Staging Breast Cancer

Staging is the process of finding out how far the cancer has spread. The stage is based on the results of the physical exam, biopsy, and other tests your doctor may have ordered. These tests may include [10]:

• Chest x-ray
• Mammograms of both breasts
• Bone scans
• Computed tomography (CT)
• Magnetic resonance imaging (MRI) scans
• Blood tests to evaluate your overall health and help detect whether the cancer has spread to certain organs

This process is very important because the stage of your cancer will determine your treatment. [10]

The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system. This system takes into account the following factors [10]:

• Tumor size and spread within the breast and to nearby organs (T)
• Whether the cancer has spread to lymph nodes (N)
• Whether it has spread to distant organs (M, for metastasis)

Numbers after the T, N, and M give 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 (ductal carcinoma in situ), the other stages are I through IV (1-4). Some of the stages are further subdivided 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 advanced cancer. [10,29]

Metastatic breast cancer

Typically, the cancer has not spread beyond the breast to distant parts of the body in stages 0 through III. [10] Stage IV means that the cancer has spread (metastasized) to distant organs, such as the bones, liver, or lungs, or to lymph nodes far from the breast. [10] This is known as metastatic breast cancer. Metastatic breast cancer is usually not considered curable. However, treatment can still help shrink the tumor, and relieve symptoms. [34]

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