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.
Learn more about:
Staging breast cancer
The most common staging system used 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 describes other details about the breast tumour such as oestrogen and progesterone receptor status, HER2 status and the grade of the cancer. Staging is usually done after surgery so the treatment team have full information about the cancer and whether it has spread to lymph nodes.
The cancer may be classified as:
- Early breast cancer (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 (stage 3) – The cancer is larger than 5 cm, has spread to tissues around the breast such as the skin or muscle or ribs, or has spread to a large number of lymph nodes.
- Metastatic breast cancer (stage 4) – The cancer has spread to other parts of the body from the breast. Also called secondary or advanced breast cancer, it is different from locally advanced breast cancer.
Gene expression profile tests help the doctors understand more about the cancer and the best way to treat it. These tests may also be called molecular assays or genomic tests. They are different from genetic tests, which check if you have inherited a gene mutation linked to breast cancer. Learn more about genetic tests.
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 breast screening, better tests and scans, and improved medicines and treatments. Doctors often use 5-year survival rates as a way to discuss prognosis. This is because research studies often follow people for 5 years; it does not mean you will survive for only 5 years. It also does not mean that the cancer cannot come back after 5 years.
Compared with other cancers, breast cancer has one of the highest 5-year survival rates when diagnosed early.
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Dr Diana Adams, Medical Oncologist, Macarthur Cancer Therapy Centre, NSW; Prof Bruce Mann, Specialist Breast Surgeon and Director, Breast Cancer Services, The Royal Melbourne and The Royal Women’s Hospitals, VIC; Dr Shagun Aggarwal, Specialist Plastic and Reconstructive Surgeon, Prince of Wales, Sydney Children’s and Royal Hospital for Women, NSW; Andrea Concannon, consumer; Jenny Gilchrist, Nurse Practitioner Breast Oncology, Macquarie University Hospital, NSW; Monica Graham, 13 11 20 Consultant, Cancer Council WA; Natasha Keir, Nurse Practitioner Breast Oncology, GenesisCare, QLD; Dr Bronwyn Kennedy, Breast Physician, Chris O’Brien Lifehouse and Westmead Breast Cancer Institute, NSW; Lisa Montgomery, consumer; A/Prof Sanjay Warrier, Specialist Breast Surgeon, Chris O’Brien Lifehouse, NSW; Dr Janice Yeh, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC.
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