The Stages of Breast Cancer: What You Need to Know
March 28, 2023
6 min read
Breast cancer is a prevalent condition among women worldwide, with an estimated one out of every eight women facing a risk of developing it throughout their lifetime. This makes it essential for women to understand breast cancer.
Breast Cancer: What Is It and What Are Its Types?
There are different types of breast cancer, and they are classified based on the type of cells that are affected.
Ductal Carcinoma in Situ (DCIS)
Ductal carcinoma in situ (DCIS) is an early form of breast cancer characterized by abnormal cells in the breast's milk ducts. Though the non-invasive and low risk for becoming invasive, DCIS should still be evaluated and treated, as it can progress to invasive cancer if left untreated.
DCIS is usually diagnosed through mammography or self-examination and is treated with options such as surgery, radiation therapy, or active monitoring. Although it carries a low risk of becoming invasive, discussing all available care options with a doctor is essential to make the best decision.
Invasive Breast Cancer (ILC/LDC)
Invasive breast cancer is one of the most common forms of malignant tumor and can spread beyond where it originated in the breast tissue. The two primary types are ductal carcinoma, beginning within milk ducts closer to the skin, and lobular carcinoma, which originates from glands deeper inside the body. This type has often metastasized throughout other parts of nearby organs via blood vessels and lymphatic pathways.
Unique Forms of Invasive Breast Cancer
Invasive breast cancers can be more complex and life-threatening than other variations, but certain special features or traits make them unique. These characteristics should always inform the treatment approach for optimal outcomes.
Triple-Negative Breast Cancer
Triple-negative breast cancer is an exceptionally persistent and challenging strain of invasive malignancy characterized by the absence of three notable markers—estrogen receptors (ER), progesterone receptors (PR), and Human Epidermal Growth Factor Receptor 2 proteins.
Representing around 15% of all cases diagnosed with breast cancer worldwide, this particularly aggressive form presents quite a formidable foe for treating physicians to tackle.
Inflammatory Breast Cancer
Inflammatory breast cancer is an uncommon yet exceptionally aggressive form of invasive breast cancer. Characterized by blocking lymph vessels in the skin, it causes inflammation and swelling on the affected side. Unfortunately, this devastating disease affects 1 to 5% of all diagnosed cases of breast cancer worldwide.
Uncommon Forms of Breast Cancer
While the most common form of breast cancer begins in milk-producing cells, less frequent varieties can grow from other cell types within this vital organ. Fortunately, these cancers generally require alternative treatment regimens that are just as effective at eliminating the cells before they become dangerous.
Paget's Disease of the Breast
Paget disease of the breast is a highly uncommon type of cancer, affecting no more than three percent of all cases involving this area. It begins in the body's ducts which then propagate to both the nipple and its surrounding areola—the dark circular complexion that serves as an identifying feature.
Angiosarcoma
While only constituting a small portion of breast cancers, angiosarcoma is essential when treating the disease. This rare type starts in cells that line blood or lymph vessels and may manifest as either involvement in the tissue or the surrounding skin. It has also been linked to prior radiation therapy conducted within its area.
Phyllodes Tumor
Phyllodes tumors are an uncommon type of breast growth originating in the breast's connective tissue (stroma). Unlike carcinomas, which form in the ducts or lobules, phyllodes tumors arise in the stroma. Although most phyllodes tumors are benign, some can be malignant (cancerous).
Breast Cancer: How Many Stages Are There?
Breast cancer ranges from stage 0 to 4, a progression depicted by the Roman numerals I through IV. Within each of these stages are several distinct variables determining severity and treatment. Measurements of tumor size utilize millimeters as their standard metric—10mm, equating precisely one centimeter in length.
Stage 0
Stage 0 marks the start of a medical journey, pointing to precancerous growths such as ductal carcinoma in situ (DCIS), which does not indicate that cancer cells have spread beyond their initial site. In this early phase, there is still an opportunity for doctors to identify and strategize treatments before further progression of the disease occurs.
Stage I
Stage I cancer is the earliest stage at which tumor cells have begun to move beyond their original location and invade other breast tissue. It can be divided into two distinct subcategories, each with symptoms and prognosis.
Stage IA
- This benign tumor, measuring up to the size of a grape, is free from any malignancy in nearby lymph nodes.
Stage IB
- A small yet concerning tumor was discovered in the breast measuring under twenty millimeters. Alarmingly, further investigation revealed cancerous cell clusters within nearby lymph nodes.
- After close examination, the results showed an absence of tumors in the breast, with only small amounts of malignant cells detected within nearby lymph nodes.
Stage II
Stage II breast cancer indicates that the tumor has grown and may have spread into surrounding lymph nodes. This stage is divided into two distinct stages, each requiring an individualized treatment approach.
Stage IIA
- There is a possibility that the breast area may be affected by a tumor whose size could potentially reach up to 20 millimeters (about as big as one grape). Moreover, cancerous cells have potentially spread into nearby lymph nodes.
- A tumor of moderate size has been detected in the breast, with no evidence that it has infiltrated nearby lymph nodes.
Stage IIB
- A distinct tumor, measuring between 20 and 50 millimeters, has been found in the breast. Additionally, cancerous cells have metastasized to up to three nearby lymph nodes.
- A tumor of a considerable size found in the breast provides a sign of concern, yet fortunately, it has not spread to any nearby lymph nodes.
Stage III
Stage III breast cancer is a serious form of disease that has spread within or beyond the confines of the affected organ. It presents three distinct gradations, each with its unique characteristics.
Stage IIIA
- Cancer can spread to four to nine nearby lymph nodes even if no breast tumor exists.
- Cancer has spread between one and three nearby lymph nodes, and the breast tumor size is over 50 millimeters.
Stage IIIB
- The spread of cancer to the skin may result in swelling or inflammation.
- A penetrating wound may cause soreness or ulcers in the affected area.
- The potential for the spread of this condition was far-reaching, potentially reaching as many as nine underarm lymph nodes or those located close to the breastbone.
Stage IIIC
The presence or absence of a tumor in the breast does not determine the stage, but rather the spread of cancer to one of the following locations:
- An increased number of underarm lymph nodes, over ten, could indicate the presence of an underlying health issue;
- nearby lymph nodes along the collarbone;
- a few lymph nodes in the underarm region and those close to the breastbone;
- and the skin.
Stage IV
Breast cancer is typically divided into four stages, of which stage IV is the most severe. At this point, malignant cells have metastasized beyond the breast and its local lymph nodes to invade other parts of one's body, be it an organ or bone.
In some cases, after a previous remission, a recurrence may also progress to Stage IV with similar compounding consequences for their physical health and well-being.
Breaking Down Barriers: Understanding Breast Cancer
Breast cancer is a severe condition that affects a significant number of women globally. Understanding the different types and stages can be overwhelming, but women can take control of their health and treatment with the correct information and support.
It is essential to talk to a healthcare provider about any concerns or questions and to have regular screenings to ensure early detection and successful treatment.
