Survival rate of breast cancer less than 1 cm at the time of detection is over 90%
In recent years, there has been an increasing concern about breast diseases, especially breast cancer. Cancer is one of the leading causes of human death, and breast cancer ranks prominently among women’s cancers. Thanks to the introduction of breast-specific imaging equipment in recent years, breast cancer can be detected early, thus reducing mortality rates. Although screening methods have improved, not as many people are being screened, and it is especially uncommon for people to be screened at an early stage. Most people go to the hospital only when they develop symptoms, and this often results in losing the best chance of treatment. Breast cancer is one of the more likely types of cancer to be detected early on its own. Therefore, it is generally recommended that women over the age of 30 should receive frequent breast palpation. In particular, women should learn to touch their own breasts and palpate them regularly within 1 week after the end of their monthly menstruation to possibly detect abnormalities. According to research, if you can detect an abnormality before it is half the size of a nickel (1 cm), you will have a 10-year survival rate of more than 90% and a 20-year survival rate of more than 85% after treatment. Early detection can be achieved by regular palpation by a specialist. If detected at this time, the cure rate can be over 90%. (So early detection of breast lumps is not scary)
The incidence of breast cancer peaks in the second half of the 40s and does not decrease thereafter. Therefore, in order to protect your breasts and your life after 40 years old, women must have regular checkups by themselves and by specialists, and it is even better if you can have an annual breast imaging examination. If your own examination reveals half a 50-cent coin-sized lump, you must go to a specialist for further precise examination without delay, together with mammography, to deny or confirm the presence of breast cancer and determine how to treat it. Clinical staging: Different clinical stages can be composed according to the above different TNM.
Stage 0 TisN0M0
Stage I T1N0M0
Stage IIa T0N1M0; T1 N1*M0 (*N1 has the same prognosis as N0); T2N0M0
Stage IIb T2N1M0;T3N0M0
Stage IIIa T0N2M0;T1N2M0;T2N2M0;T3N1,2M0
Phase IIIb T4, any N, M0;any T, N3M0
Stage IV Any T, any N, M1
● Stage I: The size of the tumor is less than 2 cm, the axillary lymph nodes remain unaffected, and the cancer cells have not spread anywhere in the body.
● Stage II: The size of the tumor is within 2 to 5 cm, or the axillary lymph nodes have been affected, or both, but it has not spread further.
●Stage III: Tumor size is more than 5 cm and the axillary lymph nodes have been affected, but have not spread further.
● Stage IV: includes tumors of any size, the lymph nodes have usually been affected, and the cancer has spread to other parts of the body, i.e. there is distant metastasis.
The 10-year survival rates for each stage of breast cancer are as follows.
▪ Stage I: 80-90%
▪ Stage 2: 60-70%
▪ Stage III: 30-40%
▪ Stage IV: less than 10%
Non-specialists may not read the following
Breast cancer TNM international staging method
The current clinical staging is the TNM international staging method, which was recommended by the International Union Against Cancer in 1959 and modified in 1978.
The clinical staging of breast cancer is a determination of how far a breast cancer patient has progressed, which is of great significance in guiding treatment and judging the future.
It depends on the following three aspects of presentation.
The growth of the cancer itself, including the size of the tumor and the extent of its infiltration, indicated by the word “T” (Tumor);
2.The degree of metastasis of regional lymph nodes, indicated by “N” (Node);
3. The presence of hematogenous metastasis in distant organs, expressed as “M” (Metastasis).
If 0, 1, 2 or 3 numbers are attached to the letters T, N and M to indicate the degree of change, the current clinical situation of a specific breast cancer can be clearly indicated. This is the clinical staging method adopted by the International Association Against Cancer, referred to as the TNM staging method. The histological manifestation of the tumor does not affect the classification of clinical staging.
T – represents the condition of the primary tumor. The T of most cancers can be classified into four grades, namely T1, T2, T3 and T4. The criteria for grading are firstly, the size of the mass and secondly, the local infiltrative manifestation. There are two other grades for certain carcinomas, namely T1S for carcinoma in situ T indicates no primary cancer foci were palpated.
N – represents the condition of regional lymph nodes. Clinically, it is also divided into four categories, namely N0, N1, N2 and N3. In order to indicate the presence or absence of lymph node metastasis in future pathological examination, “+” is added to N if metastasis is confirmed, and “-” is added to N if there is no metastasis. If there is metastasis in the lymph nodes that are not clinically palpable, it will be N0+, and if there is no metastasis in the palpable lymph nodes, it will be indicated by N1-. Clinicians can also append a or b to N to represent their judgment on the presence or absence of cancer metastasis in the lymph nodes they have palpated, e.g. N1a or N2a means the lymph nodes are palpable but considered non-cancerous metastasis, and N1b or N2b means the lymph nodes are palpable and considered to have cancer metastasis.
M – represents blood metastasis of distant tissues, M0 means no blood metastasis of distant tissues, M1 means metastasis of distant tissues.
1) Primary tumor (T) staging.
Tx Primary tumor status is unknown (resected).
T0 Primary tumor is not retrieved.
Tis carcinoma in situ (including lobular carcinoma in situ and intraductal carcinoma), Paget’s disease is limited to the nipple, and no mass is found in the breast.
T1 Tumor with a maximum diameter of less than 2 cm.
T1a Tumor diameter is less than 0.5cm.
T1b Tumor diameter is 0.5 to 1cm.
T1c Tumor with maximum diameter of 1~2cm.
T2 Tumor maximum diameter 2~5crn.
T3 Tumor with a maximum diameter of more than 5cm.
T4 Tumor of any size, directly invading the chest wall or skin (chest including ribs, intercostal muscles, anterior serratus, but not pectoral muscles).
T4a Tumor directly invades the chest wall.
T4b Breast surface skin edema (including cellulite edema), skin ulceration or satellite nodules in the skin around the tumor, but not beyond the ipsilateral breast.
T4c Including T4a and T4b.
T4d Inflammatory breast cancer.
2) Regional lymph node (N) staging.
N0 regional lymph nodes are not found.
Nx regional lymph nodes are not known (previously excised).
N1 ipsilateral axillary lymph nodes are enlarged and movable.
N2 Ipsilateral axillary lymph nodes are enlarged, fused with each other, or adherent to other tissues.
N3 Metastasis in the ipsilateral internal breast lymph nodes.
3) Distant metastasis (M) stage.
Mx The presence or absence of distant metastasis is unknown.
M0 No distant metastasis.
M1 Distant metastasis (including ipsilateral supraclavicular lymph node metastasis).
4) Clinical staging: Different clinical stages can be composed according to the above different TNM.
Stage 0 TisN0M0
Stage I T1N0M0
Stage IIa T0N1M0;T1 N1*M0(*N1 has the same prognosis as N0);T2N0M0
Stage IIb T2N1M0;T3N0M0
Stage IIIa T0N2M0;T1N2M0;T2N2M0;T3N1,2M0
Phase IIIb T4, any N, M0;any T, N3M0
Stage IV Any T, any N, M1
In this stage, Tis can only have paget disease limited to the nipple clinically, other carcinoma in situ cannot be diagnosed clinically, and N3 (metastasis of internal breast lymph nodes) is also not palpable clinically.
Generally speaking, those with small cancer (less than 5 cm) and axillary lymph nodes cannot be touched are stage I; those with small cancer but enlarged axillary lymph nodes are stage II; and those with distant metastasis are all classified as stage IV regardless of the local growth of cancer or regional lymph node metastasis. Stage III is the most complicated, and T1N2 and T4N3 represent two extreme cases. Generally speaking, those with regional lymph node metastasis in the N3 range or local mass growth in the T4 range have a poor prognosis and can be considered for radiotherapy or chemotherapy before surgery to prolong life.