Medically reviewed by Tesia McKenzie, MD.
If you or someone you know has been diagnosed with breast cancer, you’ve probably heard people ask what stage it is. So what does that mean?
Breast cancer staging can be complex. But to simplify it, it is the process of finding out how much cancer is in your body.
There are several different breast cancer staging systems. The most used is called TNM system. Staging includes pathologic staging (also called surgical staging), which means analyzing tumor tissue and lymph nodes removed during an operation, and clinical staging, which looks at physical exams, biopsies, and imaging tests.
The results provide important details that your healthcare provider uses to stage your breast cancer. Most staging systems consider:
- Tumor size
- Number of tumors
- If the cancer has spread to nearby lymph nodes.
- If the cancer has spread to other parts of the body (metastasis)
- How similar cancer cells look to healthy cells, which can affect how quickly the tumor can grow and spread (grade)
- If the cancer has estrogen and/or progesterone receptors that make it grow (biomarkers)
- If cancer cells make too much HER2 proteinwhat makes cancer grow
- Gene expression profiling results that may indicate how your genes might affect cancer growth and response to treatment.
Staging may occur before starting treatment, but the stage of breast cancer can also change throughout the treatment plan (for example, if the size of a tumor changes with radiation or chemotherapy, you may be at a different stage).
Knowing the stage is important because it helps determine:
- Treatment options
- What are the chances that the treatment will be successful?
- How serious is cancer?
The rule is that the lower the stage number (0-4), the less cancer there will be in the body.
Read: Don’t Put Off Breast Cancer Screenings: It Could Save Your Life >>
Of course, nothing is simple when it comes to cancer. In addition to stage numbers, there are also substage letters to help your healthcare providers get more precise details, such as whether there is cancer in the lymph nodes.
Here you will find the basic information you need to know about the stages of breast cancer and common treatment options for each stage. A combination of treatments is often used.
stage 0 breast cancer
The cancer cells are non-invasive or pre-invasive and have not spread outside the ducts into the surrounding breast tissue.
Treatment Options for Stage 0 Breast Cancer
stage 1 breast cancer
The cancer is small and contained in the area where the cells first began to develop, or a very small amount of cancer is found in the sentinel lymph node (the first lymph node where breast cancer can spread).
- Stage 1A breast cancer: The tumor is less than 2 centimeters and the lymph nodes are not affected
- Stage 1B breast cancer: The cluster of cells measures less than 2 millimeters (the width of a grain of rice) with or without a tumor in the breast.
Treatment Options for Stage 1 Breast Cancer
- Breast conservation surgery (eg, lumpectomy or partial mastectomy)
- Mastectomy
- Radiation
- Hormone therapy
- Chemotherapy
stage 2 breast cancer
The tumors are larger compared to stage 1, but are still in the breast and/or nearby lymph nodes.
- Stage 2A breast cancer: The tumor is less than 2 centimeters and has spread to 1 to 3 lymph nodes, or the tumor is 2 to 5 centimeters without spreading to lymph nodes.
- Stage 2B breast cancer: The tumor is 2 to 5 centimeters and has spread to 1 to 3 lymph nodes or is larger than 5 centimeters and has not spread to lymph nodes.
Possible treatments for stage 2 breast cancer
- Breast conservation surgery (eg, lumpectomy or partial mastectomy)
- Mastectomy
- Radiation
- Hormone therapy
- Targeted drug therapy
- HER2 Targeted Therapy
- Immunotherapy
Read: How to choose a bra after breast surgery >>
stage 3 breast cancer
The tumors are large and grow into surrounding tissues and/or have spread to lymph nodes but not other organs.
- Stage 3A breast cancer:
- The cancer has spread to 4 to 9 lymph nodes or has enlarged the internal mammary lymph nodes in the chest, or the tumor is larger than 5 centimeters and the cancer has spread to 1 to 3 lymph nodes or any lymph nodes in the breastbone .
- Stage 3B breast cancer:
- A tumor of any size has grown into the chest wall or skin and/or has spread to 9 lymph nodes.
- Stage 3C breast cancer:
- No tumor in the breast or tumor of any size in the breast. Cancer in 10 or more axillary (armpit) lymph nodes, internal breast nodes, or lymph nodes near the collarbone
Treatment Options for Stage 3 Breast Cancer
- Surgery (most often mastectomy)
- Chemotherapy
- Radiation
- Targeted therapy
- Hormone therapy
There is a high chance that a combination of treatments will be used for stage 3 breast cancer.
Stage 4 breast cancer (also called metastatic breast cancer)
The cancer has spread outside the breast and nearby lymph nodes to other parts of the body, which may include the lungs, bones, and liver.
- Tumors can be any size.
- Stage 4 breast cancer is considered incurable and is treated as a chronic disease.
See: Resources for patients with metastatic breast cancer >>
Possible treatments for stage 4 breast cancer (metastatic breast cancer)
- Chemotherapy
- Targeted medications
- Immunotherapy
- Hormone therapy
Radiation and surgery may also be an option depending on the diagnosis.
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