While the incidence of breast cancer has been rising, the overall mortality rate has been slowly declining. When someone receives a diagnosis of breast cancer, one of the most important things the surgeon will do is stage the disease. The staging is how medical professionals figure out if the cancer has spread, and if so, to where. This is done by gathering information from the physical exam of the patient, surgical findings, X-rays and lab tests. Breast cancer stages are numbered Stage I through Stage IV (with IV being the most advanced), and in each stage, there are subcategories.
Classification
To stage breast cancer, an oncologist will use the staging system set out by the American Joint Committee on Cancer (AJCC), which uses the TNM classification. This looks at the tumor (T), any lymph node involvement (N), and whether or not it has metastasized to other parts of the body (M). The stage of the disease helps to determine the direction and course of treatment, as well as help to give a general prognosis.
Features
Stage II breast cancer, while not the earliest stage, is still described as an early stage of breast cancer. In this stage, the cancer has gone beyond the lobe or the duct it started in, and has gone into breast tissue that is close by. There are two subcategories of Stage II breast cancer, which are broken down into further detail below. Overall, for Stage II breast cancer, the five year survival rate is 83 percent, and the 10 year survival rate is 66 percent.
Categories
Stage II breast cancer can be classified as either Stage IIA or Stage IIB. The following explains further:
Stage IIA:
- no tumor is found in the breast, but breast cancer cells were found in the lymph nodes under the arm OR
- the tumor is 2 cm or less and has spread to the lymph nodes under the arm OR
- the tumor is larger than 2 cm but less than 5 cm and has not been found in the lymph nodes under the arm
Stage IIB:
- the tumor is larger than 2 cm but less than 5 cm and has spread to the lymph nodes under the arm OR
- the tumor is larger than 5 cm but has not spread to the lymph nodes under the arm
Treatment
For early stage breast cancer (Stages I and II), lumpectomy (also called breast-conserving surgery or BCT) followed by radiation therapy, and mastectomy (with or without reconstruction) has shown comparable rates of survival and local control of the disease. The decision about which surgical route to take can depend on the size and placement of the tumor, breast size, patient wishes and possible contraindications to BCT. If the patient chooses BCT, radiation is often given afterward. Depending on patient characteristics and the possibility of distant micrometastases, which can possibly grow into metastatic cancer, sometimes chemotherapy is also given after surgery. Chemotherapy has been shown to benefit patients with early-stage breast cancers.
Implications
Stage II breast cancer is still early-stage disease, but it is important to discuss all aspects of the disease with your oncologist, such as hormone receptor status, menopausal status, family history and personal preferences. Depending on the surgical findings, lab findings and the doctor's past experiences, different courses of treatment might be suggested for different patients. There is no "one size fits all" treatment plan, and your doctor will work with you to find the best path for you.
Tags: breast cancer, breast cancer, lymph nodes, lymph nodes under, nodes under, Stage breast, larger than
