Staging and prognosis for breast cancer
Once you have had tests that show you have breast cancer, your doctor will work out the stage and grade of the cancer. The stage describes how far the cancer has spread, while the grade describes how active the cancer cells are and how fast the cancer is likely to be growing. Staging and grading help the doctor decide on the best treatment for you.
The expected outcome of your disease is called the prognosis, but it is only a prediction and some people do not find it helpful or even prefer not to know.
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The tests described here show whether the cancer has spread to other parts of the body. This is called staging.
|Stage I||Tumour less than 2 cm and no spread to lymph nodes.|
|Stage IIA||Tumour less than 2 cm and spread to 1–3 lymph nodes in armpit; or tumour 2–5 cm and no spread to lymph nodes.|
|Stage IIB||Tumour 2–5 cm and spread to 1–3 lymph nodes in armpit; or tumour more than 5 cm and no spread to lymph nodes.|
|Stage IIIA||Tumour less than 5 cm but spread to 4–9 lymph nodes in armpit or any lymph nodes under breastbone; or tumour more than 5 cm and spread to 1–9 lymph nodes.|
|Stage IIIB||Tumour any size but spread to nearby muscles and skin.|
|Stage IIIC||Tumour any size but spread to at least 10 lymph nodes in armpit; or to at least 1 node under breastbone and at least 1 in armpit; or to at least 1 node near collarbone.|
Stages I and II are called early breast cancer, while stage III is referred to as locally advanced. Stage IV breast cancer has spread to other parts of the body and is called advanced or metastatic.
The grade describes how active the cancer cells are and how fast the cancer is likely to be growing.
|Cancer cells look a little different from normal cells. They are usually slow-growing.|
|Cancer cells do not look like normal cells. They are growing faster than grade 1 cancer cells.|
|Cancer cells look very different from normal cells. They are fast-growing.|
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. In working out a prognosis, your doctor will consider the stage and grade of the cancer, as well as its hormone receptor and HER2 status.
Survival rates for people with breast cancer have increased significantly over time due to better tests and scans, earlier detection, and improvements in treatment methods. Most people with early or locally advanced breast cancer can be treated successfully.
Prof Christobel Saunders, Professor of Surgical Oncology and Head, Division of Surgery, The University of Western Australia, and Consultant Surgeon, Royal Perth, Fiona Stanley and St John of God Subiaco Hospitals, WA; Dr Marie-Frances Burke, Radiation Oncologist, Medical Director, Genesis CancerCare Queensland, QLD; Kylie Campbell, Breast Care Nurse and Clinical Lead, Murraylands, McGrath Foundation, SA; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland, QLD; Annmaree Mitchell, Consumer; Sarah Pratt, Nurse Coordinator, Breast Service, Peter MacCallum Cancer Centre, VIC; Dr Wendy Vincent, Breast Physician, Chris O’Brien Lifehouse and Royal Hospital for Women, Randwick, NSW, and Clinical Director BreastScreen NSW, Royal Prince Alfred Hospital, NSW; A/Prof Nicholas Wilcken, Director of Medical Oncology, Westmead Hospital, and Co-ordinating Editor, Cochrane Breast Cancer Group, NSW. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. This booklet is funded through the generosity of the people of Australia.
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