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

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".

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.

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.

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?

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 

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.

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. 

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!

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.

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. 

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.

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.