Staging Breast Cancer

If you have been diagnosed with breast cancer - your team will determine the stage of your cancer. Staging describes the size of the cancer, and whether it has spread anywhere else. This information is essential for planning your treatment. Doctors use a system called TNM staging to describe breast cancer in detail. 'T' stands for tumour size; 'N' for whether lymph nodes are affected, and 'M' stands for metastasis - which means whether cancer has spread to other parts of the body. The T category describes your tumour size using numbers from one to four. T1 tumours are two centimetres or smaller; T2 tumours are between two and five centimetres; and T3 tumours are larger than five centimetres. T4 is used to describe tumours that have grown into the chest wall or skin. The N category describes whether cancer has spread to your lymph nodes, particularly in the armpit area. N-Zero - means no cancer cells were found in your lymph nodes during testing. N1; N2; and N3 describe increasing amounts of lymph node involvement in your armpit, or around your collarbone. Your doctor may test lymph nodes during surgery using a procedure called sentinel lymph node biopsy to determine the categorisation. The M category describes whether cancer has spread to distant parts of your body such as bones, liver, or lungs. M0 means no distant spread has been found on any scans or tests. M1 means cancer has spread to other organs, which is also called secondary or metastatic breast cancer. Your team may also use number stages from one to four to describe your cancer more simply. These number stages combine the TNM information into a more accessible format for patients. Stage one is early breast cancer that is small, and has not spread to lymph nodes. Stage two and three describe larger tumours or cancers with lymph node involvement; while stage four means the cancer has spread beyond the breast area. Staging helps your team decide which treatments are right for you and your particular cancer. Earlier stage cancers may need less treatment, while more advanced cancers may need a combination of surgery, radiotherapy, and drug treatments. Every plan is tailored to your individual situation. To determine your stage accurately, you may need additional tests after your biopsy. These could include blood tests and imaging scans such as CT; MRI; or bone scans. Not everyone needs all of these tests, and your doctor will explain which ones are necessary for you. Learning your cancer stage can feel frightening, but please remember that staging helps your team give you the best possible care - and survival rates have improved significantly for all stages of breast cancer. Please remember to ask your breast-care nurse to explain your stage if anything is unclear. Treatment for breast cancer has never been more effective than it is today. Your stage helps your team create the best possible plan for you. Focus on the next step, and trust in your clinical team.