Stages of Breast Cancer: From Early Detection to Metastatic Disease Management - Dr Lakhan Kashyap

Breast cancer is the most common cancer diagnosed in women in India and World. Breast cancer staging involves certain investigations such as CT scan or PET scan along with some tests which are run on biopsy specimen.

On the basis of these tests, breast cancer is broadly classified into four stages. This classification takes into account size of tumour in breast, it's spread into axillary or neck nodes and to distant organs such as liver, bone and lung. The stage guide prognosis of the disease and the treatment of breast cancer.

Breast cancer in stage 0

Usually referred to as ductal carcinoma in situ (DCIS), is non-invasive. At this point, abnormal cells have not migrated to the surrounding tissue; they are still contained to the milk ducts.

Surgery is the standard form of treatment; radiation therapy may be considered in a few high-risk patients to stop a recurrence.

Stage 1

A tumour of no more than two centimetres in size is in stage I breast cancer. The cancer might not have migrated to surrounding lymph nodes at this point, or might involve only a few lymph nodes.

Depending on the features of the tumour, treatment options typically involve surgery (mastectomy or lumpectomy), radiation therapy, and sometimes hormone therapy or chemotherapy.

Stage 2

With tumours ranging in size from 2 to 5 cm, stage II breast cancer exhibits faster tumour growth and may involve multiple lymph nodes in the axilla.

Chemotherapy is more likely to be included in the treatment regimen, but radiation and surgery are still important treatments. Depending on the form of breast cancer, hormone therapy or specific targeted treatments could also be advised.

Stage 3

In this stage, breast tumour may involve skin or underlying chest wall and may spread to multiple lymph nodes in axilla or neck, but it has not spread to distant organs.

Treatment is more intensive at this stage and often involves chemotherapy along with targeted therapy or immunotherapy to shrink the tumour first, followed by surgery and radiation therapy.

Stage 4

The most advanced stage of breast cancer, known as metastatic breast cancer, is when the disease has spread to other organs such as the liver, brain, lungs, or bones.

The goals of treatment include controlling symptoms, reducing the rate at which the disease progresses, and enhancing quality of life using systemic medicines such as hormone therapy, chemotherapy, targeted therapy, or immunotherapy.

Treatment for breast cancer is individualized to manage the disease while taking the patient's general health and well-being into account. Each stage of the disease poses different problems which often requires specific individualized treatment.

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