These tests show the size of the breast cancer and if it has spread to other parts of the body. This is called staging. It helps you and your health care team decide what treatment is best for you.
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Staging breast cancer
The most common staging system for breast cancer is the TNM system. Letters and numbers describe how big the tumour is (T), if cancer has spread to nearby lymph nodes (N), or if it has spread to the bones or other organs, which is known as having metastasised (M).
The staging system also shows other details about the breast tumour such as oestrogen and progesterone receptor status, HER2 status and the grade of the cancer.
Sometimes your doctor will also do further tests to examine the changes in the cancer cells and how likely it is the cancer may come back. These are called gene activity tests.
Early breast cancer – This is stage 1 or 2. The cancer is contained in the breast and may or may not have spread to lymph nodes in the armpit.
Locally advanced breast cancer – This is stage 3. It means the cancer is larger than 5 cm, has spread to tissues around the breast such as the skin, muscle or ribs, or has spread to a large number of lymph nodes.
Metastatic breast cancer – This is stage 4 and means breast cancer has spread to other parts of the body. It is also called secondary or advanced breast cancer. It is different to locally advanced breast cancer.
The staging system for breast cancer is complicated so ask your doctor to explain how it applies to you.
Grading breast cancer
The grade describes how active the cancer cells are and how fast the cancer is likely to be growing.
| grade 1 (low grade) | Cancer cells look a little different from normal cells. They are usually growing slowly. |
| grade 2 (intermediate grade) | Cancer cells do not look like normal cells. They are growing faster than grade 1 cancer cells. |
| grade 3 (high grade) | Cancer cells look very different from normal cells. They are usually growing fast. |
Prognosis
Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor, but it is not possible for anyone to predict the exact course of the disease. To work out your prognosis, your doctor will consider the stage and grade of the cancer, as well as features such as the cancer’s hormone receptor and HER2 status.
The survival rates for people with breast cancer have increased significantly over time due to more people taking part in screening, better tests and scans, and improved medicines and treatments.
Doctors often use five-year survival rates as a way to discuss prognosis. This is because research studies often follow people for five years – it does not mean you will survive for only five years. Compared with other cancers, breast cancer has one of the highest five-year survival rates when diagnosed early.
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A/Prof Elisabeth Elder, Specialist Breast Surgeon, Westmead Breast Cancer Institute and The University of Sydney, NSW; Collette Butler, Clinical Nurse Consultant and McGrath Breast Care Nurse, Cancer Support Centre, Launceston, TAS; Tania Cercone, Consumer; Kate Cox, 13 11 20 Consultant, Cancer Council SA; Dr Marcus Dreosti, Radiation Oncologist and Medical Director, GenesisCare, SA; Dr Susan Fraser, Breast Physician, Cairns Hospital and Marlin Coast Surgery Cairns, QLD; Dr Hilda High, Genetic Oncologist, Sydney Cancer Genetics, NSW; Prof David W Kissane AC, Chair of Palliative Medicine Research, The University of Notre Dame Australia, and St Vincent’s Hospital Sydney, NSW; Prof Sherene Loi, Medical Oncologist, Peter MacCallum Cancer Centre, VIC; Dr W Kevin Patterson, Medical Oncologist, Adelaide Oncology and Haematology, SA; Angela Thomas, Consumer; Iwa Yeung, Physiotherapist, Princess Alexandra Hospital, QLD.
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