Staging

I get asked a lot what stage is my breast cancer. I haven’t been formally informed because they don’t like to stage you before surgery. Surgery can change what stage you’re in, especially when lymph nodes get involved.

On that note, I’m at least stage 2. 

One reason I know this is the clinical trial is for stage 2 to 3A. Oncologist wouldn’t suggest it if I didn’t qualify.

Second, simply by reading. Specifically, I’m stage 2B. Each stage has a further breakdown depending on size (or number) of tumor and number of lymph nodes. 

Stage 3 is when it’s in the breastbone or chest wall. Stage 4 is when it’s spread other places (metastasis).

Here’s a breakdown of 2A and 2B:

In general, stage IIA describes invasive breast cancer in which:

• no tumor can be found in the breast, but cancer (larger than 2 millimeters [mm]) is found in 1 to 3 axillary lymph nodes (the lymph nodes under the arm) or in the lymph nodes near the breast bone (found during a sentinel node biopsy) or
• the tumor measures 2 centimeters (cm) or smaller and has spread to the axillary lymph nodes or
• the tumor is larger than 2 cm but not larger than 5 cm and has not spread to the axillary lymph nodes

In general, stage IIB describes invasive breast cancer in which:

• the tumor is larger than 2 cm but no larger than 5 centimeters; small groups of breast cancer cells — larger than 0.2 mm but not larger than 2 mm — are found in the lymph nodes or
• the tumor is larger than 2 cm but no larger than 5 cm; cancer has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy) or
• the tumor is larger than 5 cm but has not spread to the axillary lymph nodes

I am that highlighted section. So, this is why I say my tumor being 2.5cm is in the “small medium” scale. If my tumor was no larger than 2cm, I could have been stage 1B (assuming my lymph node cells were/are small). On the other hand, if I had 4+ lymph nodes involved (not my current suspected 3), I’d be in stage 3A (regardless of size). My 2B vs 3A might be a little close, but I’m still 2B!

Your cancer cell grade and receptors can also make a difference. Hormone receptor cancers tend to grade a little lower based on scales than my HER2+ even if they meet stage 2 criteria. 

I do have to say that I’m very thankful for the biopsy on my lymph node early. I don’t understand how people start treatment and then get their lymph nodes tested afterwards. At least in my case we know it’s spread. We just don’t know the extent of my lymph node spreading. It’s kind of comforting knowing in advance. Don’t get me wrong, it’s scary too because my body could be fast tracking cancer to other areas, but at least we know now. 

There is also a new system called TNM Staging. You can read about it here. 

In TNM, I’m T2, N1a (I think), M0