Breast cancer affects hundreds of thousands of women each year. While new technologies are improving, the approach to treating breast cancer still greatly depends on its stage.
Regional Cancer Care Associates (RCCA) treats various cancer types, including breast cancer, at 25 locations throughout New Jersey, Connecticut, Massachusetts, and the Washington, DC area, which means patients can receive state-of-the-art care close to home.
Breast cancer occurs when cells in a person’s breast develop abnormally. The abnormal cells divide and reproduce at a rapid rate, creating a continuously growing mass called a tumor. Most breast cancer begins in the milk glands or ducts. However, cancer cells can invade nearby tissues and may even spread through the lymph or blood vessels to other parts of the body.
In the United States, breast cancer is the second most common type of cancer affecting women. The American Cancer Society estimates that one in eight women, or 13%, will develop breast cancer at some point in their lives. While rarer, the disease can affect men as well.
Physicians use a staging system to describe the extent of a patient’s cancer. Stages are based on a combination of factors including the size of the tumor and how much it has spread. This information guides medical oncologists in determining the most appropriate treatment. It is important to note that many women and men who experience one or more of the symptoms will not have breast cancer. Nonetheless, it is important to consult a physician about these symptoms. Prompt evaluation will enable a doctor to address your concerns and to provide a treatment plan for whatever condition may be responsible for the symptoms.
There are five breast cancer stages:
Stage 0 breast cancer is also called ductal carcinoma in situ, or DCIS. During this stage, cancer cells are present in the milk ducts and are pre-invasive or non-invasive. This means they have not spread to nearby tissue. DCIS is usually treated with a lumpectomy and radiation therapy, and it rarely recurs.
In Stage I breast cancer, tumor cells have spread to tissue outside the milk ducts. The tumor remains small and is limited to a small area. There are two substages:
Stage I breast cancer is typically treated with surgery, sometimes followed by radiation or hormone therapy. The five-year survival rate is 98% to 100%.
In Stage II breast cancer, the tumor in the breast is larger and may have spread further into the lymph nodes. There are two substages:
Stage II breast cancer is typically treated using more than one therapy type, which may include surgery, radiation therapy, and chemotherapy. Multiple treatments help to eliminate as many cancer cells as possible for a lower chance of recurrence. Five-year survival rates are still very good at 90% to 99%.
In Stage III breast cancer, the cancer has spread further into the breast or lymph nodes. There are three substages:
As with Stage II, treatment for Stage III cancer is typically multimodal. Many patients begin with chemotherapy before having radiation therapy or mastectomy surgery to remove the breast tumor and cancerous lymph nodes. Survival rates are 87%.
Stage IV is the most advanced stage of breast cancer. In this stage, cancer has spread or metastasized to other parts of the body beyond the breast. Parts of the body commonly affected include the bones, liver, lungs, and brain.
There is no known cure for metastatic breast cancer. Instead, treatment focuses on monitoring, slowing tumor growth, relieving symptoms, prolonging life, and improving quality of life. Recent scientific advances have led to expanded treatment options and greatly improved survival rates for patients with Stage IV metastatic breast cancer.
Inflammatory breast cancer, IBC, is a rare type of invasive ductal carcinoma. It occurs when cancer cells block lymph vessels in the skin, causing the skin to become swollen or inflamed. IBC does not typically cause a lump or other typical breast cancer signs and symptoms. Instead, patients may experience:
Cases of IBC are classified as Stage III because they involve the skin, even if there is no tumor. IBC may also advance to Stage IV if cancer cells spread to other parts of the body. Survival rates range from 19% to 52% depending on how far the cancer spreads. Recurrence is more likely than with other types of breast cancer.
Patients who have already been diagnosed and treated for breast cancer are at higher risk of developing cancer a second time. This occurs when a few cancer cells survive the initial treatment and remain undetected. These cells continue to multiply and grow, eventually developing into a new tumor. This is known as recurrent breast cancer and may occur months or even years after initial treatment is completed. Treatment options for recurrent breast cancer include:
Many patients opt for a mastectomy, or a breast removal surgery. This can improve survival rates and prevent breast cancer from recurring a second time.
Breast cancer stages are useful descriptors, but they are generalizations. Every case of breast cancer is unique. Two patients with the same stage of cancer may have quite different experiences and needs. As a result, the most effective treatments must be individualized.
Recent advances in genetic testing allow medical oncologists to deliver more precise and personalized treatment. Plans are guided by breast tumor biopsy sampling or blood testing for specific biomarkers. Doctors can also perform drug-gene testing to predict how a patient’s body will react to cancer treatment drugs, helping them determine the best and safest medication and dosage.
Most cases of breast cancer can be treated with surgery. The specific approach, however, may vary depending on the cancer stage. Tumors in the breast can be treated in one of two ways:
If cancer cells have spread to lymph nodes, additional surgeries may be required to treat the affected nodes. Options include:
Recovery time varies depending on the procedure. Most patients can go home the same day after a lumpectomy or SLNB. A mastectomy or axillary lymph node dissection, however, typically requires a short hospital stay.
Radiation therapy is an alternative treatment for breast cancer. It uses radiation to kill cancer cells and is often used after surgery to destroy any cancer cells that could not be removed with surgery.
Systemic therapies include any treatment that travels through the bloodstream, treating the whole body instead of a limited area. These therapies may be used before surgery to shrink a tumor or afterward to reduce the likelihood of cancer recurrence. They may also be more effective in eliminating cancer that has spread to lymph nodes. Types of systemic therapy include:
Systemic therapies may cause side effects. The patient’s cancer care team will help them understand possible side effects and identify strategies for management.
Some patients benefit from massage, acupuncture, and other complementary therapies. While these methods cannot treat breast cancer directly, they can reduce the person’s stress levels and may relieve some symptoms associated with cancer and its treatment. Patients should discuss complementary therapies with their oncologist before integrating them into their treatment plan.
Breast cancer research is being performed at a rapid pace, constantly uncovering new advancements, therapies, and treatment strategies. RCCA is proud to contribute to these advances through its breast cancer clinical trials program.
While early detection generally ensures better treatment outcomes, cancer research continues to identify new insights for improved treatment at all stages of breast cancer. The medical oncology team at Regional Cancer Care Associates has extensive experience in treating breast cancer at every stage.
RCCA’s more than 100 medical oncologists and hematologists offer innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers so patients can receive care close to home.
Breast cancer stages are a method doctors use to describe how much breast cancer has spread. Stages are useful for planning treatment and understanding survival rates and prognosis.
The recommended treatment plan depends on the stage of breast cancer and other health factors. Treatment options include surgery, radiation therapy, chemotherapy, hormonal therapy, immunotherapy, targeted therapy, and clinical trials. Multiple treatments may be used to ensure cancer is completely eradicated.
Survival rates are best in the earliest stages of cancer. The earlier breast cancer is diagnosed, the better chance the patient has at a successful treatment.
Breast cancer can come back if any cancer cells survive treatment and are undetected by oncologists. Breast cancer that returns after treatment is called recurrent breast cancer.
Metastatic breast cancer, or Stage IV breast cancer, is cancer that has spread to other parts of the body such as the liver, lungs, bones, or brain. There is no known cure for metastatic cancer, though it can be treated to prolong the patient’s lifespan and improve their quality of life.
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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