Breast cancer staging
Classifying your breast cancer by stage helps predict your chance of cure and helps identify the best treatment options for your particular cancer.
After discovering that you have breast cancer, your doctor will decide what additional tests may be helpful to find out if the disease has spread outside the breast. Called breast cancer staging, this process provides information about the extent of the disease.
Your breast cancer stage helps your doctor determine which treatments are most likely to benefit you.
The stages of breast cancer
The stages of breast cancer are indicated using Roman numerals ranging from 0 to IV, with 0 indicating cancer that is noninvasive or contained within the milk ducts. Greater numerals indicate a more invasive cancer. By stage IV breast cancer, also called metastatic breast cancer, the cancer has spread to other areas of the body.
The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment.
Information that helps determine your breast cancer stage
Your doctor determines your breast cancer stage by considering:
- The size of your tumor
- Whether cancer cells have spread to lymph nodes under your arm (axillary lymph nodes)
- Whether cancer cells have spread to other parts of your body
- How aggressive your cells appear when viewed under a microscope (tumor grade)
- Whether your cancer cells have receptors for the hormones estrogen and progesterone
- Whether your cancer cells have a gene mutation that causes them to make excess HER2 protein
- Results of gene expression profiling tests (Oncotype DX, MammaPrint, others)
Tests and procedures used to stage your breast cancer
To gather information about your cancer, your doctor uses a variety of sources, including:
- Physical exam. To gather the necessary information, your doctor will ask questions about your medical history, do a careful physical examination and review all the tests you've had. This can also include a review of the results from the biopsy of the tumor or suspicious area.
- Pathology report. If you've already had surgery to remove your cancer and nearby lymph nodes, your doctor will use your pathology report to help determine your stage and plan your treatment.
- Tests that evaluate your cancer cells. Cells from your cancer, collected during a biopsy procedure or during surgery to remove the cancer, are tested in a laboratory to help determine the aggressiveness of the cells and whether they are sensitive to hormones. Other sophisticated tests can determine what gene mutations are present in the cells. Not all of these tests are necessary in every case. Your doctor will help determine which tests are needed based on your particular situation.
- Blood tests. No blood test can tell you your cancer stage, but blood tests may give your doctor an idea of your overall health and clues about which other staging tests may be useful. Blood tests might include a complete blood count and a blood chemistry test, which assess your kidney and liver function.
- Breast-imaging tests. Mammogram, ultrasound and breast MRI give your doctor more information about your cancer and help determine if additional imaging tests may be necessary.
Additional imaging tests. Additional imaging can be used to look for breast cancer cells that have spread to other areas of your body. Not everyone with breast cancer needs these tests, though, so ask your doctor what's best for you.
Additional imaging tests include a bone scan, computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).
Most people with a new diagnosis of breast cancer don't need all the diagnostic tests available. Your doctor will select the necessary tests based on your situation. Particularly if your cancer is small and hasn't spread to nearby lymph nodes, additional tests may offer little benefit, but lead to additional costs and carry a risk of complications.
Feb. 12, 2022
- Amin MB, et al., eds. Breast. In: AJCC Cancer Staging Manual. 8th ed. New York, N.Y.: Springer; 2017.
- Breast cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Jan. 2, 2018.
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See also
- 3D mammogram
- Accelerated partial breast irradiation (ABPI)
- Axillary dissection
- Biopsy procedures
- Blood Basics
- Bone scan
- Brachytherapy
- BRCA gene test
- Breast cancer
- Breast Cancer
- Breast cancer chemoprevention
- Breast Cancer Education Tool
- Common questions about breast cancer treatment
- Breast cancer prevention
- Infographic: Breast Cancer Risk
- Breast cancer risk assessment
- Breast cancer supportive therapy and survivorship
- Breast cancer surgery
- Breast cancer types
- Breast cancer-related lymphedema
- Breast implants and cancer
- Evaluating breast lumps
- Breast lumps
- Breast MRI
- Breast self-exam for breast awareness
- Cancer blood tests
- Cancer survivorship program
- Chemo targets
- Chemotherapy
- Chemotherapy and hair loss: What to expect during treatment
- Chemotherapy and sex: Is sexual activity OK during treatment?
- Chemotherapy for breast cancer
- Chemotherapy nausea and vomiting: Prevention is best defense
- Chest X-rays
- Complete blood count (CBC)
- Contrast-enhanced mammography
- Coping with pain after breast surgery
- COVID-19 vaccine: Should I reschedule my mammogram?
- CT scan
- Dense breast tissue
- Does soy really affect breast cancer risk?
- Dragon Boats and Breast Cancer
- Flat aesthetic closure
- Genetic Testing for Breast Cancer
- Genetic testing for breast cancer: Psychological and social impact
- HER2-positive breast cancer: What is it?
- Hormone therapy for breast cancer
- Intralesional injection therapy
- Lumpectomy
- Magic mouthwash
- Mammogram
- Mammogram guidelines: What are they?
- Mastectomy
- What is breast cancer? An expert explains
- Minimally invasive inguinal lymphadenectomy (MILND)
- Modified radical mastectomy
- Molecular breast imaging
- MRI
- MRI-guided breast biopsy
- Nipple discharge
- Nipple-sparing mastectomy
- Oncoplastic breast-conserving surgery
- PALS (Pets Are Loving Support)
- Paulas story A team approach to battling breast cancer
- Pink Sisters
- Positron emission mammography (PEM)
- Positron emission tomography scan
- Precision medicine for breast cancer
- Prophylactic mastectomy
- Radiation therapy
- Radiation therapy for breast cancer
- Seeing inside the heart with MRI
- Sentinel node biopsy
- Skin-sparing mastectomy
- Stereotactic breast biopsy
- Support groups
- Surgical biopsy
- The Long Race Beating Cancer
- Thyroid guard: Do I need one during a mammogram?
- Tomosynthesis-guided breast biopsy
- Ultrasound
- Sentinel node biopsy for melanoma
- Mammogram for breast cancer — What to expect
- MRI
- Weight Loss After Breast Cancer
- X-ray
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