Stages of Breast Cancer - How They are Determined

Staging and the TNM System, Part 2

All of the TNM information will be combined twice, once by the surgeon, and again by the pathologist in the lab. Each expert will give an opinion about the cancer, in terms of its TNM stage. Neither of these opinions will be the exact answer to "what stage is this cancer?" You may need to know more about it, such as

• the hormone receptor status (fueled by a hormone)
• the grade of the tumor (speed of growth)
• and if it has spread (metastasized)
• where it has traveled to in your body

All of these things affect your diagnosis, and will be considered in looking at your treatment options.

Four Stages of Breast Cancer

There are four stages of breast cancer,and your diagnosis depends on the tumor's TNM rating. Here's how the stage and the TNM numbers relate.

• Stage 1 means you have a T-1 tumor and clear lymph nodes with no evidence of metastasis, or T1N0M0.
  
  
• Stage 2 has at least three subdivisions, which are a combination of T1, T2, or T3 tumor, positive or negative lymph nodes, and no metastasis; for example T1N0M0.
  
  
• Stage 3 also has at least three subdivisions, which come from a mix of any size of tumor, positive lymph nodes or nodes located in the collarbone area, and no metastasis; for example T3N1M0.
  
  
• Stage 4 is also called metastatic breast cancer, and is rated by having any size of tumor, positive lymph nodes, and obvious metastasis, for example T1N1M1.

The staging and the TNM systems are always being revised and fine-tuned, so ask your doctor to explain these results to you. Ask questions until you have an answer that you can understand. Your doctor can use a picture or a graph to help give you a clear explanation, or perhaps provide some literature for you to read later.

Planning an Appointment with Your Doctor

When you plan a doctor visit, and you know that you will be discussing your diagnosis, lab results, or treatment plans, you may want to ask someone to come along with you, to take notes. If that's not possible, taking a small tape recorder along is a good idea. Sometimes we when get unpleasant news, it is a shock to our minds or our emotions, and we may stop taking in the rest of the conversation. Having a relative or supportive friend along can really help, both in keeping a record of questions and answers, and by giving you an emotional cushion. Be sure that your friend or relative can keep your health information private, if that is what you wish.

How does staging relate to the TNM system? Read more on page 1.
See a comparison table showing the relationship between TNM and Stages