The 4 Stages of Breast Cancer

Get in the Know, so You Can Worry Less

The definition of cancer may soon change: Some experts recently suggested in The Journal of the American Medical Association that early, noninvasive cancers not be called cancer to nix unnecesary treatments. But understanding the current phases of breast cancer can help take the mystery out of staying healthy.

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Stage I

What It Is: Either a tumor mass 2 centimeters or smaller within the breast; a tumor 2 centimeters or less along with small clusters of cancer cells in the lymph nodes; or cancer cells (no tumor) found in the lymph nodes. Treatment may involve mastectomy or lumpectomy and radiation; sometimes chemo or hormone therapy. The five-year survival rate is high—88 percent.

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Stage II

What It Is: Stage IIA can include any tumor that's 2 to 5 centimeters but hasn't spread to the lymph nodes, or is smaller than 2 centimeters and has spread to up to three nodes under the arm or near the breastbone. A stage IIB tumor is either 2 to 5 centimeters with cancer also in lymph nodes, or is larger than 5 centimeters with no lymph nodes involved. Surgery, chemo and/or hormone therapy may be needed.

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Stage III

What It Is: There are several different scenarios. For instance, it may be a tumor of any size that has also invaded the chest wall or skin; the cancer may also have reached lymph nodes in the collarbone area or have affected 10 or more lymph nodes under the arm. Treatment may involve chemo, surgery (possibly mastectomy), often radiation and appropriate drugs.

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Stage IV

What It Is: A small percentage of cancers are diagnosed at this stage, in which cells have spread from the bloodstream, tissue or lymph system (typically to bones, lungs, liver or brain). Treatments such as drugs for hormone-sensitive cancers, chemo and targeted therapies have progressed—docs can now keep some stage IV cancers at bay for up to 20 years.

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Sources: Annals of Internal Medicine; National Cancer Institute's Surveillance Epidemiology and End Results; Alonzo P. Walker, M.D., director of the Froedtert & Medical College of Wisconsin Breast Care Center; Carey Anders, M.D., Lineberger Cancer Center, University of North Carolina at Chapel Hill; Centers for Disease Control; American Cancer Society.

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