What is
Staging?
Staging is the process physicians
use to assess the size and location of a patient’s cancer. Identifying the cancer
stage is one of the most important factors in selecting treatment options. Several tests
may be performed to help stage breast cancer including clinical
breast exams, biopsy, and certain imaging tests such as a chest x-ray, mammogram, bone scan, CT scan, and MRI scan. Blood tests are used to evaluate a woman's overall
health and detect whether the cancer has spread to certain organs often follow imaging
tests.
To stage cancer, the American Joint
Committee on Cancer first places the cancer in a letter category using the TNM
classification system. Cancers are designated the letter T (tumor size), N (palpable
nodes), and/or M (metastasis):
T: Tumor
Size
The letter T followed by a number
from 0 to 4 describes the tumor's size and whether it has spread to the skin or chest wall
under the breast. Higher T numbers indicate a larger tumor and/or more extensive spread to
tissues surrounding the breast.
- TX: Tumor cannot be assessed
- T0: No evidence of a tumor
- Tis: Cancer may be lobular
carcinoma in situ (LCIS), ductal carcinoma in situ (DCIS) or Paget’s disease)
- T1: Tumor is 2 cm or less in
diameter
- T2: Tumor is between 2 and 5 cm in
diameter
- T3: Tumor is more than 5 cm in
diameter
- T4: Tumor is any size, has attached
itself to the chest wall and spread to the pectoral (chest) lymph nodes
N:
Palpable Nodes
The letter N followed by a number
from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if
so, whether the affected nodes are fixed to other structures under the arm.
- NX: Lymph nodes cannot be
assessed (lymph nodes were previously removed, etc.)
- N0: Cancer has not spread to
lymph nodes
- N1: Cancer has spread to the
movable ipsilateral axillary lymph nodes (underarm lymph nodes on same side of breast
cancer)
- N2: Cancer has spread to
ipsilateral (same side of body as breast cancer) lymph nodes fixed to one another or to
other structures under the arm
- N3: Cancer has spread to the
ipsilateral mammary lymph nodes or the ipsilateral (same side of body as breast cancer)
supraclavicular lymph nodes
M:
Metastasis
The letter M followed by a 0 or 1
indicates whether or not the cancer has metastasized (spread) to distant organs (i.e.,
the lungs or bones) or to lymph nodes that are not next to the breast, such as those above
the collarbone.
- MX: Metastatis cannot be assessed
- M0: No distant metastasis to
other organs
- M1: Distant metastatis to other
organs
CONTINUED
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