Table of ContentsView AllTable of ContentsBreast Cancer Tumor SizeTNM SystemStagesOther Staging FactorsAfter Clinical StagingFAQ
Table of ContentsView All
View All
Table of Contents
Breast Cancer Tumor Size
TNM System
Stages
Other Staging Factors
After Clinical Staging
FAQ
Cancer stagingis the process of determining how muchcanceris within the body (tumor size) and if it has spread. Forbreast cancer, this might take the form of clinical (pre-surgical) staging or pathologic (surgical) staging.
This article explains what is involved in clinical breast cancer staging and what the different stages mean. It also explains what to expect after the clinical stage has been established.
Verywell / Gary Ferster
Doctors usually measure the size of the tumor in centimeters (cm). Some common foods analogies can help to better understand tumor sizes:
For the clinical staging of breast cancer, your cancer specialist (oncologist) may use one or more of the following imaging tools:
TNM System for Breast Cancer Staging
Breast cancer and most other solid tumor cancers are staged with a system called the TNM Classification of Malignant Tumors. The abbreviation “TNM” stands for the three characteristics used to determine the stage of cancer:
Based on the findings, cancer is staged from 0 to 4, with 0 being the least advanced stage and 4 being the most advanced stage. The cancer stage directs the appropriate course of treatment and predicts the likely outcome (prognosis).
This includes determining whether alumpectomy(the removal of the tumor) or amastectomy(the removal of the tumor and breast) is needed.
Clinical vs. Pathologic StagingClinical breast cancer staging can help direct if a lumpectomy or mastectomy is most appropriate. But for the purpose of cancer diagnosis and treatment, pathologic breast cancer staging is considered the gold standard.
Clinical vs. Pathologic Staging
Clinical breast cancer staging can help direct if a lumpectomy or mastectomy is most appropriate. But for the purpose of cancer diagnosis and treatment, pathologic breast cancer staging is considered the gold standard.
T Classification for Clinical Breast Cancer Staging
In the TNM system, tumor size plays a central role in clinical and pathologic staging. The extent to which the tumor has grown into surrounding tissues is also important.
Tumor size is categorized in the TNM system as follows:
N Classification for Clinical Breast Cancer Staging
The number and extent of lymph node involvement are central factors for the staging of breast cancer. This primarily involvesaxillary lymph nodesof the armpit, but may also involvesupraclavicular lymph nodesaround the collarbone andmediastinal lymph nodesaround the breastbone.
For the clinical staging of breast cancer, your oncologist will palpate (physically touch) areas of skin nearest the tumor to feel for lumps. The clinical staging is ultimately based on the number, size, texture, and location of swollen lymph nodes.
Alternatively, your lymph nodes may be evaluated with asentinel node biopsy. This is when one or two lymph nodes nearest the tumor are removed and directly inspected for cancer cells in the laboratory.
M Classification for Clinical Breast Cancer Staging
Metastasis is the extent to which cancer has spread beyond the primary (original) tumor. The M in breast cancer refers to spread to distant organs (liver, lung, bone) or the contralateral lymph node basins on the opposite side of the diagnosed breast cancer.
Procedures to confirm metastasis include acomputed tomography (CT) scanand/or apositron emission tomography (PET) scan, both of which can pinpoint cancer cells in other parts of the body.
Where Can Breast Cancer Spread?
3:01Breast Cancer Treatment Options
3:01
Breast Cancer Treatment Options
Stages of Breast Cancer
Breast cancer has five stages. Your stage is based on the TNM classification.
Stage 0
Stage 1
Stage 1 means that cancer is small and is only in the breast tissue or possibly in the lymph nodes closest to the breath. There are two subcategories of stage 1 breast cancer:
Stage 1A:
Stage 1B:
An Overview of Stage 1 Breast Cancer
Stage 2
Stage 2 is cancer that has become invasive and has spread into regional tissue. This stage also is divided into two subcategories:
Stage 2A:
Stage 2B:
An Overview of Stage 2 Breast Cancer
Stage 3
Stage 3 cancers are invasive. This stage is divided into three subcategories:
Stage 3A:
Stage 3B:
Stage 3C:
An Overview of Stage 3 Breast Cancer
Stage 4
Common sites of metastasesinclude the lungs, skin, bones, liver, brain, and distant lymph nodes.
An Overview of Stage 4 Breast Cancer
Breast Cancer Healthcare Provider Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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Other Factors for Breast Cancer Staging
Biopsies and imaging studies give an approximate measurement of your tumor, but you need the actual tumor size in order to make the best treatment decisions.
Armed with this information, your oncologist can decide what other treatments are needed and when, including chemotherapy, radiation, hormonal therapy, or immunotherapy.
How Breast Cancer Is Treated
Summary
Breast cancer staging determines how much cancer is within the body (tumor size) and if it has spread. Doctors use the TNM system to stage breast cancer and guide treatment. Additional testing may be done to determine the prognosis and best treatment approach.
After the staging process, a lumpectomy or mastectomy is performed. Additional treatment may include chemotherapy, radiation, hormonal therapy, or immunotherapy.
Frequently Asked QuestionsVolume doubling time estimates how fast breast cancer grows. This is the amount of time it takes for a tumor to double in size. Growth also depends on the type of breast cancer you have and whether you have been treated with hormone therapies.Learn MoreHow Fast Does Breast Cancer Start, Grow, and Spread?You will need to have a mammogram, CT (computed tomography) scan, or MRI. Additionally, you may need a biopsy to rule out cancer.Learn MoreBenign and Malignant Breast LumpsBenign tumors usually have a smooth, regular shape, whereas a cancerous tumor may have an uneven shape and appearance. A biopsy may be needed to rule out cancer.
Frequently Asked Questions
Volume doubling time estimates how fast breast cancer grows. This is the amount of time it takes for a tumor to double in size. Growth also depends on the type of breast cancer you have and whether you have been treated with hormone therapies.Learn MoreHow Fast Does Breast Cancer Start, Grow, and Spread?
Volume doubling time estimates how fast breast cancer grows. This is the amount of time it takes for a tumor to double in size. Growth also depends on the type of breast cancer you have and whether you have been treated with hormone therapies.
Learn MoreHow Fast Does Breast Cancer Start, Grow, and Spread?
You will need to have a mammogram, CT (computed tomography) scan, or MRI. Additionally, you may need a biopsy to rule out cancer.Learn MoreBenign and Malignant Breast Lumps
You will need to have a mammogram, CT (computed tomography) scan, or MRI. Additionally, you may need a biopsy to rule out cancer.
Learn MoreBenign and Malignant Breast Lumps
Benign tumors usually have a smooth, regular shape, whereas a cancerous tumor may have an uneven shape and appearance. A biopsy may be needed to rule out cancer.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Breast cancer stages.National Library of Medicine PDQ Cancer Information Summaries.Tumor sizes.American Cancer Society.Imaging tests to find breast cancer.American Joint Committee on Cancer.Cancer staging system.American Cancer Society.Your Breast Pathology Report: Breast Cancer.American Cancer Society.Cancer staging.American Cancer Society.Breast cancer stages.Additional ReadingBreastcancer.org 2018.Breast Cancer Stages.National Cancer Institute 2015.Cancer Staging.Susan G. Komen 2019.Breast Cancer Stages and Staging.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Breast cancer stages.National Library of Medicine PDQ Cancer Information Summaries.Tumor sizes.American Cancer Society.Imaging tests to find breast cancer.American Joint Committee on Cancer.Cancer staging system.American Cancer Society.Your Breast Pathology Report: Breast Cancer.American Cancer Society.Cancer staging.American Cancer Society.Breast cancer stages.Additional ReadingBreastcancer.org 2018.Breast Cancer Stages.National Cancer Institute 2015.Cancer Staging.Susan G. Komen 2019.Breast Cancer Stages and Staging.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Breast cancer stages.National Library of Medicine PDQ Cancer Information Summaries.Tumor sizes.American Cancer Society.Imaging tests to find breast cancer.American Joint Committee on Cancer.Cancer staging system.American Cancer Society.Your Breast Pathology Report: Breast Cancer.American Cancer Society.Cancer staging.American Cancer Society.Breast cancer stages.
American Cancer Society.Breast cancer stages.
National Library of Medicine PDQ Cancer Information Summaries.Tumor sizes.
American Cancer Society.Imaging tests to find breast cancer.
American Joint Committee on Cancer.Cancer staging system.
American Cancer Society.Your Breast Pathology Report: Breast Cancer.
American Cancer Society.Cancer staging.
Breastcancer.org 2018.Breast Cancer Stages.National Cancer Institute 2015.Cancer Staging.Susan G. Komen 2019.Breast Cancer Stages and Staging.
Breastcancer.org 2018.Breast Cancer Stages.
National Cancer Institute 2015.Cancer Staging.
Susan G. Komen 2019.Breast Cancer Stages and Staging.
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