Staging means finding out how far cancer has spread in your breast or other parts of your body. Accurate staging helps your physicians decide which therapies to use to treat your disease. There are two main systems for staging breast cancer: TNM staging and overall stage grouping.
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How We Determine Your Stage
Your Fred Hutch Cancer Center physicians will base your stage on a physical exam, imaging tests and biopsies. This is sometimes called clinical staging. We will do all the tests you need at Fred Hutch. Your team will help plan your appointments to make a schedule that works best for you.
Most people with breast cancer will have surgery to remove their tumor as well as some lymph nodes under their arm. Tests on the tumor and nodes can give your physicians more details about the type of breast cancer and the treatments you may need. It is normal to learn more about your stage after this surgery. This is called pathologic staging.
TNM Staging
TNM stands for tumor, nodes and metastasis. Your TNM stage is:
- The letter T with a number from 0 to 4. A higher T number means the tumor is larger, has spread more widely into nearby tissues or both.
- The letter N with a number from 0 to 3. A higher N number means more spread of cancer cells to lymph nodes near the breast, such as in the armpit or under the collarbone.
- The letter M with a 0 or 1. M0 means physicians did not find cancer in lymph nodes away from your breast or in distant organs. M1 means distant spread was found.
Overall Stage Grouping
After your physician finds your TNM stage, they will assign a stage using Roman numerals 0, I (1), II (2), III (3) or IV (4).
- Stage 0: Noninvasive cancers (which are only in the milk ducts or glands).
- Stage I: The tumor is smaller than 1 inch across. It has not spread to lymph nodes under your arm or to other places outside your breast.
- Stage II: The tumor is 1 to 2 inches across, or cancer has spread to lymph nodes under your arm. Stage I or II cancers are considered early-stage cancers.
- Stage III: Cancer is in your breast, surrounding tissues and lymph nodes. Stage III cancers may be considered early-stage or advanced cancers.
- Stage IV: Cancer has spread to distant parts of your body or to lymph nodes outside your armpit. This is called metastatic cancer.