Question About Staging

Kimm992

I never got an official stage because I had neoadjuvant chemo.

I had 4 tumours - the largest was 17mm and the other were 6mm, 7mm and 12mm.

At surgery time my lymph nodes were clear. The pathologist said there was no evidence that there had ever been cancer in the nodes. I had very tiny microscopic cells in one of my lymph vessels.

Does anyone know, based on what we know, what stage this might put me at?

The MO just doesn't seem all that concerned with staging so I've never had an answer to this. For some reason in my head I feel like it's something I need to know.

Samanthavt7091

Stage I

Stage I describes invasive breast cancer (cancer cells are breaking through to or invading normal surrounding breast tissue) Stage I is divided into subcategories known as IA and IB.

Stage IA describes invasive breast cancer in which:

• the tumor measures up to 2 centimeters AND
• the cancer has not spread outside the breast; no lymph nodes are involved

Stage IB describes invasive breast cancer in which:

• there is no tumor in the breast; instead, small groups of cancer cells – larger than 0.2 millimeter but not larger than 2 millimeters – are found in the lymph nodes OR
• there is a tumor in the breast that is no larger than 2 centimeters, and there are small groups of cancer cells – larger than 0.2 millimeter but not larger than 2 millimeters – in the lymph nodes

Microscopic invasion is possible in stage I breast cancer. In microscopic invasion, the cancer cells have just started to invade the tissue outside the lining of the duct or lobule, but the invading cancer cells can't measure more than 1 millimeter.

Learn about what treatments you can generally expect for stage IA and IB in the Options by Cancer Stage: Stage IA and IB page in Planning Your Treatment.

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Stage II

Stage II is divided into subcategories known as IIA and IIB.

Stage IIA describes invasive breast cancer in which:

• no tumor can be found in the breast, but cancer (larger than 2 millimeters) is found in 1 to 3 axillary lymph nodes (the lymph nodes under the arm) or in the lymph nodes near the breast bone (found during a sentinel node biopsy) OR
• the tumor measures 2 centimeters or smaller and has spread to the axillary lymph nodes OR
• the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes

Stage IIB describes invasive breast cancer in which:

• the tumor is larger than 2 centimeters but no larger than 5 centimeters; small groups of breast cancer cells -- larger than 0.2 millimeter but not larger than 2 millimeters -- are found in the lymph nodes OR
• the tumor is larger than 2 centimeters but no larger than 5 centimeters; cancer has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy) OR
• the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes

Learn about what treatments you can generally expect for stage IIA and IIB in the Options by Cancer Stage: Stage IIA and IIB page in Planning Your Treatment.

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Stage III

Stage III is divided into subcategories known as IIIA, IIIB, and IIIC.

Stage IIIA describes invasive breast cancer in which either:

• no tumor is found in the breast or the tumor may be any size; cancer is found in 4 to 9 axillary lymph nodes or in the lymph nodes near the breastbone (found during imaging tests or a physical exam) OR
• the tumor is larger than 5 centimeters; small groups of breast cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes OR
• the tumor is larger than 5 centimeters; cancer has spread to 1 to 3 axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy)

Stage IIIB describes invasive breast cancer in which:

• the tumor may be any size and has spread to the chest wall and/or skin of the breast and caused swelling or an ulcer AND
• may have spread to up to 9 axillary lymph nodes OR
• may have spread to lymph nodes near the breastbone

Inflammatory breast cancer is considered at least stage IIIB. Typical features of inflammatory breast cancer include:

• reddening of a large portion of the breast skin
• the breast feels warm and may be swollen
• cancer cells have spread to the lymph nodes and may be found in the skin

Stage IIIC describes invasive breast cancer in which:

• there may be no sign of cancer in the breast or, if there is a tumor, it may be any size and may have spread to the chest wall and/or the skin of the breast AND
• the cancer has spread to 10 or more axillary lymph nodes OR
• the cancer has spread to lymph nodes above or below the collarbone OR
• the cancer has spread to axillary lymph nodes or to lymph nodes near the breastbone

Learn about what treatments you can generally expect for stage IIIA and operable IIIC in the Options by Cancer Stage: Stage IIIA and Operable IIIC page in Planning Your Treatment.

Learn about what treatments you can generally expect for stage IIIB and inoperable IIIC in the Options by Cancer Stage: Stage IIIB and Inoperable IIIC page in Planning Your Treatment.

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Stage IV

Stage IV describes invasive breast cancer that has spread beyond the breast and nearby lymph nodes to other organs of the body, such as the lungs, distant lymph nodes, skin, bones, liver, or brain.

You may hear the words "advanced" and "metastatic" used to describe stage IV breast cancer. Cancer may be stage IV at first diagnosis or it can be a recurrence of a previous breast cancer that has spread to other parts of the body.

Learn about what treatments you can generally expect for stage IV in the Options by Cancer Stage: Stage IV section in Planning Your Treatment.

inks

With multiple tumors they do go by the size of the largest tumor. I had 18 tumors and the second opinion staged me higher than the treatment center where I had chemo. You would be staged at stage I if there was about 2mm healthy tissue between the tumors. Did you have BRCA testing? Multiple tumors may be a sign of BRCA mutation. I think you would be considered to have a greater tumor load than your stage suggests.

Kimm992

I did have the testing and everything came back negative!

My tumours were all in different parts of my breast...not close to each other at all. I had a mastectomy because of that...the surgeon said because they were all so spread apart that it was not possibly to do a lumpectomy.

I'm just not sure with multiple tumours and LVI what that puts me at!

But you seem to think stage 1?

Thanks for the help

inks

Since your tumors were far apart you would be stage I. But the stage in your case does not give an adequate picture that's probably why your doctor is not so concerned about the stage but the whole picture. And in your case the whole picture is micromets in sentinel node, overall tumor load, LVI. I don't like the staging for multiple tumors because it does not take into account the overall tumor load.

Kimm992

Okay, makes sense!

hanley50

HI kimm992 - Do you have a copy of your pathology report from your Mastectomy? Mine has the stage listed like below. For the tumor in the breast, the "y" means I had neoadjuvant chemotherapy, the "p" means pathological result after surgery, the "T1" represents the tumor size. Then for the lymph nodes, the "y" again means I had neoadjuvant chemotherapy, the "p" means pathological result after surgery, the N1a represents the number and size of the lymph nodes. The G3 means grade 3. This is as I understand it anyway. Hope this helps. If you don't have a copy of your report you can easily get one from your surgeon or oncologist.

Best wishes,

Maryann

13. 7th ED AJCC Stage: at least Stage IIA - ypT1c, ypN1a, G3

Kimm992

I don't have a copy...I will ask for one!