Breast cancer stages 0 through iv z gastroenterol


Breast cancer stage is usually expressed as a number on a scale of 0 through IV — with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body.

Your pathology report will include information that is used to calculate the stage of the breast cancer — that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.

The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer (AJCC). The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.

“The updated guidelines mean that staging is now catching up to how people are actually treated,” explained Elizabeth Mittendorf, M.D., Ph.D., Rob and Karen Hale Distinguished Chair in Surgical Oncology and director of the Breast Immuno-Oncology Program at the Dana-Farber Cancer Institute, who served on the expert panel that wrote the updated guidelines. “When developing a treatment plan, doctors always consider tumor grade, hormone-receptor status, HER2 status, and the Oncotype DX score, if applicable. So, a woman diagnosed with stage II disease that is triple-negative [estrogen-receptor-negative, progesterone-receptor-negative, and HER2-negative] will have a very different treatment plan than a woman diagnosed with stage II disease that is estrogen-receptor-positive. The staging guidelines now take into account what doctors have been doing all along.”

In general, according to experts, the new staging system classifies triple-negative breast cancer (estrogen-receptor-negative, progesterone-receptor-negative, and HER2-negative) at a higher stage and classifies most hormone-receptor-positive breast cancer at a lower stage.

Sometimes doctors use the term “locally advanced” or “regionally advanced” to refer to large tumors that involve the breast skin, underlying chest structures, changes to the breast’s shape, and lymph node enlargement that is visible or that your doctor can feel during an exam.

The updated AJCC breast cancer staging guidelines have made determining the stage of a cancer a more complicated but accurate process. So, the characteristics of each stage below are somewhat generalized. To see all the possible characteristics of each stage, you can review the AJCC Breast Cancer Staging Guidelines (PDF) online.

Stage 0 is used to describe non-invasive breast cancers, such as DCIS (ductal carcinoma in situ). In stage 0, there is no evidence of cancer cells or non-cancerous abnormal cells breaking out of the part of the breast in which they started, or getting through to or invading neighboring normal tissue.

Microscopic invasion is possible in stage I breast cancer. In microscopic invasion, the cancer cells have just started to invade the tissue outside the lining of the duct or lobule, but the invading cancer cells can’t measure more than 1 millimeter.

You may hear the words “advanced” and “metastatic” used to describe stage IV breast cancer. Cancer may be stage IV at first diagnosis, called “de novo” by doctors, or it can be a recurrence of a previous breast cancer that has spread to other parts of the body.