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After the Tests: Staging

Staging is the process of finding out how widespread the cancer is and whether it has spread to lymph nodes under the arm or to other parts of the body like the liver, bones, or lungs. This is very important because the treatment and the outlook for your depend on the stage of the cancer. The stage, in turn, is based on the results of the physical exam, biopsy, and other tests the doctor may have ordered.

The most common system used to describe the stages of breast cancer is the AJCC/TNM system. This system takes into account the tumor (T), whether the cancer has spread to lymph nodes (N), and whether it has spread to distant organs (M, for metastasis). More letters after the T, N, and M give further details about the cancer.

All of this information is combined in a process called stage grouping. The stage is then expressed as a Roman numeral. After stage 0 (carcinoma in situ), the other stages are I through IV (1-4). Some of the stages are further sub-divided using the letters A, B, and C. In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more serious cancer.

After looking at your test results, the doctor will tell you the stage of your cancer. Be sure to ask your doctor to explain your stage in a way you understand. This will help you both decide on the best treatment for you.


Stages

From: Cancer Info.com

Stage I The cancer is no larger than 2 centimeters (about 1 inch) and has not spread outside the breast.

Stage II Any of the following may be true:

The cancer is no larger than 2 centimeters but has spread to the lymph nodes under the arm (the axillary lymph nodes).

The cancer is between 2 and 5 centimeters (from 1 to 2 inches). The cancer may or may not have spread to the lymph nodes under the arm.

The cancer is larger than 5 centimeters (larger than 2 inches) but has not spread to the lymph nodes under the arm.

Stage III Stage III is divided into stages IIIA and IIIB.

Stage IIIA is defined by either of the following:

The cancer is smaller than 5 centimeters and has spread to the lymph nodes under the arm, and the lymph nodes are attached to each other or to other structures.

The cancer is larger than 5 centimeters and has spread to the lymph nodes under the arm.

Stage IIIB is defined by either of the following:

The cancer has spread to tissues near the breast (skin or chest wall, including the ribs and the muscles in the chest).

The cancer has spread to lymph nodes inside the chest wall along the breast bone.

Stage IV The cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain. Or, tumor has spread locally to the skin and lymph nodes inside the neck, near the collarbone.


Breast Cancer Survival by Stage

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Of course, many people live much longer than 5 years. Five-year relative survival rates exclude patients dying of other diseases. This means that anyone who died of another cause, such as heart disease, is not counted.

The numbers below are based on the precise stage of the cancer. Check with your doctor to find out the exact stage of your cancer. The numbers are also based on women treated a number of years ago. Because we now find more cancers early and use newer treatments, the survival rates are getting better all the time.

Stage 5-year relative survival rate

0100%
I98%
IIA 88%
IIB76%
IIIA56%
IIIB49%
IV 16%

While these numbers provide an overall picture, keep in mind that every womanís situation is unique and the statistics canít predict exactly what will happen in your case. Talk with your cancer care team if you have questions about your own chances of a cure, or how long you might survive your cancer. They know your situation best.


American Cancer Society website: http://www.cancer.org



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