Tracy JerisoWhat Is Stadium?
The stage is the phase or evolutionary step in which the cancer is found. It is essential to know the effort to establish the prognosis and possible treatments for each patient.
Staging is the process that aims to identify the situation of propagation or extension in which the cancer is, how much it has grown if it has spread to other areas of the body and what other organs may be affected. The staging process involves performing various tests that the doctor considers necessary to know the extent of the disease; these tests include physical examination, biopsies, mammograms, ultrasound, computed tomography (CAT or scanner), magnetic resonance imaging, analytics, etc.
In the case of breast cancer, there are five stages (from 0 to IV); stage 0 corresponds to those cases in which a carcinoma in situ (non-invasive) is diagnosed, and the rest of the four stages correspond to cancer Invasive or infiltrating breast cancer, being stage I in which the disease is in a more initial phase and stage IV in which the disease has already spread to other organs of the body. In general, the prognosis of patients worsens as the stage is more advanced, which means that cure rates are higher when the cancer is diagnosed in earlier stages.
Breast Cancer Staging
The system used for staging breast cancer is the TNM system, accepted by the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC).
The letters TNM stand for:
T (FOR TUMOR)
N (FROM NODE)
M (FOR METASTASIS)
T (for tumour). Size of the primary tumour located in the breast, which may present different values depending on the largest size of the tumour:
T0: There is no evidence of the tumour in the breast after carrying out several tests.
Tis: Non-invasive cancers (carcinoma in situ) are considered in this category.
T1: equal to or less than 2 cm.
T2: between 2 and 5 cm.
T3: greater than 5 cm.
T4: the tumour has spread to the skin of the breast, appearing with nodules or ulcerations and to the chest wall, and may affect the muscles or ribs below the breast, or it is an inflammatory carcinoma; this category is independent of the size of the breast tumour.
Stage determination
Once the values for T, N, and M have been identified, the stage is determined.
Stage 0 (Tis N0 M0)
It corresponds to non-invasive cancer (carcinoma in situ) since the malignant cells have not yet invaded the tissues around the site of tumour origin (the basement membrane is intact).
Stage IA (T1 N0 M0)
The largest tumour size (including invasive cancers above this stage) in the breast is 2 cm or less and has not spread to any lymph nodes.
Stage IB (T0 or T1 N1mi M0)
As for stage IA, the largest measurement of the tumour in the breast is equal to or less than 2 cm, but in this case, the tumour has spread to the lymph nodes near the breast, although these metastases are small. Size (micrometastases, less than 2 mm).
Stage IIA
Stage IIA includes the following situations:
T0 or T1 N1 M0: There is no evidence of the tumour in the breast or a tumour whose largest measurement is equal to or less than 2 cm is detected; In addition, in this case, metastases have developed in the lymph nodes near the breast, as mentioned above.
T2 N0 M0: A giant tumour in the breast is greater than 2 cm but less than or equal to 5 cm, and there is no spread to any lymph nodes.
Stage IIB
Stage IIB includes the following situations:
T2 N1 M0: A giant tumour in the breast is greater than 2 cm but less than or equal to 5 cm, and there is also spread to lymph nodes near the breast.
T3 N0 M0: A giant tumour in the breast is greater than 5 cm, and there is no spread to any lymph nodes.
Stage IIIA
Stage IIIA also includes different situations:
T0 – T3 N2 M0: the breast tumour can be of different sizes as described above (T1, T2 or T3), or even in some cases, the breast tumour is not detected. However, an extension has occurred to lymph nodes close to the breast (as described above for “N2”).
T3 N1 M0: A giant tumour in the breast is greater than 5 cm, and there is also spread to nearby lymph nodes in the breast (as described above for “N1”).
Stage IIIB
In this case, the tumour has spread to the skin of the breast, appearing with nodules or ulcerations, and to the chest wall, which may affect the muscles or ribs that are below the breast or be an inflammatory carcinoma, which may be the tumour of any size and may or may not be accompanied by involvement of the lymph nodes near the breast (T4 N0, N1 or N2 M0).
Stage IIIC
The breast tumour can be any size and has spread to lymph nodes near the breast, as explained above for “N3” nodal involvement (any T N3 M0).
Stage IV
In this case, breast cancer has spread to other body parts such as the bones, liver or lungs, among others. The tumour in the breast can be of any size and extent to which it has spread to the lymph nodes near the breast (any T any N M1).
Robert Desauza
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