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Staging System

You may come across a staging system for breast cancer. This is a way of summarising all of the information about a particular cancer.

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You may come across a staging system for breast cancer. This is a way of summarising all of the information about a particular cancer.
There are different staging schemes in use. A common scheme is the Number Staging System such as that used by Cancer Research UK:
Stage 0: This is used to describe preinvasive cancer (sometimes called precancerous change). There is no evidence that the cells can spread beyond the breast.
Stage I:  An invasive cancer up to 2 cm across with no evidence of spread.
Stage II: Stage II is divided into IIa and IIb.
Stage IIa.An invasive cancer less than 2cm where there are cancer cells in the armpit gland, but the glands are not stuck together OR A cancer that is less than 5cm where no lymph glands are involved OR Where there are cancer cells in the armpit nodes, but the nodes are not stuck together, but there is no cancer to be found in the breast (it is occult).
Stage IIb.The cancer is less than 5cm, the armpit glands contain cancer cells but the glands are not stuck together and the cancer had not spread any further OR The cancer is bigger than 5cm with no cells in the armpit glands and the cancer had not spread.
Stage III: Stage III is divided into IIIa, IIIb and IIIc.
Stage IIIa.is where there are cancer cells in the lymph glands and the glands are stick together, but there is no cancer to be found in the breast, OR The tumour is smaller than 5cm and the armpit glands contain cancer cells that are stuck together, but there is no evidence of any further spread, OR The cancer is larger than 5cm and the armpit glands contain cancer cells and may be stuck together, but there is no sign of any further spread
Stage IIIb.The cancer is fixed to the skin or chest wall, the lymph nodes may or may not contain cancer, but there is no further spread
Stage IIIc.The cancer can be any size and has spread to lymph nodes in the armpit and under the breast bone, or to nodes above or below the collarbone, but there is no further spread
Stage IV: A cancer of any size where cancer has spread to other parts of the body, for example the liver or lungs. The lymph nodes may or may not be involved.
The YNM system considers the tumour (T), the lymph nodes (N) and the presence of any distant spread (or metastases, M).

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T1 The tumour is no more than 2 centimetres (cm) across T1 is further divided into 3 groups
  • T1a the tumour is more than 0.1 cm but not more than 0.5 cm  
  • T1b the tumour is more than 0.5 cm but not more than 1 cm  
  • T1c the tumour is more than 1 cm but not more than 2 cm

T2 The tumour is more than 2 centimetres, but no more than 5 centimetres across.

T3 The tumour is bigger than 5 centimetres across.

T4 is divided into 4 groups.

  • T4a The tumour is fixed to the chest wall
  • T4b The tumour is fixed to the skin
  • T4c The tumour is fixed to both the skin and the chest wall
  • T4d Inflammatory carcinoma - this is a cancer in which the overlying skin is red, swollen and painful to the touch
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Nodes (N)

N0 No cancer cells found in any nodes.
N1 cancer in nodes in the armpit but nodes not stuck to other structures.
N2 is divided into 2 groups;

  • N2a - there are cancer cells in the lymph nodes in the armpit, which are stuck to each other and to other structures 
  • N2b - there are cancer cells in the lymph nodes under the breast bone (the internal mammary nodes).  These have either been seen on a scan or felt by the doctor.  There is no evidence of cancer in lymph nodes in the armpit
  • N3 is divided into 3 groups
  • N3a - there is cancer in lymph nodes below the collarbone
  • N3b - there is cancer in lymph nodes in the armpit and under the breast bone
  • N3c - there is cancer in lymph nodes above the collarbone
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Metastases (M)

M0 No sign of cancer spread.
M1 Cancer has spread to another part of the body, apart from the breast and lymph nodes under the arm.  

Although summarising the information about a cancer as a stage can sometimes be useful, we will always give you more detailed information about your cancer. This will include the size, the type, the grade (an indication of how quickly it has grown), the presence of any involved lymph glands, as well as other factors such as the hormone receptor status and the sensitivity to other drugs, such as Herceptin. All of this information allows a detailed assessment of what extra treatment may be required. 

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