These tests show the size of the breast cancer and whether it has spread to other parts of the body. This is called staging. It helps you and your healthcare team decide what treatment will be best
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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 may be done before or after surgery, depending on when the doctors have full information about the cancer.
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’s different from locally advanced breast cancer.
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 can talk to your doctor about what might happen, but it’s 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 due to more people taking part in screening, better tests and scans, and improved treatments. Compared to other cancers, breast cancer has one of the highest survival rates when diagnosed early.
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A/Prof Cindy Mak, Breast Surgeon and Director of Breast Services, Chris O’Brien Lifehouse, Royal Prince Alfred Hospital, NSW; A/Prof Nick Murray, Consultant Medical Oncologist, Royal Adelaide Hospital and GenesisCare Adelaide, SA; Caroline Bennett, Consumer; Tamara Casey, Clinical Nurse Consultant, Breast Assessment Unit, Fiona Stanley Hospital, WA; A/Prof Joe Dusseldorp, Reconstructive Plastic Surgeon, Chris O’Brien Lifehouse, NSW; Lauren Lores, Consumer; Dr Linda Madigan, Breast Physician, Royal Adelaide Hospital, SA; Catherine Meredith, Consumer; Ash Mondolo, Breast Cancer Clinical Nurse Consultant, Mater Private Hospital, QLD; Chris Rivett, 13 11 20 Consultant, Cancer Council SA; Catrina Ross, McGrath Breast Care Nurse, Northern Sydney Local Health District, NSW; Prof Christobel Saunders AO, James Stewart Chair of Surgery and Director of Research, Melbourne Medical School, The University of Melbourne, VIC; Dr Janice Yeh, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; A/Prof Yvonne Zissiadis, Radiation Oncologist, Medical Director, GenesisCare WA and Adjunct A/Prof, Curtin University, WA.
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