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Staging and Treatment for Breast Cancer: Understanding What Comes Next

By January 17, 2019 - 3:11am

Upon first being diagnosed with breast cancer, it’s common to feel overwhelmed and to have a lot of questions about what comes next. What type of breast cancer is it? How do you treat it? And what stage is it? Proper treatment is highly individualized and understanding your particular cancer is the first step towards successful treatment.

Staging Cancer

Staging breast cancer relies on several characteristics, primarily the size of the tumor and its location in the body – ranging from stage 0 cancer, sometimes referred to as “precancer” or carcinoma in situ to stage IV cancer, which involves large tumors. Cancers are also typically identified based on whether they have infiltrated the lymph nodes and metastasized throughout the body. The larger the tumors and the wider the cancer’s dissemination, the more advanced the cancer is considered, and the more aggressive treatment will need to be.

Stage 0: Basic Treatment

If cancer is diagnosed while it’s still in stage 0, you’re unlikely to need anything more than surgical excision to treat the disease; the “in situ” designation means the cancer has remained in the original location in the milk glands or ducts. After a lumpectomy, you will be considered cancer free. Indeed, the goal of monthly self-exams along with regular mammograms is to identify breast cancers at stage 0.

Stage I: Comprehensive Care

Once a breast cancer reaches stage 1, patients require comprehensive care involving surgeons, pathologists, oncologists, and other specialists, so while most patients at this stage will still qualify for surgical excision, they’ll also need chemotherapy and possibly radiotherapy. Luckily, recent studies have found that patients with stage 1 cancer, even if mildly invasive, can benefit from lower dose, more targeted radiation treatment after surgery, with equal efficacy and fewer side effects. This improves patient quality of life without compromising survival.

Stage II And Beyond

When cancer reaches stage II and beyond, both naming and treatment become more complex. For example, a “triple positive” cancer – a cancer that is positive for the HER2 marker, estrogen receptors, and progesterone receptors, when found in fewer than three lymph nodes, is often classed as stage I, even if size-wise it would otherwise be categorized as stage II. This has to do with how triple positive cancers are treated, compared to those with other marker classifications.

As breast cancer becomes more invasive, treatment becomes more urgent, and often more challenging, but that’s not the only factor at play. In fact, among more advanced cancers, specific biomarkers are often more important in determining course of treatment. Cancers that are HER2 positive but negative for other major markers, for example, have a higher risk of recurrence and new treatments, specifically Kadcyla, are being tested as preferable to Herceptin, which is the standard first-line treatment. Identification of cancer type in these cases may make a bigger difference than cancer staging.

Breast cancer is the most common cancer among women, with a 12.4% lifetime risk across all populations, but it’s also one of the most treatable cancers, with a nearly 90% five-year survival rate. By receiving regular screenings and performing self-exams, though, you can detect breast cancer early and increase that survival rate even more.

Cancer is frightening, but we have the tools to detect and treat it early so that you can live and thrive, cancer free.

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