The stage of breast cancer may be something you're interested in learning about if you've received a diagnosis or are simply curious. The answers will assist both you and your doctor to decide the course of treatment.

The clinical staging of breast cancer can be determined in several ways by doctors. Physical examinations, biopsies, X-rays, bone scans (and other imaging techniques), and blood tests can all provide them with some clues. A pathologist is a medical professional who uses a microscope to examine tissue samples from lymph nodes and the breast to understand more. 1 2

Invasive breast cancer (carcinoma in situ) and non-invasive breast cancer are the two different types of breast cancer.

Breast cancer staging:

The Roman numbers 0 and I, II, III, or IV (typically followed by A, B, or C) represent the four stages of breast cancer. Generally speaking, the higher the number, the more advanced the cancer is. But there's more to it than that. According to the size of your tumour and the extent of its spreading throughout the body, doctors typically divide breast cancer into stages.

Cancers that are large or have spread to the tissues or organs around them are at a more advanced stage than cancers that are tiny or still contained inside the breast tissue. 

1. Stage 0 -

Breast cancer is in its first stage and was discovered quickly. It starts in the milk glands or breast ducts and has remained there, never spreading to other tissues. You're likely to hear or see phrases like in situ, which means "in the original location."

2. Stage 1 - 

It is breast cancer's first stage. At this stage, when it has expanded to attack healthy tissue, breast cancer is referred to as invasive.

• Stage 1A - It suggests that the cancer has spread to the fatty breast tissue. The tumour may not even exist; it is not much bigger than a shelled peanut.

• Stage 1B - It suggests that a few lymph nodes contain a few cancer cells, although in tiny amounts.

3. Stage 2 cancer - 

Breast cancer has developed and spread at this point (or both).

• Stage 2A - It shows that if a tumour is there at all, it is still small. It's possible that the lymph nodes don't contain any cancer or that it has progressed to three or more.

• Stage 2B - The tumour is larger and can be anywhere between a walnut and a lime in size at this point. Lymph nodes may or may not be affected. 3

Is Stage 2 breast cancer curable?

Breast cancer in stage 2 is very treatable, and the prognosis is good. Breast cancer in stage 2 has not progressed past the breast or adjacent lymph nodes. So, how serious is stage 2 breast cancer? As with most cancer types, the earlier your cancer can be found and treated, the better your outlook is. Your doctor may be better able to determine the best course of treatment for you if they know the HR and HER2 status of your stage 2 breast cancer. 

Surgery, radiation therapy, chemotherapy, and targeted therapy are all possible forms of treatment. The adverse effects of these treatments, like those of other treatments, can range from moderate to severe. After treatment, most people become better, though there can be some long-term issues.

Does breast cancer Stage 2 need chemotherapy? 

For some types of stage 2 breast cancer, doctors advise chemotherapy. Typically, a combination of medications is used to kill cancer cells while they are in the bloodstream. Chemotherapy can be given to a patient either before or after surgery. To assist minimise the size or severity of the cancer, they could receive chemotherapy before surgery. 4

4. Stage 3 cancer - 

Cancer is reported to be advanced and challenging to treat, despite not having spread to bones or organs.

• Stage 3A - It means that cancer has progressed to up to nine lymph nodes between your underarm and collarbone. Additionally, the lymph nodes located deep inside your breast may spread or grow. There may be a large tumour in the breast in some cases but not in others.

• Stage 3B - Even if the tumour has not gone to your lymph nodes, it signifies the tumour has grown into the skin around your breast or the chest wall.

• Stage 3C - It indicates that cancer has progressed above or below the collarbone or is present in 10 lymph nodes or more. It is referred to as 3C if there are fewer lymph nodes outside the breast but those that are there have become enlarged or cancerous. 5

Is Stage 3 breast cancer curable?

Stage 3 breast cancer is a locally advanced but treatable cancer. Although it is curable with intensive treatment, there is a significant chance that the tumour will return after treatment. Stage 3 breast cancer can be harder to treat than earlier-stage breast cancer since it has progressed outside the breast, though this depends on several different circumstances. 

Surgery, hormone therapy, chemotherapy, and targeted therapy are all possible types of treatment. The outcome of treatment could be influenced by your breast cancer kind, overall well-being, and several additional factors which are beyond your control. 6

5. Stage 4 - 

It is referred to as the worst stage of breast cancer and is in an advanced stage. At this stage, the breast cancer cells have gone far beyond the breast and the lymph nodes around the breast. The most frequently impacted organs are the brain, liver, lungs, bones, and lungs. This stage is referred to as "metastatic," which denotes that cancer has spread outside of the area of the body where it was initially found and identified. 7

What stage is Stage 4 breast cancer? 

The fourth stage of breast cancer is said to be the final one. The earliest stage of breast cancer, known as carcinoma in situ, is thought to be stage 0. It then moves on to stages 1–4. The less spread the cancer is throughout the body, the lower the number. When the number is large, as in stage 4, it means the cancer has spread more widely.

Can breast cancer stage 4 be cured?

Breast cancer that has spread to other organs and may present with new symptoms is called metastatic breast cancer, commonly known as stage 4 breast cancer. Although there is no cure, there are treatments and breast cancer survival rates are rising with time. Since breast cancer survival rates are higher in the early stages, you need to take early diagnosis and treatment. But remember that the quality of life and longevity can be improved with the appropriate treatment for stage 4 breast cancer.

Can you live with Stage 4 breast cancer?

Though it can be managed with medicines, frequently for years, stage 4 breast cancer does not yet have a cure. Breast cancer patients who have spread to other organs need ongoing care. The doctor can try different treatment options if one doesn't work. 

Even at stage 4, remember that each person is unique, and your response to treatment may vary from someone else's. Researchers are still studying several treatments for metastatic breast cancer. Every year, things become better. To find out more about the factors that could impact your outlook, speak with your doctor. 

Is there a stage 5 breast cancer?

There is no stage 5 of breast cancer, which is categorised into 5 stages (from stage 0 to stage 4). So, is Stage 4 breast cancer the final stage? Yes, metastatic breast cancer at stage 4 is the final stage of breast cancer. The most advanced stage of breast cancer is when it has spread to numerous other body parts outside the area near the lymph nodes. 8

Can you live 20 years with breast cancer?

Many early breast cancer patients survive for at least 20 years after being identified and treated. The lifespan of 20 years for someone with metastatic breast cancer is unusual. Researchers are trying to develop more effective treatments for metastatic breast cancer.9

Is breast cancer painful?

Breast cancer is typically not painful, but anyone who experiences unexplained breast pain or notices any unexpected changes to their breasts should consult their doctor. 10

How to avoid breast cancer?

According to a study, lifestyle modifications can lower the chance of breast cancer, even in high-risk females. Consequently, you can reduce your risk by carrying out the following:

• Limit your alcohol consumption.

• Keep a healthy weight.

• Get some exercise and breastfeed 

• Do not overuse postmenopausal hormones  11

TNM staging of breast cancer: 

Tumor-node-metastasis (TNM) is the most often used cancer staging method. Here is further information on each component of TNM staging:

T (Primary tumour) - The size and location of a cancerous tumour at the time of diagnosis are described below. Stage I tumours are tiny and have not spread. Stage II cancers are larger tumours that have spread to surrounding tissues. Tumours are categorised as T0 through T4.

N (nodes) - This evaluates if cancer has migrated to neighbouring lymph nodes. Lymph nodes help the cancer spread to other parts of your body. Node classification varies depending on the type of cancer, with a range from N0 to N3. According to the N0 classification, the cancer has not migrated to nearby lymph nodes. Patients might be categorised by a doctor depending on the number and location of cancerous lymph nodes.

M (metastasis) - When a tumour has invaded organs outside of the local lymph nodes, the condition is known as metastasis. An MI classification denotes the spread of cancer.

Doctors use TNM data to categorise cancers into one of four stages.

According to the TNM staging system, what are the four stages of breast cancer?

• Stage 1 - Smaller tumours (T1-T2) that have not spread to nearby lymph nodes (N) or other body locations (M0) are included in this stage.

• Stage 2 - It comprises larger tumours that are contained within your body and have not spread to nearby lymph nodes or other locations. T2-T4, N0, and M0 make up the TNM category.

• Stage 3 - This applies to large tumours that have only migrated to nearby lymph nodes and not other body regions. The TNM category includes M0, N1, N3, and T1–T4.

• Stage 4 - This is known as metastatic cancer. It indicates that cancer has spread to other body parts from the initial tumour. T1-T4, N1-N3, and M1.12 are the TNM categories. 12

References

1,3,5,7 - What Are the Stages and Grades of Breast Cancer?; From Web MD

(https://www.webmd.com/breast-cancer/stages-grades-breast-cancer). Retrieved on 10.02.2023 

2 - Breast cancer in women; From NHS UK

(https://www.nhs.uk/conditions/breast-cancer/).  Retrieved on 10.02.2023

4 - What Does Stage 2 Breast Cancer Mean and What’s the Prognosis?; From Healthline

(https://www.healthline.com/health/breast-cancer/stage-2-breast-cancer).  Retrieved on 10.02.2023

6 - Stage 3 Breast Cancer: Understanding Your Outlook; From Healthline

(https://www.healthline.com/health/breast-cancer/prognosis-stage-3-breast-cancer).  Retrieved on 10.02.2023 

8 - Metastatic Breast Cancer: Prognosis and Survival Rate; From Healthline (https://www.healthline.com/health/breast-cancer/metastatic-prognosis).  Retrieved on 10.02.2023 

9 - You Ask, We Answer: Living as a breast cancer survivor; From Medical News Today

(https://www.medicalnewstoday.com/articles/breast-cancer-survivor#living-a-long-life). Retrieved on 10.02.2023

10 - Is breast cancer painful?; From Medical News Today

(https://www.medicalnewstoday.com/articles/is-breast-cancer-painful). Retrieved on 10.02.2023

11 - Breast cancer prevention: How to reduce your risk; From Mayo Clinic

(https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/breast-cancer-prevention/art-20044676). Retrieved on 10.02.2023

12 - Cancer Staging System; From Cleveland Clinic

(https://my.clevelandclinic.org/health/diagnostics/22607-cancer-stages-grades-system). Retrieved on 18.02.2023