Decoding a Breast Cancer Diagnosis
Breast cancer is not a one-size-fits-all disease. There are actually many types of breast cancer based on the unique biological features of an individual's tumor.
Understanding the size, status, stage and subtype can help decode a diagnosis and shed light on appropriate treatment options.
What’s my size?
Breast cancer tumors vary in shape and size. Tumor sizes range from non-invasive tumors (in situ) to more than 5 cm across.
The letter T followed by a number describes the tumor size. Higher T numbers mean a larger tumor or growth into the tissues near the breast.1
Non-invasive tumor (in situ)
Tumor is 2 cm (3/4 of an inch) or less
Tumor is more than 2 cm, but not more than 5 cm (2 inches) across
Tumor is more than 5 cm across
Tumor of any size growing into the chest wall or skin; also includes inflammatory breast cancer
What’s my status?
Lymph node-negative or lymph node-positive status depends on whether the breast cancer has spread to the lymph nodes. Lymph nodes located under your arms are the first places breast cancer is likely to spread.
The letter N followed by a number indicates whether the cancer has spread to lymph nodes and, if so, the location, size and extent of the spread.
Cancer has not spread to nearby lymph nodes (lymph node-negative).
Cancer has spread to lymph nodes (lymph node-positive). The difference between N1, N2 and N3 depends on the location and number of lymph nodes the cancer has spread to, as well as the size of the cancer in these nodes.
What’s my stage?
The stage of a cancer describes whether it has spread and, if so, how far.
Considered non-invasive or pre-invasive breast cancer. Cells that line the ducts have changed to look like cancer cells, but have not spread through the walls of the ducts into surrounding breast tissue.
Tumor 2 cm or less with, at most, microscopic spread to the lymph nodes.
Tumor 5 cm or less that has spread to the lymph nodes (N1), or tumor greater than 2 cm that has not spread to the lymph nodes.
Tumor of any size that has more extensively spread to the lymph nodes (N2 or N3), tumor greater than 5 cm that has spread to the lymph nodes (N1), tumor that has spread into the chest wall or skin, or any size tumor with most extensive spread to lymph nodes (N3).
Tumor of any size and lymph node status that has spread to distant organs (metastatic).
What’s my subtype?
Breast cancer can also be classified into certain subtypes based on the proteins on or in the cancer cells.3
What are my treatment options?
Once the size, status, stage and subtype of your tumor have been determined, your doctor can help identify treatments available for your specific type of breast cancer. Treatments are often used in combination and/or sequentially.
FDA-approved treatments include chemotherapy, radiation, targeted therapies and hormone therapies. When discussing options with your healthcare provider, it is important to ask about the potential benefits and risks of treatment. Some treatments can be given before surgery (neoadjuvant) or after surgery (adjuvant).
Surgery options include a lumpectomy, mastectomy and/or lymph node removal.
Clinical trials provide the opportunity to participate in a trial testing investigational medicines or procedures that experts think might improve the treatment of cancer. Talk to your healthcare provider about your eligibility for a clinical trial and the benefits and risks of participating.
1American Cancer Society. How is breast cancer staged? http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-staging. Accessed May 19, 2016.
2National Cancer Institute. Metastatic Cancer. http://www.cancer.gov/about-cancer/what-is-cancer/metastatic-fact-sheet. Accessed May 19, 2016.
3American Cancer Society. How is breast cancer classified? http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-classifying. Accessed May 19, 2016.