Breast Cancer Stages
Breast cancer is one of the most prevalent oncologic conditions in the world, affecting an average of 1 out of 8 patients. Treatment for this malignancy – and whether it will be effective – is highly dependent on the cancer’s staging and severity. To learn more about your prognosis, as well as the therapeutic options available, it is best if you familiarize yourself with the different stages of breast cancer.
What are the Stages of Breast Cancer?
Stage 0 Breast Cancer
Stage zero breast cancer is a condition wherein the cancerous cells remain within the breast duct, or the passageway that transports the milk from the lobule (glands which produce breast milk) towards the nipple. In this condition, the malignant cells remain confined within the area, and have not yet breached the nearby tissues and organs. Of all the stages of breast cancer, it has the highest 5-year survival rate at 93%.
Treatments for stage 0 breast cancer are the following:
- Surgery, usually Lumpectomy.
- Radiation therapy after lumpectomy.
- Hormone therapy to prevent the cancer from developing in the same or adjacent breast.
Stage 1 Breast Cancer
Stage one breast cancer, which is considered early stage breast cancer, has a 5-year survival rate of 88%. It has two types, namely:
Breast Cancer Stage 1 A – In this condition, the tumor measures 2 centimeters or smaller. It remains within the breast and has not infiltrated nearby tissues yet.
Breast Cancer Stage 1 B – For this stage, small patches of malignant cells are detected in lymph nodes located near the breast. Apart from this, there is no tumor visible in the breast, OR there is a tumor in the area, yet it measures 2 centimeters or smaller.
Stage 1 Breast Cancer Treatment Modalities
- Surgery: Since the tumor is small, you can elect to have a lumpectomy, which is just the removal of the breast mass. You can elect for mastectomy as well to eliminate the possibility of breast cancer recurrence.
- Radiation therapy: which is given after surgery to kill any remaining malignant cells.
- Chemotherapy: which is also provided after surgery, to prevent the cancer cells from growing back.
- Hormone therapy: oftentimes used after surgery in patients whose tumors are dependent on estrogen.
Biologic therapy: which is prescribed in individuals with high levels of HER2 protein.
Stage 2 Breast Cancer
Breast cancer stage 2, which is also classified as early stage breast cancer, is also divided into two phases. Stage 2 breast cancer survival rate depends on the phases, which are:
Stage 2A Breast Cancer – It has the highest of stage 2 breast cancer survival rates at 81%. There are two scenarios for this stage:
- There is no tumor present, or there is one measuring 2 centimeters within the breast. Malignant cells are also present in 1-3 armpit or breastbone lymph nodes. OR
- A tumor measuring anywhere between 2 to 5 centimeters is present, however, there are no cancerous cells present in the lymph nodes.
Stage 2B Breast Cancer – It comes with a 5-year survival rate of 745. The following are the findings for this stage:
- A tumor measuring 2 to 5 centimeters is present, and there are malignant cells present in the lymph nodes. OR
- The tumor amounts to more than 5 centimeters, and there are no cancerous cells detected in the lymph nodes.
Stage 2 Breast Cancer Treatment Options
- Surgery – Lumpectomy, which involves the removal of the mass, and Mastectomy, which removes the entire breast, are two options available.
- Radiation Therapy, which is recommended after surgery, especially in patients with large tumors.
- Chemotherapy, which can be used to shrink the tumor size prior to surgery. It can also be prescribed after the operation to eliminate any remaining malignancies in the body.
- Hormonal Therapy for patients with hormone receptor positive-cancer.
- Biological Therapy for individuals with HER2 protein-caused cancer.
Stage 3 Breast Cancer
Stage 3A Breast Cancer
- It can be that no tumor exists in the breast, but malignant cells are detected in 4 to 9 lymph nodes in the axilla or the breastbone. OR
- A tumor measuring 5 centimeters or bigger is present, and there are small groups of cancerous cells in the lymph nodes.
- Of all the stage 3 breast cancer survival rates, it has the highest at 67%.
Stage 3B Breast Cancer
- A tumor measuring any size is present, and it has already infiltrated the chest wall or the skin along the breast area. Malignant cells are detected either in the lymph nodes in the axilla or the breastbone.
- Inflammatory breast cancer which has infiltrated the skin is also known as stage 3b breast cancer.
- This has the worst stage 3 breast cancer survival rate at 41%. Yes, it is lower than that of Stage 3C.
Stage 3C Breast Cancer
- There might be no tumor present, or there might be any-sized tumor detected. The cancerous cells have already targeted the skin, resulting in ulceration and inflammation. Malignant cells are present in the lymph nodes of the breastbone and axilla, as well as the lymph nodes above or below the collar bone.
- Breast cancer stage 3C may also be diagnosed as that of the inflammatory kind.
- Stage 3 breast cancer survival rate for this phase is higher at 49%.
- Stage 3 breast cancer treatment features two options. You can undergo surgery if your tumor is considered operable. If not, other forms of management are recommended, which will be discussed later on.
Stage 3 breast cancer prognosis depends on the cancer cells detected in the lymph node biopsy. The prognosis is generally sounder if there is only a few number of cancer cells found upon examination.
Stage III Breast Cancer Treatments
- Chemotherapy – Given prior to surgery to shrink the tumor and to improve the chances of removing the cancer cells completely.
- Surgery – Lumpectomy is an option for those with smaller tumors, but those with larger masses are usually recommended to undergo mastectomy, or the removal of the entire breast.
- Radiation Therapy – Usually prescribed post-surgery to kill the cancer cells that might have been left in the body after the operation.
- Hormone Therapy – Medications such as Anastrozole or Tamoxifen are prescribed to stop hormones that promote tumor growth in breast cancer stage 3.
- Biological Therapy – Medications such as Trastuzumab are given to patients with breast cancer caused by the HER2 protein.
Stage 4 Breast Cancer
Stage IV breast cancer, can have any of the metastatic breast cancer symptoms:
- Presence of any-sized tumor
- Lymph nodes with or without cancerous cells
Stage 4 breast cancer survival rate is at a lowly 15%. Stage 4 breast cancer life expectancy depends on the age of the person. Patients aged 40-49 years have a higher expectancy rate at 25%, while those 80 years or older have a lower expectancy rate at 15%. With that being said, metastatic breast cancer survival rates are better in younger patients.
What is Metastatic Breast Cancer?
In 75% of all the diagnosed cases, the malignancy has targeted the bones.
Metastasis of stage four breast cancer is made possible by these three methods:
- Invasion of the surrounding tissue.
- Invasion of the lymphatic system, wherein the cancer cells are circulated and distributed to the different parts of the body through the different lymph vessels.
- Invasion of the capillaries and the veins, making the spread of malignant cells possible through the blood stream.
While there are some therapies that can cure your stage 4 metastatic breast cancer, they are not as effective as those used in earlier stages. Stage 4 breast cancer prognosis is usually the lowest of all categories. In fact, the focus of stage 4 breast cancer treatment (chemotherapy, radiation therapy, surgery, hormone therapy, biological therapy or targeted therapy) is not immediate cure, but the limitation of growth of the malignant cells, and the relief of the symptoms. For these reasons, metastatic breast cancer treatment is considered palliative or that which only brings comfort. With mostly palliative cures, the metastatic breast cancer prognosis is usually poor.
The ICD 9 code for metastatic breast cancer is 174.9. The metastatic breast cancer ICD 9 code is used by healthcare professionals in order to bill and code the symptoms and conditions associated with stage 4 breast cancer. Contrary to popular beliefs, there is no stage 5 breast cancer. The most advanced form of the malignancy is stage 4.
As with any other disease, immediate diagnosis and treatment will help you win your battle with breast cancer. At the first mark of any sign or symptom, consult with your physician right away so he can determine your breast cancer stage, and prescribe the appropriate treatments and procedures for your condition.