Updated on November 17, 2020
Breast Cancer Staging
It is ESSENTIAL to know the stage of your breast cancer because it helps your doctors to evaluate and plan your treatment options.
How breast cancer is staged
Staging depends on where the cancer starts and how much of the cancer has spread out of the breast to the rest of the body. The most commonly used staging system is based on the American Joint Committee on Cancer (AJCC) TNM system for both clinical (cTNM) and pathological (pTNM) findings.
- The clinical staging is done before the surgery using results based on the clinical assessment, imaging tests (such as mammogram, ultrasound, CT, MRI or PET scans) and a breast biopsy.
- The pathological staging is done after the surgery and is based on the results of the cell type, cancer grade, number of lymph node involvement and immunohistochemistry analysis
Click to view PMCC video on Cancer Staging
These are the 7 key pieces of information used for staging
- Size of tumour (T)
- Spread of lymph nodes (N)
- Spread to other part of the body (M)
- Progesterone Receptor (PR) status
- Estrogen Receptor (ER) status (ER+ suggests it may respond to hormone therapy)
- HER-2 status (excess HER-2 protein suggests a more aggressive cancer)
- Cancer grade (higher grades suggest a more aggressive cancer)
Summary of the TNM staging
T: T1-T4, depending on the size and/or extent of the primary tumour
N: N1-3 depending whether the cancer has not spread to the lymph nodes
M: M0-1 depending on whether the cancer has spread to rest of the body
|T||T0||NO evidence of tumour|
|T1||Size is less than 2 cm|
|T2||Size is 2 to less than 5 cm|
|T3||Size is 5 cm or larger|
|T4||Cancer involve skin or chest wall|
|N||N0||Has NOT spread to lymph nodes|
|N1||Spread to 1-3 lymph nodes|
|N2||Spread to 4-9 lymph nodes|
|N3||Spread to 10 or more lymph nodes|
|M||M0||NO distant spread|
|M1||Spread to distant organs|
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