When someone is diagnosed with breast cancer, doctors do tests to see how far the cancer has spread. This process is called staging. They check the size of the tumor, if it’s in nearby lymph nodes, and if it’s spread to other parts of the body. This helps them plan the right treatment.
For breast cancer, staging is based on things like the size of the tumor, if it’s spread to lymph nodes, how aggressive it is, and certain biomarkers. They use a system called TNM, tumor grade, and biomarkers to figure out the stage.
Furthermore there are five stages for breast cancer: stage 0, followed by stages I through IV. The higher the stage number, the more the cancer has grown or spread.
Let’s explore the different staging groups and tests done in the process of determining an individual’s stage.
Staging groups in breast cancer help doctors understand how advanced the cancer is and how serious it might be. These groups are important because they guide doctors in choosing the right treatment and predicting what might happen to the person with cancer. By organizing the cancer into these groups, doctors can personalize treatments for each person, giving them the best chance of beating the cancer and providing them with information about their prognosis and potential risks.
Below are the two main types of breast cancer stage groups
Clinical Prognostic Stage
The Clinical Prognostic Stage is a way doctors determine how advanced breast cancer is based on various factors like a person’s medical history, physical exam results, imaging tests, and biopsy results.
This stage helps doctors understand the extent of the cancer before starting treatment, guiding them in making decisions about the best course of action.This stage is crucial for planning the initial steps of treatment and predicting the outcome for the person with breast cancer.
TNM [Tumor, Node, Metastasis] System
TNM system is a way doctors measure the size of a tumor (T), whether it’s spread to nearby lymph nodes (N), and if it’s moved to other parts of the body (M). This system, along with other factors like tumor grade and biomarker status, helps doctors determine the stage of cancer.
Tumor grade
Tumor grade refers to an evaluation of the cancer cells under a microscope to determine how abnormal they appear compared to normal cells. This assessment helps classify the aggressiveness or differentiation of the tumor.
Biomarker Status
Biomarker status checks for certain signals on breast cancer cells that help them grow. These signals include:
Cancers can also be described as triple negative (lacking all three signals) or triple positive (having all three).
Pathological Prognostic Stage
After surgery, doctors determine the Pathological Prognostic Stage for breast cancer patients.
This stage provides a more precise assessment of the cancer’s characteristics after surgical removal and helps guide further treatment decisions and prognostic predictions.
Clinical Information
This includes the patient’s medical history, physical examination findings, and any pre-surgery tests or imaging results.
Laboratory Test Results
Pathologists examine the breast tissue and lymph nodes removed during surgery under a microscope. They assess various characteristics of the cancer cells, such as their size, shape, and degree of aggressiveness.
Biomarker Status
Biomarker status checks for certain signals on breast cancer cells that help them grow. These signals include:
Cancers can also be described as triple negative (lacking all three signals) or triple positive (having all three).
Also there is Anatomic Stage of breast cancer which is determined by the TNM system, focusing on the size of the tumor and its spread. It’s used in regions where biomarker testing isn’t available.
furthermore the TNM system assesses Metastasis (M), which indicates whether cancer has spread beyond the breast. M0 means cancer hasn’t spread, while M1 indicates it has spread to distant parts like bones, lungs, liver, or brain, often resulting in metastatic breast cancer.
Additional tests and procedures are often employed during the staging process to gather more information about the extent and characteristics of the cancer.
These may include imaging tests like MRI or PET scans, as well as procedures such as bone scans or biopsies of nearby lymph nodes.
These tests help doctors gain a comprehensive understanding of the cancer’s spread and guide them in determining the most effective treatment approach for the individual patient
A sentinel node biopsy is a procedure to test if cancer has spread beyond the original tumor. It’s most commonly used in people with breast cancer and melanoma. During the procedure, healthcare providers remove small organs called sentinel nodes and test them for cancer cells. The results help providers determine the most appropriate treatments.
Doctors can check your blood for certain substances or markers that may indicate cancer or how well your body is handling treatment.
A detailed picture of the inside of your body, helping doctors see if there’s anything unusual, like a tumor.
It shows areas in your body where cells are using a lot of energy, which can indicate cancer. It helps doctors find out if cancer has spread to other parts of your body.
It’s a test to see if cancer has spread to your bones. You get a special injection, and then they take pictures of your bones to see if there are any areas that look different.
It uses sound waves to create images of your body’s organs. It’s often used to look at the breast or nearby lymph nodes to see if there are any abnormalities.
Along with the above systems and processes, the primary stage of breast cancer is most commonly denoted by the number staging system.
Number Staging System
In breast cancer, the number staging system tells us how big the cancer is and whether it has spread. This helps doctors choose the best treatment. Early stages mean the cancer is small and hasn’t spread much, while later stages mean it’s bigger and may have spread further. Knowing the stage also helps predict how the treatment will go and what to expect in the future.