Difference between Stage1A and 1B??

DCODED · June 2016

I just filled out my profile for this discussion Board...I didn't know what stage to fill out.My lymph were clear so Stage 1 but what is the distinction between A and B ?

thanks

Anonymous · June 2016

The stages differ by whether or not the lymph nodes are involved. If you have no lymph node involvement then you are Stage 1A. If you have up to 3 lymph nodes involved with micrometestases then you are Stage 1B. My understanding is that Macrometestases would take you up to Stage 2A.

I am a newbie in this, so would also like to hear from anyone that maybe can correct me or tell me if this is incorrect.

Dolly

SpecialK · June 2016

Here is the Stage IA&B info from BCO's main site:

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.

BarredOwl · June 2016

Hi DECODED:

Your profile info is not showing, so you may need to change the setting.

By "clear nodes", I take it to mean that you had no clinical evidence of lymph node involvement, and the sentinel node biopsy results on final surgical pathology were designated as purely "N0".

Then, I assume your tumor is "T1" in terms of size (tumor ≤ 20 mm in greatest dimension), including any one of the following:

T1mi Tumor ≤ 1 mm in greatest dimension

T1a Tumor > 1 mm but ≤ 5 mm in greatest dimension

T1b Tumor > 5 mm but ≤ 10 mm in greatest dimension

T1c Tumor > 10 mm but ≤ 20 mm in greatest dimension

T1 disease that is purely node negative (N0) with no evidence of distant metastasis (M0) would be T1 N0 M0 and that is considered Stage IA.

For a T1-size tumor to be Stage IB requires micromets in the lymph nodes (i.e., "pN1mi" = Micrometastases (greater than 0.2 mm and/or more than 200 cells, but none greater than 2.0 mm):

https://cancerstaging.org/references-tools/quickreferences/Documents/BreastMedium.pdf

I am a layperson with no medical training, so if unsure about the above, please ask your doctors for clarification.

BarredOwl

Anonymous · June 2016

Wish they had a LIKE button on this site. That was a super explanation BarredOwl. I am starting to think I am 1B. Still not asked at hospital. But have seen others on this site with similar info as me and they are putting themselves down as 2A? I am wondering if it's also to do with grade of cancer and what hormones are also involved?

I shall ask this coming Friday when I am getting next infusion.

Dolly

BarredOwl · June 2016

Hi Dolly:

Grade and receptor status are not used to determine stage according to the current AJCC process of "TNM" staging.

The profile section does not permit one to specify the extent of node involvement, just number of positive nodes. However, the degree of node involvement can lead to different stage assignments. T1-size tumors with nodal micrometastases only are classified as Stage IB (T1 N1mi M0). In contrast, those whose node involvement is larger than a micrometastasis, for example with a metastases in 1–3 axillary lymph nodes, and at least one metastasis greater than 2.0 mm, would be Stage IIA (T1 N1 M0). Compare lines 4 versus line 6 of the chart:

https://cancerstaging.org/references-tools/quickreferences/Documents/BreastMedium.pdf

To be certain about your degree of nodal involvement, check your surgical pathology report for descriptive information about the degree of node involvement and any determination of "N" status by the pathologist (e.g., pN0, pN0(i+), pN1mi, pN1, etcetera), and ask your doctors for your exact stage.

BarredOwl

DCODED · June 2016

Thanks BarredOwl for all the info on this. I have since edited my Profile - so I think my Dx etc should be shown now?

I had an appointment this past week - was supposed to be with my RO but he was busy so spoke with his Resident (I'm guessing) and I asked the question. That Dr. indicated the difference between 1A and 1B is strictly tumor size and therefore pegged me as 1B. However, I see that he is quite possibly wrong on this and will bring it up this week when (hopefully) I can chat with my RO.

Thanks again for the clarity on this.

BarredOwl · June 2016

Hi DCODED:

Your profile is currently showing as Stage IB.

Per my post above, if there was no clinical evidence of lymph node involvement and the sentinel node biopsy results on final surgical pathology were totally negative, I would think Stage IA too. I think the distinction between IA and IB is not tumor size, but is nodal status per the little chart (line 2 versus lines 3 and 4). However, I am a layperson with no medical training, so please do follow up with your treatment team as you propose.

BarredOwl

keepsake · June 2016

Hi DollyDimples and DCODED,

Just a thought...Perhaps the MD was referring to tumor size, not stage, when he stated the tumor was 1b. According to AJCC, 7th edition, a tumor size of 1cm, which you have cited on your profile, is a T1b (Tumor > 5 mm but ≤ 10 mm in greatest dimension) and your stage may be either 1A or 1B depending on nodal status (which BarredOwl explained so well) and with no evidence of distant mets (M0).

Difference between Stage1A and 1B??

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