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Blog, Breast Cancer

Breast Cancer-Staging


Staging helps to determine the disease prognosis and to select an appropriate treatment strategy. TNM is the most commonly used staging system for breast cancer. It uses mainly 3 parameters: “T” stands for “Tumor”; “N” for “Lymph Nodes”; and “M” for “Metastasis”. Numbers and/or letters after T (0, is, 1, 2, 3, and 4), N (0, 1mi, 1, 2, and 3), and M (0 and 1) provide more details about each of these parameters. Once T, N, and M are determined, it is used to assign an overall stage (from 0 to IV).

breast cancer T staging

 

breast cancer N staging

breast cancer M staging

Following table describes the detailed TNM for breast cancer staging.

Stage TNM  Score  

Description

 

 

0

 

Tis N0 M0

 

Pre-cancerous changes or carcinoma in situ (CIS). No spread to nearby lymph nodes or distant body parts.

 

IA

 

T1 N0 M0

 

Tumor size is 2 cm or less. No spread to nearby lymph nodes or distant body parts.

 

IB

 

T0-1 N1mi M0

 

CIS or tumor </=2 cm in size with spread to the lymph nodes under the arm >0.2 mm, but </=2 mm in size (micrometastases). No spread to distant body parts.

 

IIA

 

 

T0-1 N1 M0

OR

T2 N0 M0

 

CIS or tumor </=2 cm in size with cancer spread to 1-3 axillary (underarm) lymph nodes or tiny cancer deposits in internal mammary lymph node(s) (those near the breastbone) on sentinel lymph node biopsy. No spread to distant body parts.

OR

Tumor size >2 cm, but </=5 cm. No spread to nearby lymph nodes or distant body parts.

 

IIB

 

 

T2 N1 M0

 

OR

T3 N0 M0

 

Tumor size >2 cm, but </=5 cm with cancer spread to 1-3 axillary lymph nodes or tiny cancer deposits in internal mammary lymph node(s) on sentinel lymph node biopsy. No spread to distant body parts.

OR

Tumor size >5 cm. No spread to nearby lymph nodes or distant body parts.

 

IIIA

 

 

T0-2 N2 M0

 OR

T3 N1-2 M0

 

CIS or tumor </=5 cm in size with cancer spread to 4-9 axillary lymph nodes or enlargement of internal mammary lymph node(s). No spread to distant body parts.

OR

Tumor size >5 cm with cancer spread to 1-9 axillary lymph nodes or spread to internal mammary lymph node(s). No spread to distant body parts.

 

IIIB

 

T4 N0-2 M0

 

Tumor of any size with direct extension to the chest wall or skin or inflammatory breast cancer. No spread to nearby lymph nodes or cancer spread to 1-9 axillary lymph nodes or spread to internal mammary lymph node(s). No spread to distant body parts.

 

IIIC

 

Any T N3 M0

 

CIS or tumor of any size with spread to

>/=10 axillary lymph nodes (>/=1 area >2 mm), or cancer spread to the infraclavicular (those under the collarbone) lymph nodes (>/=1 area >2 mm) [N3a],

or cancer spread to >/=1 axillary lymph nodes (>/=1 area >2 mm) with internal mammary lymph node(s) enlargement, or cancer spread to >/=4 axillary lymph nodes (>/=1 area >2 mm) with micrometastasis in internal mammary lymph node(s)[N3b], or

cancer spread to the supraclavicular (those above the collarbone) lymph nodes (>/=1 area >2 mm)[N3c].

No spread to distant body parts.

 

IV

 

Any T Any N M1

 

CIS or tumor of any size with no or any extent of spread to nearby lymph nodes. Cancer spread to distant organs like bones, lungs, liver, brain, etc.

 

Breast cancer stage grouping

In addition to staging, estrogen receptor (ER), progesterone receptor (PR), HER2/neu (HER2) status, and grade of the cancer is evaluated on the surgical specimen to assess the prognosis of the disease, and planning the treatment.

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