Breast Cancer Staging
Once an intital diagnosis has been made in the breast cancer 'screening' process, then a number of subsequent tests and evaluations are done to determine the 'staging'. "What stage is the cancer in?" basically means, is the cancer in the early stages or more advanced? Staging results are used to determine the treatment and the follow-up procedures for managing the breast cancer. Breast cancer 'stage' is a phrase that may seem to imply that a breast tumor will move from one stage to the next higher stage, over time. That is somewhat true if cancers were left untreated. But when breast cancers are treated, they are often cured.The physicians and surgeons who offer treatments for breast cancer are required to make an informed evaluation and a balanced judgement of how aggressively the breast cancer needs to be treated, whether this treatment is urgent or not, and how best to monitor the progress over time. They need to know the stage, in order to make these recommendations.
Several articles in this section will also discuss breast cancer 'grade', which is different from breast cancer 'stage'. The grading of a breast tumor is largely based upon a microscopic and histological evaluation of the actual tissue samples and cells of the breast tumor. There are 'visual' cues that are seen when viewing the cancer cells through the microscope, that can give extra clues about how the cancer will behave. Microscopic analysis of the cells also looks for immunochemical indicators or 'markers', which give an indication of how well certain treatments are likely to work. The histological evaluation can also give indications and reassurances of the benign or 'likely-benign' nature of the tumor. Aggressive breast cancers might spread or 'metastasize' to different areas of the body, and that is what makes them dangerous and harmful. The staging of a breast cancer therefore also involves tests to determine whether or not the cancer has spread, or might spread, to the lymph nodes and other areas of the body. There are many statistics that touch upon the disease-free and overall survival rates of various types of breast cancer at different stages. But, bear in mind that breast cancer is by-and-large a cureable disease (up to 90%). A higher stage of breast cancer may require more aggressive interventions, but the outcome is usually positive.
Breast Cancer Staging in General
Breast cancer staging is all about deciding how to treat the breast cancer. The extent of the breast cancer must be determined immediately. Staging also involves additional histological evaluations of the primary breast tumor in order to gain the broadest possible understanding of the predicated behaviour of the breast cancer and its responsiveness to treatment.
- What is breast cancer staging and how is it different from breast cancer screening?
- Staging for breast cancer is directed at the most beneficial treatment
- Histology: a general discussion of the chemical and microscopic evaluations used in breast cancer diagnosis and staging.
- Myoepithelial markers for breast cancer staging purposes
- The typical 'stages' a breast cancer goes through.. in general laymans terms.
Breast cancer staging more specifically
- Breast cancer staging and TNM classifications
- Characteristics of breast cancer and staging, at diagnosis: Statistics
- Breast cancer staging and problem solving may require a percutaneous biopsy
- Percutaneous biopsy, vaccuum assited biopsy, gauges used in breast tumor evaluation
- Details of the sentinal node biopsy technique for assessing breast cancer spread.
- Reliability and prognostic implications of sentinel lymph node biopsy for breast cancer staging purposes
Diagnositic imaging during breast cancer staging
Even though breast cancer is often detected from screening mammography, additional imaging studies will be necessary as part of the staging process. The doctors will want to determine if the cancer has spread to other areas of the body, and how best to plan and remove the primary breast tumor.
Grading of breast carcinoma: DCIS and LCIS
After the intial diagnosis, more detailed staging processes are undertaken to learn about the extent of the breast cancer, and to arrive at a prognosis and treatment strategy. One part of the staging process is to give the breast tumor a 'grade', with lower grades usually indicative a good prognosis, while higher grade breast cancers tend to have a poorer prognosis. DCIS and LCIS are actually considered a stage 0 or non-invasive breast cancer, as the tumor is still confined within the breast ducts or lobules. But even DCIS and LCIS tumors may be graded.
- Descriptive Cellular images of Ductal Carcinoma in various risk stages.
- Lobular neoplasia, atypical lobular hyperplasia
- Type and grade of DCIS or ductal carcinoma in situ.
- Histological Risk Grading and Evaluation for DCIS
- Classification of Lobular Carcinoma and LCIS
- The Van Nuys prognostic index for breast DCIS
Diagnosis and Staging/Grading of infiltrating and invasive ductal carcinomas
Staging of invasive and infiltrating ductal and lobular carcinomas refers to the progression of the tumor and any metastatized breast cancer, while grading is more a descirption of the tumor itself and a prediction of the aggressiveness of a particular breast tumor. Once a breast tumor is thoroughly staged and graded, treatment begins. There are many different types of breast cancer, some quite rare in fact. Different types of breast cancers have proven to be more or less aggressive and to a certain extent to respond differently to treatments.
Copyright Steven B. Halls, MD Last edited 17-July-2011
