Some breast tumors go undetected until they reach stage 2. Although any cancer diagnosis sounds bad, this is considered early stage breast cancer, and most cases can be successfully treated. Most patients who are diagnosed at stage 2 take treatment, recover, and live out their natural lifespan. Even though this stage sometimes involves cancer in nearby lymph nodes, it is not viewed as metastatic. Let's take a look at the facts about classifying, treating, and surviving stage 2 breast cancer.
Stage 2 Breast Cancer
Stage 2 breast cancer is a tumor that is at least 2 cm or up to 5 cm in the breast or in a lymph node near the breast. Stage 2 is scored by the TNM system. TNM refers to numbers for the Tumor, Node Status, and Metastasis of the cancer. Sometimes it isn't possible to find the tumor, but cells may congregate in lymph nodes near your breast. There are five scenarios for stage 2:
- Stage 2A: T0, N1, M0: No tumor has been found in breast tissue, but cancer cells have lodged in lymph nodes near your breast.
- Stage 2A: T1, N1, M0: You have a tumor of 2 cm or smaller that has spread to at least one lymph node, OR: your tumor has invaded nearby tissue at least 0.1 cm and has spread to at least one lymph node.
- Stage 2A: T2, N0, M0: Your tumor is over 2 cm or less than 5 cm, but hasn't affected any lymph nodes.
- Stage 2B: T2, N1, M0: Your tumor is bigger than 2 cm and less than 5 cm, and has involved nearby lymph nodes.
- Stage 2B: T3, N0, M0: Your tumor is more than 5 cm, but has not reached your chest wall or skin, and has not traveled to any lymph nodes.
Survival Rates for Stage 2
The National Cancer Data Base finds that the 5-year survival rate for stage 2A breast cancer is 81% for patients who completed treatment. Patients who were diagnosed with stage 2B tumors had a 74% survival rate for 5 years after treatment. These percentages are based on data taken between 2001 and 2002, so that means that these numbers are 10 years old. Treatments have improved greatly over that time, so you may hope for longer-term survival if you are newly diagnosed. You will see your oncologist for 5 years of follow-up care, to make sure that recovery is going smoothly and that treatment for recurrence won't be needed. When you celebrate being a 5-year survivor, remember that it means your cancer hasn't come back and may never return. You may still have to deal with other health problems, but odds are low that you will die of stage 2 breast cancer. So after you've completed treatments and all of your follow-up visits, your prognosis is very good.
Treating Stage 2 Breast Cancer
Your oncologist will compile all the test results on your cancer and give you a comprehensive diagnosis. Treatment options will be very similar to those for Stage 1 breast cancer, with some variations for larger tumors or high-grade types of cancer.
- Local Treatments: Surgical choices will include a lumpectomy or a mastectomy, which may be followed by radiation treatments to the breast or chest wall. If radiation is recommended, that will affect the timing of any breast reconstruction that you may have.
- Systemic Treatments: These therapies will affect cells all over your body and will help prevent a recurrence. Depending on your age, general health, hormone status, lymph node involvement and HER2/neu results, you may be given chemotherapy, hormonal therapy, Herceptin, or other targeted biological therapies.
- Neoadjuvant Treatment: You may prefer breast-conserving surgery, but have a tumor that is too large to have a good result after a lumpectomy. In this case, your oncologist may suggest having systemic treatments before surgery, in hopes of shrinking the tumor. When this approach is successful, the smaller tumor can be removed and local treatment may be given if needed. Some tumors don't respond well to pre-treatment and when that happens, a mastectomy will be necessary. You may then consider breast reconstruction.
Follow-up Care After Primary Treatments
You may spend between three to eighteen months or longer in active treatment for your stage 2 breast cancer. It may be as simple as surgery and six weeks of radiation, or as involved as the full array of chemo, radiation, and additional therapies. Either way, you will have a 5-year follow-up period of checkups with your oncologist, during which you may need to take hormone therapy if your tumor was hormone sensitive. Your doctor visits will gradually be spaced out and barring a recurrence, you will graduate from taking estrogen-lowering drugs and having regular cancer checkups. Continue to have breast screenings and don't forget to do your monthly breast self-exams. Take the time you need to recover and reflect on ways you can take good care of your health.
AJCC Cancer Staging Manual 6th Edition. Springer Verlag, New York, NY. 2002, pp. 223-240.
Breast cancer survival rates by stage. American Cancer Society. Last Revised: 06/11/2012.
Stages of Breast Cancer. Stage II. National Cancer Institute. Last Modified: 06/21/2012.
Treatment of invasive breast cancer, by stage. American Cancer Society. Last Updated: 06/11/2012.
What Kind of Breast Cancer Do I Have: Staging. Pp. 303-321. Dr. Susan Love's Breast Book. Susan M. Love, M.D. Fifth Edition, 2010.