"Early Breast Cancer" v. "Advanced Breast Cancer"

Anonymous

Dear everyone:  I don't know why the medical community ever started putting us in "stages" of BC, but I was told I was Stage 3A or she also called it "early" BC.  When looking at the stage descriptions on Johns Hopkins website, it says anything from stage 3A on down to Stage 4 are in the "Advanced BC" category.  Has anyone else had their oncologist say that we stage 3'rs are early BC?   Let's just all call ourselves "thrivers" and "survivors". 

debbie6122

Shelly, Im no doctor but i agree with you that it is Not early stage bc- She may of meant  it wasnt agressive?? Not sure what your stats are- size of tumors er/pr her2, if it has entered the chest wall, skin ect,,,, could be the size of your tumor and more than 2 nodes positive put you in the stage 3??  Im not a stage 3 but wanted to help in any way i could, im sure some stage 3 ladies will be along later to answer your question sending big hugs your way

Debbie

krcll

This is from the bc.org website-

Additional staging information

You may also hear terms such as "early" or "earlier" stage, "later," or "advanced" stage breast cancer. Although these terms are not medically precise (they may be used differently by different doctors), here is a general idea of how they apply to the official staging system:

Early stage

• Stage 0
• Stage I
• Stage II
• Some stage III

Later or advanced stage

• Other stage III
• Stage IV

My impression is that "advanced" cancer is cancer that has metastisized. I have heard stage III referred to as "locally advanced" which makes sense in that it has metastisized locally (to the lymph nodes). But I have also heard all stages I-III referred to as "early" and only IV as "advanced".

Mamita49

I know that my doc said that the stages are only there for the docs to see which chemo and how much chemo are given to each patient. Dont forget...... the cancer does not know its stage, and has a behavior of its own.

I met at a wellness center some women who had a 6cm tumor no nodes DICS, no chemo.

And another one with a less than 1cm tumor lots of nodes, and 6 months of chemo. 

If you had chemo before surgery, you will never know the real size of your tumor, or how many nodes involved. Some women are staged as Stage II, but actually where Stage III.

My doc tells me that its only for the treatment decisions. 

DCMom

It is my understanding that stage IIIA is considered early stage breast cancer.  It is included in many studies as early stage.  However it is also strange to see how different people are placed with different stages although diagnostically they have very similar physicalities.  I like to think of my self as being early stage and that's my story and I'm sticking to it. 

In the long run this is a crap shoot, which for someone with stage I is a scary thing to hear, but I for one kind of like the fact that chemo is now 98% effective (according to some studies) in breast cancer and that once I was cancer free I was right back in with the crap shoot.  F*%$ the statistics I'm kicking butt.

geewhiz

I'm with ya!! Don't label me with some numbers and expect it to stick !!!

I am surviving and thriving for sure!!!

Anonymous

Dear everyone:  Here are my stats so you can compare and see if your onc or my onc have similar descriptions on staging.  I had a large tumor 5.0 x 6.5 cm.  I had also all grades in it, from least aggressive grade 1 to most aggressive grade 3.  The recommended only 4 chemo's and 4 taxols for my treatment, plus 28 rads.   A friend of mine stage 2 did 12 taxol and I believe 6 chemo, but I believe that was the cocktail of a clinical trial and this friend is 12 years younger than myself.  I had 4 out of 15 nodes positive, but no nodes showed positive on either the pre-surgery CT or PET scans.  My onc says my prognosis will be based actually on nodes and not so much size.  But I've heard other docs say size matters too.  What the heck?

thanks for weighing in --- take care

Shelly

Jane_M

My docs love to remind me that I'm "late stage" cancer.  Everytime I ask about a new treatment, they say..."Oh, that's for early stage cancer; you have late stage cancer."  It's a fact I know, but it hurts to hear them say it.

LRM216

Shelly - just FYI - the 12 taxol's your friend had are the equivalent to the 4DD Taxol - just weaker in solution, but covering a longer time period.  Some docs prefer doing it that way, others do not.  I myself had 4 A/C and 4 DD taxol (actually 1 taxol and 3 taxotere's).  Being triple negative - one wants to go as heavy as possible.

LRM216

JaneM:  I think you have an inconsiderate doctor.  Shame on him.  The only cancer my onc regards as late stage is Stage IV and only because that stage is then treated as a chronic condition.  Even at that, she does not refer to it as "late stage" but "chronic".

Anonymous

LRM216:  If that is true, then I really cannot figure out why our chemo was basically the same.  She was a Stage 2B, had a few more nodes than me and only 2 cm. tumor.  My pathology was ER/PR +, but HER2 Negative, so was hers. I read where 65-70% of BC is this type of pathology.  Only 10-12% of cases are triple negative.  What does your onc prescribe for you now? 

Anonymous

Jane M: I agree with LRM216 that you have an inconsiderate, insensitive doctor.  He/she/ or they should be reinforcing the fact that your pathology shows a favorable prognosis going forward, and that it has not spread to other organs !  I truly wish they would eliminate the staging labels in the future.  God bless.

shells43

I find it this topic very interesting because my Onc never told me my stage. I had to look it up, and was glad that I could do it when I was ready. He told me everything I needed to know to "stage myself", tumor size, grade, nodes, etc. I'm really not sure what to think about him not telling me, except that maybe he knows it's better mentally to not be given that information up front?

lago

I usually see stage III as not early but IIIA does seem like it's on the cusp. I haven't beens staged yet but my surgeon (when asked) said I would probably be III do to the size of my tumor and grade3 status. We don't know about the lymph nodes yet. Both the physcial and MRI show no involvement but we won't know till we rip 'em out. 70% no involvement.

But I too say to everyone that it's better to be a stage III and respond to all the treatment then be a stage II and not respond!  There are stage IV people that respond well to treatment and live for years/decades!

cbm

I have a different view of all this, I guess.  I think the whole staging thing is a little misleading; I had only one lymph node, but there might well have been a lot more cancer in that node than some of the women who had five or six nodes involved.  The fact that mine was kind of crammed full--but was still only one node--might make my disease look like stage two, but warrant treatment for stage three.  I don't know; I didn't want rads, so I was fine with what was offered to me, bmx and chemo, but then I asked for a second year of herceptin on the basis of that node.  

All I'm saying is that I don't take the stage 2 thing as any kind of reassurance. . . I'd like to be stage 0 or 1 but qualify for the treatment that stage 3 women get!

It is the medical establishment with the insurance companies that devise these guidelines to organize treatments and protocols, so trusting them comes with some risk, imho.

And JaneM, I agree that there is never an appropriate discussion that reminds anyone at any stage of such an arbitrary classification.  It doesn't come with any guarantee at all.

Peace,

Cathy 

Jayne_in_UK

I am stage IIIa and my surgeon and onc refer to it as early stage. I took part in a clinical trial that was specifically for 'early stage' bc. At the time it surprised me that I was put in that category.

I think the staging is mainly putting a label on it to determine a treatment plan and monitor the statistics. Size of tumour and number of positive nodes are taken into consideration, so in some cases there can be just one positive lymph node between stages. Although I was initially alarmed to find out my stage I was also glad that I got the kitchen sink thrown at it in terms of treatment.

Anyway early or late stage I'm also surviving and thriving!

jsw19

This conversation is interesting to me because my surgeon wouldn't even tell me my stage when I asked.  He said that he does not like the 0-4 staging and instead says that doctors are moving to the TNM staging.  There is a nice description of it on the Komen website: http://ww5.komen.org/BreastCancer/StagingofBreastCancer.html

Based on my info I think I am stage 3A but like others have said I think the key info is size of tumor, number of nodes, presence (or not) of mets, plus your receptor status.  Thinking about early vs. advanced makes me feel more anxious so I just focus on the fact that I caught it as soon as I could (by self-exam) and now I am getting the best treatment that I can and that is really all that I can control.

Mom3

I got a 2nd opinion at City of Hope about 2 years ago. At the time I was under the mistaken impression that I was 'late stage'. The oncologist who I saw corrected me when I said this. She said it emphatically "YOU ARE NOT LATE STAGE. YOU ARE EARLY STAGE". Actually, she even surprised me how strongly she said it. As if to deprogram my thinking. But I got it. Okay, okay, early, early stage bc.And that's how I've viewed myself since. I guess it worked.

AgentMo

With regard to this staging question, does anybody know why the cut-off point for stage III versus stage II is drawn at three positive nodes? I mean, did they run tests to find out that survival deteriorates really a lot when you go from three to four nodes compared with two to three nodes and four to five nodes? Or is the cut-off point just an artefact because in former times with limited computer capacity someone just started to build convenient subgroups for survival calculations and ended up having 0, 1-3, 4 or more lymph nodes? So far, I have never read an explanation as to why these cut-off points have been chosen.

By the way, the "better" TNM-staging uses the same cut-off points, so even in this new staging system it is still interesting to know why they were chosen. 

I would certainly feel better having early-stage breast cancer but my oncologist has stressed  often that I am not early stage. Even three month after my diagnosis I find this statement devastating. It certainly eradicates hope. 

sam52

AgentMo - I really think your dx is EARLY bc.......my pathology is not so different from yours and I have always been told early stage.It seems only stage iv is considered late stage.

You have an inconsiderate and insensitive onc also.I know I was devastated when my surgeon gave me my results after the mast and told me, almost gleefully, that grade 3 is the most aggressive.I could not bear to say that word for years afterwards.

You certainly have hope.

((((hugs)))

Sam

kimber3006

I agree, AgentMo, that you're early stage.  At least according to the literature I was sent home from the hospital with after my mx you are.  And even if you weren't, the odds would still be in your favor for survival.  There is always hope and you, my dear, have every reason to have plenty of it!

violet7

I asked my oncologist what specifically is my stage.  I had a 2 1/2 cm grade 3 tumor and one lymph node with a 1/2 cm tumor, the other 7 taken were clear.  He told me I was 2b or 3, but that staging is obsolete.  He said depending on the circumstance a person dxed with stage 3 may have a better prognosis than someone dxed with stage 1.  I personally refer to myself as 2 or 2b, because that is what I've found to be the case on the internet sites I've visited. 

lago

Many times the treatment is more aggresive for stage III then stage I or II. I think this might help at times with stage III sometimes having a better survival rate then some earlier stages. IMO it all depends on how well you respond to the treament (chemo, hormone therapy, rads). At least that is what I keep telling mom. I know she's so scared for me.

chrishat

hi all,

my surgeon referred to mine as 'late early stage'....i think that's a term he made up but i like it. i had a 1.7cm tumor but it had multifocal points, like a starfish, with dots of IDC between the points, and 5/11 pos nodes, one with extracapsular extension. anyway, he is very optimistic that we got it 'in time' and i like his optimism!

hmh23

My onc also refers to my stage 111A as early stage.  He is one of the top oncs in the country.  Additionally, my surgical onc also supports the early stage diagnosis.  The bottom line is that we are all breast cancer survivors, having survived our diagnosis and now surviving our treatment and disease. 

Anonymous

hmh23:  I like your onc's outlook as a stage 3A.  How many positive nodes, if any, did you have?  I had 4 positive.  Keep up the positive outlook on us all !! 

diana50

i have not had conversations with m surgeon or onc on "early or late" stage cancer. for me, it just has always been treatment; surgery....chemo (clinical trial), rads and arimidex. my idea on it is this"  it is cancer....and i am going to do the treatment available for my diagnosis " and that is pretty much it. for me, i just see it as cancer...and don't think about prognosis...statistics...etc.  i just did what i needed to do...and i continue to do that. so far, the treatment has worked for me. i am sure i got into the clincial trial back in 2002 because of the number of nodes...and for that i am grateful.

rreynolds1

If you look at the stage 4 thread, there are women who were originally diagnosed with stage 1 or stage 2 breast cancer.  I believe the staging is their best effort to decide what treatment to use and it also changes the risk of recurrence.  However, any of us could move to more advanced stages so my goal is to live the best life I can today.  No one, even our doctors, knows what will happen to us in the future.  I have a friend who was a famous surgeon and author (Dr. Bernie Seigel) who's specialty is cancer.  He treated a woman with breast cancer 30 years ago.  The woman had a large tumor with all positive lymph nodes.  He thought she would not survive the cancer because the treatments back then were so limited.  She is 80 and doing fine.  Who knows?

Let's not let our doctors frighten us with unnecessary conversations about staging and what they believe about our prognosis.  We are not statistics.

Roseann

blondie45

jsw19 - My doc also uses the TNM staging and told me I was stage II based on this. That did not matter in his recommendation to do a tough chemo regimen, rads, and hormone therapy though which I am glad he did. I now try to eat better and try to exercise at least 5 hours a week especially after reading about exercise reducing recurrence rate. I just want to make sure I did everything I could and so did my doctors and it didn't depend on if I had 1 lymph node positive or 6 as I did.