast cancer, while stage IV is advanced cancer, where the cancer has spread to other parts of the body, such as the liver. The stage of cancer is usually determined by examining the tumor removed after surgery and one or more axillary lymph nodes.
Stage 0
Stage 0 is carcinoma in situ. Ductal carcinoma in situ (DCIS) presents as abnormal cells that have grown in the ducts of the breast but have not invaded the adjacent breast tissue or spread outside the ducts.
Stage IA
The maximum diameter of the breast tumor does not exceed 2 cm. The cancer has not yet spread to the lymph nodes.
■ Stage IB
The maximum diameter of the tumor does not exceed 2 cm. Cancer cells are found in the lymph nodes.
▪ Stage IIA
The tumor size does not exceed 2 cm, and the cancer has spread to the ipsilateral axillary lymph nodes. Or, the tumor size is 2 to 5 cm, but the cancer cells have not yet spread to the lymph nodes.
■Stage IIB
The tumor size is 2 to 5 cm and the cancer has spread to the ipsilateral axillary lymph nodes. Or, the tumor is larger than 5 cm, but the cancer has not yet spread to the ipsilateral axillary lymph nodes.
▪ Stage IIIA
The breast tumor is no larger than 5 cm and the cancer cells have spread to the ipsilateral axillary lymph nodes, fused with each other or adhered to adjacent tissues. Alternatively, the cancer cells may have spread to the retrosternal lymph nodes. Alternatively, the tumor is more than 5 cm and the cancer cells have spread to the ipsilateral axillary lymph nodes, fused with each other or adhered to adjacent tissues. Or, the cancer cells may have spread to the retrosternal lymph nodes but not to the axillary lymph nodes.
Stage IIIB
The breast tumor can be any size, and it has grown into the chest wall or the skin of the breast. The breast may have become enlarged or there may be a hard lump in the skin of the breast. The cancer has spread to the ipsilateral axillary lymph nodes, fused with each other or adhered to adjacent tissue. Or, the cancer may have spread to the lymph nodes behind the sternum.
Stage IIIC
The breast cancer can be any size and it has spread to the lymph nodes behind the sternum and in the axilla. Or, the cancer has spread to the lymph nodes above or below the clavicle.
■Stage IV
The tumor can be any size and the cancer has spread to other parts of the body, such as the lungs, liver, bones and brain.