Stages I to IV
If treatment is started in stage I breast cancer, cure is achieved in more than 90% of cases.
In stage II - 60%.
In stage III - 40%.
In stage IV - 10%.
Identification of the disease at an early stage increases the possibility of treatment.
In stage I cancer, cancer cells have not spread beyond the breast, and the tumor is no more than 2 cm (about 3/4 of an inch) across.
Stage II cancer is classified as either stage IIA or stage IIb.
In stage IIA cancer the tumor is either:
No more than 2 centimeters and has spread to the underarm lymph nodes (axillary lymph nodes)
Between 2 - 5 centimeters and has not spread to the underarm lymph nodes
In stage IIB cancer the tumor is either:
Larger than 2 centimeters and less than 5 centimeters and has spread to 1 - 3 axillary lymph nodes
Larger than 5 centimeters but has now spread to lymph nodes
Treatment options for stage I and stage II breast cancer may include:
Breast-conserving surgery (such as lumpectomy) followed by radiation therapy
Modified radical mastectomy with or without breast reconstruction
Post-surgical therapy (adjuvant therapy), including radiation of lymph nodes, chemotherapy, or hormone therapy
Trastuzumab (Herceptin) given along with or following adjuvant chemotherapy for women with HER2-positive cancer
Stage III (Locally Advanced). Stage III breast cancer is classified into several sub-categories: Stage IIIA, stage IIIB, and stage IIIC (operable or inoperable).
In stage IIIA breast cancer, the tumor is either of the following:
Not more than 5 centimeters and has spread to 4 - 9 axillary lymph nodes
Larger than 5 centimeters and has spread to 1 - 9 axillary nodes or to internal mammary nodes.
Treatment options for stage IIIA breast cancer are the same as those for stages I and II.
In stage IIIB breast cancer, the tumor has spread to either of the following:
Tissues near the breast (including the skin or chest wall)
Lymph nodes within the breast or under the arm
Stage IIIB treatment options may include:
Chemotherapy, and possibly hormone therapy (sometimes in combination with chemotherapy)
Chemotherapy followed by surgery (breast-conserving surgery or total mastectomy) with lymph node dissection followed by radiation therapy and possibly more chemotherapy or hormone therapy
Stage IIIC breast cancer is classified as either operable or inoperable.
In operable stage IIIC, the cancer may be found in:
10 or more of the underarm lymph nodes
Lymph nodes beneath the collarbone and near the neck on the same side of the body as the affected breast
Lymph nodes within the breast as well as underarm lymph nodes
Treatment options for operable stage III breast cancer are the same as those for stage I and II breast cancers.
In inoperable stage III breast cancer, the cancer has spread to lymph nodes above the collarbone and near the neck on the same side of the body as the affected breast. Treatment options are the same as those for stage IIIB.
Stage IV (Advanced Cancer)
In stage IV, the cancer has spread (metastasized) from the breast to other parts of the body. In about 75% of cases, the cancer has spread to the bone. The cancer at this stage is considered to be chronic and incurable, and the usefulness of treatments is limited. The goals of treatment for stage IV cancer are to stabilize the disease and slow its progression, as well as to reduce pain and discomfort.
Treatment options for stage IV cancer include:
Surgery or radiation for any localized tumors in the breast.
Chemotherapy, hormone therapy, or both. Targeted therapy with trastuzumab (Herceptin) or lapatinib (Tykerb) should be considered for women with HER2-positive cancer.
Cancer that has spread to the brain may require radiation and high-dose steroids.
Cancer that has spread to the bone may be helped by radiation or bisphosphonate drugs. Such treatments can relieve pain and help prevent bone fractures.
Clinical trials of new drugs or drug combinations, or experimental treatments such as high-dose chemotherapy with stem cell transplant.