T3N1M0 is locally advanced or early stage?

I always understood that locally advanced breast cancer is only stage IIIc, but I may be wrong. I thought that N3 is what makes it locally advanced.

I am stage IIIa and have thought of myself as locally advanced AND early. If the choices are just early or advanced (what I think of as stage IV) , then I think I am early. If you want to define more, I have thought that "locally advanced" differentiates having positive lymph nodes from those with negative nodes, without meaning that we are stage IV. It is true that the terms are used differently by different people and I don't really know what is "right".

If you are concerned about if it is curable, it can absolutely be beaten. Stage IV is a different can of worms, but at stage IIIa, for the majority of women, the first treatment will get rid of the cancer. It doesn't matter if it is called early or locally advanced!

If I have gotten any of the facts wrong, please correct me! This is just my personal understanding.

Stage IIIA is still considered early stage.

Definition of early stage:  http://www.cancer.gov/dictionary/?CdrID=446564

Detailed information on each stage:
http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/page2

Thanks Sherri,

I'm happy to Know I'm not the only one that noticed that. Hey Mabey were no stage cause the beast is gone!!!

Big hugs to all!!

 Faithful

When I was first diagnosed I am certain my oncologist told me I was stage IIb.  But, if you look at my signature line, clearly, I am IIIa.  I read somewhere that the staging categories changed around the time I was diagnosed so maybe that's why.  A couple yrs. ago I asked my rad. onc. what stage I was (notice I said WAS) and he looked at my chart and said, "stage III".  I am glad I thought I was a lower stage when diagnosed.  I think all along I knew I was stage III but did not really want to ask for clarification.

BTW-I am coming up on 5 years!!!

I know for sure that staging has changed in 2002 or 2003. Before 2002, all patients with positive axillary lymph nodes were regarded N1 and hence stage II. This definition has been changed, now N2 start with 4 positive lymph nodes. Therefore, those with more than 3 positive lymph nodes today would all be classified as stage III. The location of the positive nodes matters for the N3 classification and hence for the distinction withing stage III.

Caaclark, I certainly would also feel better being stage II. Unfortunately, by now I have dwelved too much into the topic. Glad you are approaching five years.

According to BCO,

http://www.breastcancer.org/symptoms/diagnosis/staging.jsp

wherever axillary lymph nodes are mentioned for the stages they distinguish whether they "are clumped together or sticking to other structures", otherwise they just say axillary nodes without mentioning any specific number of nodes, so it seems it's the progression of cancer in the nodes rather than the number that affects prognosis and treatment.

Stage IIb `... and has spread to the axillary lymph nodes."

Stage IIIa `... and has spread to axillary lymph nodes that are clumped together or sticking to other structures."

When the tumour is larger than 5cms it belongs in IIb if there are no nodes and IIIa if nodes have "clumped or stuck" but then there is nowhere when nodes have not "clumped or stuck" with a tumour greater than 5cms. Of course there are other reasons for staging not affected by the nodes. I assume these changes are the result of prognostic statistics gathered from many studies and wonder why they haven't been more widely publicised.

I know one of my cancerous nodes had ruptured but have no idea whether that puts me in stage II or III.

My original tumor was over 4cm IDC, 1cm ILC, and DCIS all in one breast and after full axillary lymph nodes dissection I had 3 pos and 2 clumped (grouped together) that were possitive,  And it also mentioned extracapsular extension. Im not sure if it was in my superclavical area but I do remember them saying something about that, and they are highly radiating that area right now.  But it was after the discussion about the poss group of nodes that made me understand that I was Stage 3b.  I did have neoadjunctive dose dense chemo, bilat mast with expanders (did find precancer in other breast too) having rads and may also have a ooph and then switch out expanders for silicon in a few months. But the stage still does scare me now that most of my active treatment is almost over.

Margie, yes, I was told it was stage 3 but I don't know whether I should be stage 2 with the new rules.  They probably have different criteria here in Australia anyway but if the prognosis has now been improved I'd love to be stage 2 for my own peace of mind. 

Tammy, that's what my pathology said, extracapsular extension, but I don't know what it means or if it fits the new category for stage 3.  I suppose I could see if adjuvant online gives me different statistics now if they take into account the new information but the thought of going to that site gives me the creeps.

@Sheila: The staging information that you have posted is the old staging information (today it is only used for the clinical staging, but not for the staging after pathology). Today's staging can for instance be found at the American Joint Committee on Cancer. One possible link is the following: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-staging

The NCCN Treatment Guidelines are updated every year.  V2-2011 is the most current.  Their info on staging is on pages 61 - 63. It is necessary to register to view the physicians version of the guidelines:

http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf  

Staging is a guide for treatment. The decision of whether to recommend any particular treatment is based on an weighting of the benefits of the treatment vs. the risks from the treatment.  While the risks of most treatments remain consistent regardless of the diagnosis, the benefits change as the diagnosis/staging changes. The way that staging is set up, those conditions that put the patient at higher risk of recurrence (and particularly, distant recurrence) are placed in higher stages. For example, all T4 tumors, which are tumors with an extension to the chest wall or the skin, are Stage IIIB, regardless of the size of the tumor or whether there is nodal involvement. Similarly, all women with N2 nodal status (4+ nodes) are Stage IIIA (or higher) regardless of the size of the tumor.  This is because studies have shown that recurrence risk increases when more than 3 nodes are affected.  

So staging unquestionably is also an indication of the likelihood of recurrence.  To suggest otherwise is simply wrong.  At time of diagnosis, those who are higher stage have a greater likelihood of recurrence. Based on this greater likelihood of recurrence, the "benefit vs. risk" equation from certain treatments swings in favor of the "benefit" and therefore these treatments are more likely to be recommended for those who are higher stage. Because these additional treatments are given, those who are higher stage may be able to reduce their risk of recurrence to levels that are similar to those who are lower stage who do not get these same treatments.

Sorry for intruding on this Stage III discussion and into the Stage III forum but I thought the NCCN Physician's Guide staging info might be helpful and might clear up some of the confusion.  And I felt the need to comment because my head explodes when people say that staging doesn't matter. 

lago, there has been so much discussion on this board lately about the fact that "stage doesn't matter" that I think the point that you just made needs to be explicitly stated.  That's what I tried to do.  Stage matters. We are not all alike. That's why we get different treatments.  And the fact is that even with these treatments, the overall recurrence rate increases as stage increases. So while these additional treatments are effective at eliminating some of the differences in recurrence risk between the stages, unfortunately they are not effective at eliminating all of the differences.  Might there be a blurring of the line between some of the stages?  Of course, but that doesn't change the fact that overall and on average, there is a difference between the stages.

It's times like this I wonder what a stage I BC is doing on the III site.  We are in a crappy boat, but bottom line is it is more likely we will die of something other than breast cancer (even at 51%).  The number of nodes does come into play, but once the cancer is removed we are just as "cancer free" as the stage I girls.  It's about looking at the bright side instead of focusing on the what if's.  

The recent blog about stage forums and whether or not they should restrict postings to girls of that stage is just because of moments like this.  Thank God for Beesie that she was so lucky to be at stage I, but we weren't all so lucky and we'd like to put on some rose colored glasses when it comes to staging issues.  Sure our dice aren't as lucky as hers, but we are still rolling the dice just like she is.  Give it up girls.  Stage doesn't matter after treatment is over...you either recur or you don't.  I'm banking on never fighting cancer again because I don't like the other option.  If it happens well pooo, but for now all I can do is live EXACTLY LIKE THE STAGE I GIRLS.  Ok now we do have something in common. 

Sorry, I  just got my gripe on. Lago I'm very likely to see you posting in 10 years and I look forward to it! 

Also need to respond to dobbins_margie's statement that beyond stage IIIA, "not much can be done" and that she caught hers in the "nick of time".

I was wondering about that as well. Whatever our private thoughts might be about our dx, as members of the Stage III board, we encourage each other with our posts.