Breast cancer stages from 0 to 4: information, options, treatment on each stage of Breast Cancer

Medically reviewed: 1, January 2024

What Are Breast Cancer Stages?

Breast cancer is a disease that is most common in women. Characterized by the formation of a malignant tumor of the breast. In this article we will look at breast cancer stages which are from 0 to 4 and discover their symptoms, severity and consider possible treatment options.

The main features of this disease are that it has a rapid growth and a tendency to spread metastasis to other organs. In rare cases, breast cancer can also develop in a strong half of humanity.

As static information over the past few years is shown, breast cancer is more than one in nine women, which is why it is so important after 40 years to regularly undergo all diagnostic tests.

There are several stages of breast cancer.

• Stage Zero;
• First stage;
• Second stage;
• The third stage, which includes three more substages;
• The last stage is the fourth.

Knowing the stages of breast cancer are important for choosing an adequate amount of treatment, but the prognosis of the disease and a woman’s life expectancy are largely determined by the biological characteristics of cancer cells: their dependence on sex hormones and resistance to drugs, the initial aggressiveness and health status of the woman.

Breast cancer stages overview

IIIA. Here a cancer can be 5 centimeters in diameter and slightly larger. Cancer cells begin to actively spread in the lymph nodes of the axillary region, which are located in close proximity to each other.

Stage IIIB is characterized by an increase in the area of ​​the lesion that engulfs the skin of the breast or chest wall. After that, the cancer cells begin to spread further into the lymph nodes, which are located behind the sternum. One type of breast cancer grade 3 group b is inflammatory cancer.

Stage IIIC involves the spread of cancer cells to the lymph nodes, which are located in the armpits or behind the chest, and it can also be the lymph nodes in the clavicle.

The first stage of treatment is the patient undergoing a course of chemotherapy. If after a course of treatment there is a positive trend, then an operation is performed to remove the tumor.

The tactics of treating breast cancer of the third degree is developed on the council. If there is a need for a mastectomy, then a plastic surgeon is also involved, in order to determine the size of the implant to be installed in the future in place of the removed mammary gland.

The choice of the method, as well as drugs for chemotherapy, is determined based on the size of the tumor, damage to the lymphatic system and the individual characteristics of the patient.

Breast Cancer Stage Zero

Zero or precancerous stage is characterized by the development of intraepithelial carcinoma, which can be of two types:

• lobular;
• ductal.

In the first case, the abnormal cells begin to develop in the lobular membrane. As a rule, such breast cancer, in rare cases, can turn into an invasive form. However, if the examination reveals the presence of lobular intraepithelial carcinoma in the breast, this indicates the presence of high risks of breast cancer.

The second type of carcinoma is ductal, which is characterized by the location of abnormal cells in ductal membranes. These cells do not go beyond the ducts, but such a cancer can turn into an invasive form, if during the time the treatment methods are not applied.

Breast Cancer Stage 1

 

After the zero stage, the abnormal cells begin to develop vigorously, and already the cancer tumor enters the first stage – this is the stage of invasive breast cancer. The total size of the tumor in diameter has a maximum size of 2 cm.

Oncological cells do not spread beyond the chest.

The first stage refers to early cancer, which is curable in the vast majority of patients. Clinical manifestations with this prevalence of the tumor process are practically absent, but a tumor nodule can be felt in a small breast. Axillary lymph nodes are not detectable by touch, but ultrasound can indicate their increase due to the immune response to the malignant process. As a rule, a neoplasm is detected during a routine mammogram or ultrasound. Stage 1 is divided into A and B, in all cases the tumor in the mammary gland cannot be more than 2 centimeters, but with 1B, there are already microscopic metastases in the axillary lymph nodes – clusters of cancer cells no more than 2 millimeters.

If cancer is detected at the first stage with modern diagnostic methods, the prognosis is favorable and in 90% of cases a complete recovery takes place. If you carry out an effective treatment in stage 1, then the recovery occurs quickly. The main thing is the observance of all medical recommendations and the passage of the necessary number of procedures.

Breast cancer treatment at the stage 1

The main method of treatment is surgical. The extent of the operation depends on the location of the tumor, breast size and the woman’s desire. Today, preference is given to interventions that preserve the reproductive organ, limited to the removal of a section of the mammary gland, including the tumor and a little more than 3 cm of tissue around it. However, resection or lumpectomy is quite extensive and must be supplemented with radiation therapy. It is possible that for symmetry it will be necessary to reduce healthy breasts.

A woman may initially prefer a mastectomy, including preservation of the skin covering the mammary gland, and reconstruction with a prosthesis immediately or after a few months. During the operation, an “urgent”, that is, a quick morphological examination of the edges of the removed piece of glandular tissue for the presence of cancer cells, is required. If cells are found, they either increase the boundaries of the resected tissue or resort to mastectomy—complete removal of the gland.

Today, oncologists prefer not to immediately remove the axillary lymphatic collector with the surrounding tissue, but during the operation to do a biopsy of the sentinel lymph node, that is, the lymph node closest to the chest. Numerous clinical studies have proven that if there are no metastases in it, removal is not required, which significantly reduces the likelihood of developing arm lymphostasis. If a sentinel biopsy is impossible or metastases are detected in it, all the tissue with the lymph nodes located in it is removed from the armpit – this stage of the operation is called “lymphadenectomy”.

If the gland is preserved, irradiation is necessary; it takes about 2 months and begins after complete healing of the scar and completion of preventive chemotherapy. The need for drug prevention of relapse is determined by the degree of aggressiveness of cancer cells, their hormonal sensitivity, and the presence of certain genetic markers of poor prognosis.

Today there is no standard chemotherapy; the combination of drugs is selected individually, taking into account the health status and other diseases of the woman; at least 4 courses are recommended. There is no need for chemotherapy for carcinomas smaller than 5 mm because recurrence is not expected.

If the level of hormonal receptors is high, 5 years of antihormonal therapy is carried out, which can be combined with radiation. It is often difficult for a patient to decide on the optimal extent of surgical intervention, so most are initially ready for the most radical method – complete breast removal. At the international clinic Medica24, a woman will be helped to choose the right treatment – no more and no less than necessary, and make an informed decision.

It should be immediately noted that after the doctor announces oncological diagnosis, it is strictly forbidden to perform treatment with traditional methods. In practice, there are a large number of cases where a delay in drug treatment has led to drastic measures. And, in fact, at the first stage of breast cancer, you can do without operable intervention.

Breast Cancer Stage 2

After the first stage, the oncological disease of the breast passes into the second form, which is characterized by the following features:

• The size of the tumor in diameter has a maximum size of 2 centimeters.
• Cancer cells begin to spread to the lymph nodes located in the armpit.
• The tumor over time begins to increase in size from 2 to 5 cm in diameter.
• The diameter of the tumor can reach 5 cm or more in diameter. Cancer cells do not spread to the axillary lymph nodes.

Symptoms of the second stage of breast cancer do not have a pronounced color, in some cases, the development of the disease may even proceed without any symptoms.

If a specialist is diagnosed regularly, then the tumor, of course, will be noticed. The main thing is not to try to diagnose yourself, but to go to a specialist, because, the sooner the treatment is started, the more chances for full recovery.

There are several options for this stage:

• the neoplasm in the mammary gland is microscopic or not determined, but metastatic damage to the axillary lymph nodes is obvious and proven by morphological examination – IIA (T0N1M0);
• tumor no more than 2 cm, but with metastases in the axillary collector – IIA (T1N1M0);
• nodule in the chest up to 5 cm without damage to the axillary region – IIA (T2N0M0);
• the tumor in the breast is no more than 5 cm and there are metastases under the armpit – IIB (T2N1M0);
• cancer node more than 5 cm without lymphatic metastases – IIB (T3N0M0).

Surgical treatment necessarily includes manipulations in the axillary region, that is, lymphadenectomy is performed, with the exception of the last variant of spread – a node larger than 5 cm without obvious metastases or T3N0M0, when a biopsy of the sentinel node is first performed, in the absence of cancer cells in it and this is limited.

Both resection followed by radiation therapy and mastectomy are performed on the mammary gland. After mastectomy, irradiation is necessary for metastases in the lymphatic collector; radiation therapy is not necessary if only one lymph node is affected and the biological characteristics of the cancer are favorable.

Radiation begins no earlier than a month after surgery and no later than 12 weeks, but by this time it is necessary to undergo adjuvant – preventive chemotherapy of 4 courses. Plastic surgery with a prosthesis can be done a month after completion of irradiation.

Breast Cancer Stage 3

If at the second stage the cancer was not noticed, then after it it goes into a more severe form. The third stage of this disease has three varieties (a, b, c), which successively replace each other as the tumor develops. A cancerous tumor can grow in size, but does not spread further to the breast and lymph nodes.

The stage corresponds to a significant spread of the malignant process, but so far only local, although there is a high probability of spread of microscopic metastases that cannot be detected.

Locally advanced carcinoma has the following staging options:

• IIIA – a tumor node in the gland can be anything and may not even be detected on ultrasound and mammograms, but a conglomerate of fused lymph nodes can be felt in the axillary region and is often even visible;
• IIIB – carcinoma has emerged from the glandular tissue, invades other tissues of the chest wall, sometimes the skin ulcerates, the condition of the lymph nodes does not play a special role in the gradation – the process is no longer operable;
• IIIC – a neoplasm of any size in the mammary gland, metastases have involved the supraclavicular or subclavian lymph collector; at the first stage it is definitely not subject to surgery.

Stage IIIA is treated in the same way as stage 2. In other cases, surgery is technically impossible, so chemotherapy is performed at the first stage, and further tactics depend on its result.

Drug treatment takes about six months – 6-8 cycles are carried out; if they contributed to the partial or complete resorption of cancerous nodes, then a follow-up examination is followed by surgical intervention.

In all cases, tissue with lymph nodes must be removed from the armpit, subclavian and subscapular areas; the volume of removed gland tissue can be very significant and even with partial excision of the pectoral muscle, or it will be limited to leaving a skin “bag” on the chest, where a prosthesis is inserted immediately or after a few months . With the very high effectiveness of preoperative chemotherapy, partial resection of the gland is not excluded.

The need for radiation therapy after surgery is obvious – the likelihood of recurrence in the scar is reduced, radiation also affects the supraclavicular and axillary zones. If chemotherapy fails to transform the carcinoma into an operable state, approximately 25 sessions of radiation are performed and the question of the possibility of breast removal is again raised. Refusal of surgery is a reason to continue radiation therapy.

Good results are demonstrated by a combination of radiation with hyperthermia, which is “wedged in” in the second week of radiation therapy. In most cases, 6-8 hyperthermic procedures are sufficient. This completes the treatment; in case of positive hormone receptors in the tumor, long-term antihormonal therapy is proposed.

At the international clinic Medica24, before the start of antitumor therapy, the individual sensitivity of cancer cells to drugs is determined, in fact offering the patient targeted chemotherapy.

Breast Cancer Stage 4

Body-spreading metastases

The last degree of the oncological disease, the fourth, is characterized by the spread of metastasis to other organs. If breast cancer was detected at the last stage, then a strong treatment with various drugs is used. In this case, a positive outcome is possible in 10% of cases.

But, in this situation, there is a problem of side effects that can be caused by potent chemicals.

During treatment, in the first place, they begin to use various hormonal preparations and agents that kill cancer cells. After undergoing this course of treatment, symptoms such as general weakness, vomiting, nausea, changes in blood structure, etc. are possible.

The entire course of chemotherapy should be conducted in a medical institution under the strict supervision of doctors. The patient should be regularly checked in order to find out the state of cancer. As a rule, already at the third stage, the cancer begins to manifest itself quite brightly, so the disease can be detected much earlier than the tumor will metastasize to other organs.

Recurrent breast cancer is a cancer that manifests itself some time after an oncological tumor has been eliminated. Cancer cells can re-form in the mammary gland, lymph nodes, or other internal organs.

Therefore, it is so important to complete the full course of taking certain drugs, even if it lasts for several years. Also after breast cancer treatment. It is necessary to visit the mammologist several times a year and undergo a number of diagnostic procedures in order to exclude the possibility of a relapse.