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Breast Cancer Stages and Care in NJ, CT, MD, and the Washington, D.C., Area

Breast cancer affects hundreds of thousands of women each year. Fortunately, there are many treatment options available, and early detection can improve treatment outcomes. Serving patients in New Jersey, Connecticut, Maryland, and the Washington, D.C., area, Regional Cancer Care Associates (RCCA) offers cutting-edge treatment for all types of breast cancer. Learn about the stages of breast cancer and how it is treated.

Breast Cancer Basics

Breast cancer develops when cells in a person’s breast grow abnormally and develop into tumors. Tumor cells can invade surrounding breast tissue and spread to other parts of the body.

In the United States, breast cancer is one of the most common types of cancer among women. While it is rare, breast cancer can also affect men. The American Cancer Society estimates that roughly 297,000 women and 2,800 men will be diagnosed with breast cancer in 2023.

What Is Breast Cancer Staging?

Staging is a method physicians use to describe the extent of a patient’s breast cancer. Breast cancer stages are based on the size of the tumor, whether cancer is present in the lymph nodes, and whether cancer has spread to other parts of the body. Staging guides oncologists in determining the best course of treatment for a particular patient.

Breast Cancer Stages

There are five stages of breast cancer.

Stage 0: Ductal Carcinoma in Situ (DCIS)

DCIS, or Stage 0 breast cancer, is the earliest stage. Pre-invasive or non-invasive cancer cells are present in the milk ducts but have not spread to nearby tissue. DCIS is diagnosed with a mammogram and needle biopsy and usually is treated with a lumpectomy and radiation therapy. DCIS is very treatable and rarely recurs after surgery.

Stage I Breast Cancer

In Stage I breast cancer, tumor cells have spread to nearby breast tissue, but are still limited to a small area. Substages are:

  • Stage IA: The patient’s tumor measures 2 centimeters (cm) or less, and the cancer has not spread to the lymph nodes.
  • Stage IB: In this stage, a small number of cancer cells are found in the lymph nodes. There may be no tumor in the breast or a tumor that measures 2 cm or less.

Surgery is the primary treatment option for Stage I breast cancer and may be followed by radiation or hormone therapy. The five-year survival rate at this stage is 98% to 100%.

Stage II Breast Cancer

Stage II is divided into two substages:

  • Stage IIA: The breast tumor measures 2 cm to 5 cm and has not spread to the lymph nodes. Or cancer cells are found in the lymph nodes under the arm, but the tumor is less than 2 cm, or no tumor is identified.
  • Stage IIB: In this stage, there may be a breast tumor that is larger than 5 cm. Or the tumor is between 2 cm and 5 cm, but the cancer has spread to multiple lymph nodes.

Usually, Stage II breast cancer is treated with more than one type of therapy to eliminate as many cancer cells as possible and to lower the chance of recurrence. Therapies can include surgery, radiation, and chemotherapy. Five-year survival rates for Stage II are still very good; Susan G. Komen® reports a 90%-99% five-year survival rate for Stage II breast cancer.

Stage III Breast Cancer

In this stage, cancer has spread further into the patient’s breast or lymph nodes. There are three substages:

  • Stage IIIA: Cancer is found in four to nine nearby lymph nodes, or the breast tumor is larger than 5 cm and cancer cells are present in one to three nearby lymph nodes.
  • Stage IIIB: In this stage, a tumor has spread into the chest wall or the skin, and cancer may have spread to up to nine underarm lymph nodes or internal mammary lymph nodes.
  • Stage IIIC: During this stage, the cancer has spread to one of the following locations:
    • 10 or more underarm lymph nodes
    • Lymph nodes near the collarbone
    • Both underarm and internal mammary lymph nodes
    • The skin

In Stage IIIC, treatment typically is multimodal; many patients will begin with chemotherapy and have radiation or surgery to remove the breast tumor or the axillary (underarm) lymph nodes.

Stage IV Breast Cancer (Metastatic Breast Cancer)

As the most advanced stage of breast cancer, Stage IV indicates that cancer has spread to the patient’s lymph nodes and other parts of the body beyond the breast. Also known as metastatic breast cancer, Stage IV cancer can spread to the bones, liver, brain, and other parts of the body. Symptoms of metastatic breast cancer may include severe bone pain, changes in speech or vision, or persistent headaches. Because there is no known cure for metastatic breast cancer, treatment will focus on shrinking or slowing the growth of tumors, relieving symptoms, and prolonging life while maintaining a good quality of life. The last several years have seen a dramatic expansion in treatment options for metastatic breast cancer, accompanied by gains in survival.

Healthcare worker helps patient prepare for a mammogram

Inflammatory Breast Cancer (IBC)

A rare condition, IBC is a type of invasive ductal carcinoma. Symptoms of IBC include:

  • Swelling in the breast and surrounding lymph nodes
  • Redness, pitting, or thickening of breast skin
  • Pain, tenderness, or itchiness in the breast
  • An inverted or retracted nipple
IBC typically is diagnosed using imaging tests and a biopsy of the breast tissue. Cases of IBC are classified as Stage III because they involve the skin, or Stage IV if cancer has spread to other parts of the body. IBC is more likely to recur than other types of breast cancer. Five-year relative survival rates for IBC range from 19% to 52%, depending on how far the cancer has spread.

Recurrent Breast Cancer

Breast cancer that comes back after treatment is completed is known as recurrent breast cancer. This can happen when undetected cancer cells multiply and grow. Recurrent breast cancer can develop months or even years after a patient’s initial treatment is completed. Treatment for recurrent breast cancer may include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy
  • Immunotherapy
  • Targeted therapy

Mastectomy may improve survival rates for patients with recurrent breast cancer.

Personalized Medicine in Breast Cancer Treatment

When it comes to breast cancer care, each patient is different. With recent advances in genetic testing, oncology teams can now deliver personalized, precision treatment plans for patients. Personalized medicine includes using blood testing for specific biomarkers or tumor biopsy sampling to help guide treatment. Doctors also can perform drug-gene testing to gauge how a patient’s body might process certain cancer drugs. This helps determine the best medications and dosages for a patient.

The Role of Surgery in Breast Cancer Stages

There are several surgical procedures commonly used in treating breast cancer. In early-stage cancers, patients often can choose between a lumpectomy, also known as breast-conserving surgery (BCS), or a mastectomy:

  • Lumpectomy: In this procedure, a surgeon removes the tumor and some of the healthy tissue that surrounds it.
  • Mastectomy: This surgery removes all of one or both breasts, including the lobules, ducts, fatty tissue, and some of the breast skin.

If cancer cells have spread to the lymph nodes, additional surgeries may be recommended:

Sentinel Lymph Node Biopsy (SLNB):

The sentinel node is the lymph node that cancer is most likely to spread to first. For patients with breast cancer, that’s usually one of the underarm lymph nodes. An SLNB may be performed during a lumpectomy or as a separate procedure. If no cancer is found in a sentinel node, it is unlikely that cancer cells have spread to lymph nodes in other parts of the body.

Axillary Lymph Node Dissection

If an SLNB does identify cancer in underarm lymph nodes, a patient may need to have multiple underarm lymph nodes removed. This can stop the cancer from spreading to other lymph nodes and reduce the likelihood of cancer recurrence.

While all forms of surgery carry some degree of risk, breast cancer is far riskier if left untreated. Recovery time will vary: most lumpectomy patients can go home the same day, while a mastectomy usually requires a hospital stay.

Radiation Therapy in Breast Cancer Treatment

Radiation therapy uses high-energy beams to kill cancer cells. In breast cancer treatment, radiation therapy often is used after surgery to destroy any remaining cancer cells. The main types of radiation used in breast cancer treatment are external beam radiation therapy and brachytherapy, which uses internal radiation to destroy cancer cells. Side effects of radiation can include skin peeling and redness, swelling, and fatigue.

Systemic Therapies for Breast Cancer

Systemic therapy refers to any treatment that uses medications or substances that travel through the bloodstream, treating the entire body instead of one specific area. Systemic therapies for breast cancer include:

  • Chemotherapy: Often given as an infusion treatment, chemotherapy uses various kinds of drugs to destroy cancer cells.
  • Hormone therapy: Certain types of breast cancer are affected by estrogen levels. Hormone therapy is used in breast cancer treatment to lower or block estrogen production.
  • Targeted therapy: This form of systemic therapy uses medications to destroy cancer cells or slow their growth by acting on mutations, proteins, or enzymes specific to the cancerous cells.
  • Immunotherapy: This approach harnesses the power of the body’s immune system to identify and attack cancer cells.

These therapies may be used before surgery to shrink the size of a tumor. Hormone therapy is sometimes used after initial treatment is complete to reduce the likelihood of cancer recurrence. While chemotherapy, immunotherapy, and targeted therapy can cause side effects, a patient’s oncology team can provide strategies and medications for managing those issues.

Complementary and Alternative Therapies for Breast Cancer

Some patients benefit from massage, acupuncture, and other complementary and alternative therapies, which can help reduce a person’s stress levels and mitigate the symptoms associated with cancer treatment. Complementary therapies can be integrated into a patient’s treatment plan but should be discussed with a patient’s oncologist before they are initiated.

Survivorship and Supportive Care

Breast cancer survivors may face long-term side effects or other health problems, so developing a survivorship care plan that includes long-term monitoring is important. Survivors are encouraged to take advantage of supportive services and resources offered by their treatment center.

Promising Advances in Breast Cancer Research

Advances in breast cancer research are occurring at a rapid pace and are driving the development of new therapies and treatment strategies. Regional Cancer Care Associates is proud to contribute to these advances through its comprehensive breast cancer clinical trials program.

Frequently Asked Questions About Breast Cancer

What Are the Main Risk Factors for Breast Cancer?

Risk factors for breast cancer include:

  • Family history: A person is more likely to develop breast cancer if she or he has a relative with breast or ovarian cancer.
  • Age: The risk of breast cancer increases as a woman ages.
  • Genetics: Certain genetic mutations, including BRCA1 and BRCA2, increase the risk of breast cancer.

What Are the Treatment Options for Metastatic Breast Cancer?

Metastatic breast cancer usually is treated with systemic therapies, including chemotherapy, immunotherapy, and targeted therapies.

What Should I Expect During Radiation Therapy?

During radiation, a patient will lie on a treatment table while a machine moves around the patient, delivering doses of radiation. Each appointment usually takes less than an hour. A patient may have multiple appointments over several weeks.

Find Compassionate Breast Cancer Care at Regional Cancer Care Associates

While early detection generally ensures better treatment outcomes, cancer research is always advancing and identifying new insights to inform treatment approaches for all stages of breast cancer. At Regional Cancer Care Associates, the oncology team has extensive experience in treating breast cancer at each stage. Regional Cancer Care Associates has more than 20 locations throughout New Jersey, Connecticut, Maryland, and the Washington, D.C., area, so patients can access care for cancer or blood disorders close to home. Contact us for more information or request an appointment today.

Trust Your Care to Us

No matter which stage your breast cancer falls under, the team of experts at Regional Cancer Care Associates won’t let you fight alone. Once we determine the stage of your cancer, we will collaborate with our on-site oncologists, plastic surgeons and other specialists to devise an effective course of treatment. To learn more, contact us today.

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