Questions About Cancer? 1-800-4-CANCER

Breast Cancer Treatment (PDQ®)

Patient Version
Last Modified: 03/22/2012

Stages of Breast Cancer

Key Points for This Section


After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.

The process used to find out whether the cancer has spread within the breast or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

  • Through tissue. Cancer invades the surrounding normal tissue.
  • Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
  • Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

The following stages are used for breast cancer:

Stage 0 (carcinoma in situ)

There are 2 types of breast carcinoma in situ:

Enlarge 1
Tumor size compared to everyday objects; shows various measurements of a tumor compared to a pea, peanut, walnut, and lime 1
Pea, peanut, walnut, and lime show tumor sizes.

Stage I

In stage I, cancer has formed. Stage I is divided into stages IA and IB.

Stage II

Stage II is divided into stages IIA and IIB.

  • In stage IIA:
    • no tumor is found in the breast, but cancer is found in the axillary lymph nodes (lymph nodes under the arm); or
    • the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or
    • the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.
  • In stage IIB, the tumor is either:
    • larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or
    • larger than 5 centimeters but has not spread to the axillary lymph nodes.

Stage IIIA

In stage IIIA:

  • no tumor is found in the breast. Cancer is found in axillary lymph nodes that are attached to each other or to other structures, or cancer is found in lymph nodes near the breastbone; or
  • the tumor is 2 centimeters or smaller. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer has spread to lymph nodes near the breastbone; or
  • the tumor is larger than 2 centimeters but not larger than 5 centimeters. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer has spread to lymph nodes near the breastbone; or
  • the tumor is larger than 5 centimeters. Cancer has spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.

Stage IIIB

In stage IIIB, the tumor may be any size and cancer:

Cancer that has spread to the skin of the breast is inflammatory breast cancer. See the section on Inflammatory Breast Cancer 2 for more information.

Stage IIIC

In stage IIIC, no tumor is found in the breast or the tumor may be any size and may have spread to the chest wall and/or the skin of the breast. Also, cancer:

Cancer that has spread to the skin of the breast is inflammatory breast cancer. See the section on Inflammatory Breast Cancer 2 for more information.

Stage IIIC breast cancer is divided into operable and inoperable stage IIIC.

In operable stage IIIC, the cancer:

  • is found in ten or more axillary lymph nodes; or
  • is found in lymph nodes below the collarbone; or
  • is found in axillary lymph nodes and in lymph nodes near the breastbone.

In inoperable stage IIIC breast cancer, the cancer has spread to the lymph nodes above the collarbone.

Stage IV

In stage IV, the cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.



Glossary Terms

abnormal (ab-NOR-mul)
Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
axillary lymph node (AK-sih-LAYR-ee limf node)
A lymph node in the armpit region that drains lymph from the breast and nearby areas.
blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
bone cancer (bone KAN-ser)
Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).
bone scan (bone skan)
A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner.
breast (brest)
Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
breast cancer (brest KAN-ser)
Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
breast carcinoma in situ (brest KAR-sih-NOH-muh in SY-too)
There are 2 types of breast carcinoma in situ: ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). DCIS is a noninvasive condition in which abnormal cells are found in the lining of a breast duct (a tube that carries milk to the nipple). The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known how to predict which lesions will become invasive cancer. LCIS is a condition in which abnormal cells are found in the lobules (small sections of tissue involved with making milk) of the breast. This condition seldom becomes invasive cancer; however, having LCIS in one breast increases the risk of developing breast cancer in either breast. Also called stage 0 breast carcinoma in situ.
breastbone (brest-bone)
The long flat bone that forms the center front of the chest wall. The breastbone is attached to the collarbone and the first seven ribs. Also called sternum.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
capillary (KA-pih-layr-ee)
The smallest type of blood vessel. A capillary connects an arteriole (small artery) to a venule (small vein) to form a network of blood vessels in almost all parts of the body. The wall of a capillary is thin and leaky, and capillaries are involved in the exchange of fluids and gases between tissues and the blood.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
centimeter (SEN-tih-MEE-ter)
A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.
chest wall (chest wawl)
The muscles, bones, and joints that make up the area of the body between the neck and the abdomen.
chest x-ray (chest EX-ray)
An x-ray of the structures inside the chest. An x-ray is a type of high-energy radiation that can go through the body and onto film, making pictures of areas inside the chest, which can be used to diagnose disease.
collarbone (KAH-ler-bone)
One of a pair of bones at the base of the front of the neck. The clavicles connect the breastbone to the shoulder blades. Also called clavicle.
condition (kun-DIH-shun)
In medicine, a health problem with certain characteristics or symptoms.
contrast material (KON-trast muh-TEER-ee-ul)
A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.
CT scan (… skan)
A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.
duct (dukt)
In medicine, a tube or vessel of the body through which fluids pass.
ductal carcinoma in situ (DUK-tul KAR-sih-NOH-muh in SY-too)
A noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, ductal carcinoma in situ may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Also called DCIS and intraductal carcinoma.
glucose (GLOO-kose)
A type of sugar; the chief source of energy for living organisms.
inflammatory breast cancer (in-FLA-muh-TOR-ee brest KAN-ser)
A type of breast cancer in which the breast looks red and swollen and feels warm. The skin of the breast may also show the pitted appearance called peau d'orange (like the skin of an orange). The redness and warmth occur because the cancer cells block the lymph vessels in the skin.
injection (in-JEK-shun)
Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."
inoperable (in-AH-peh-ruh-bul)
Describes a condition that cannot be treated by surgery.
invasive cancer (in-VAY-siv KAN-ser)
Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer.
lesion (LEE-zhun)
An area of abnormal tissue. A lesion may be benign (not cancer) or malignant (cancer).
liver (LIH-ver)
A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
lobular carcinoma in situ (LAH-byuh-ler KAR-sih-NOH-muh in SY-too)
A condition in which abnormal cells are found in the lobules of the breast. Lobular carcinoma in situ seldom becomes invasive cancer; however, having it in one breast increases the risk of developing breast cancer in either breast. Also called LCIS.
lobule (LOB-yule)
A small lobe or a subdivision of a lobe.
lung (lung)
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
lymph (limf)
The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.
lymph node (limf node)
A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
lymph vessel (limf ...)
A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.
lymphatic system (lim-FA-tik SIS-tem)
The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.
malignant (muh-LIG-nunt)
Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.
metastasis (meh-TAS-tuh-sis)
The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).
millimeter (MIH-luh-MEE-ter)
A measure of length in the metric system. A millimeter is one thousandth of a meter. There are 25 millimeters in an inch.
noninvasive (NON-in-VAY-siv)
In medicine, it describes a procedure that does not require inserting an instrument through the skin or into a body opening. In cancer, it describes disease that has not spread outside the tissue in which it began.
operable (AH-peh-ruh-bul)
Describes a condition that can be treated by surgery.
organ (OR-gun)
A part of the body that performs a specific function. For example, the heart is an organ.
PET scan (… skan)
A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body. Also called positron emission tomography scan.
primary tumor (PRY-mayr-ee TOO-mer)
The original tumor.
radioactive (RAY-dee-oh-AK-tiv)
Giving off radiation.
scanner (SKA-ner)
In medicine, an instrument that takes pictures of the inside of the body.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stage I breast cancer (... brest KAN-ser)
Stage I breast cancer is divided into stages IA and IB. In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast. In stage IB, (1) no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or (2) the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.
stage IA breast cancer (... brest KAN-ser)
Stage I breast cancer is divided into stages IA and IB. In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast.
stage IB breast cancer (... brest KAN-ser)
Stage I breast cancer is divided into stages IA and IB. In stage IB, (1) no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or (2) the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.
stage II breast cancer (... brest KAN-ser)
Stage II breast cancer is divided into stages IIA and IIB. In stage IIA, (1) no tumor is found in the breast, but cancer is found in the axillary (under the arm) lymph nodes; or (2) the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes. In stage IIB, the tumor is (1) larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or (2) larger than 5 centimeters but has not spread to the axillary lymph nodes.
stage IIA breast cancer (... brest KAN-ser)
Stage II breast cancer is divided into stages IIA and IIB. In stage IIA, (1) no tumor is found in the breast, but cancer is found in the axillary (under the arm) lymph nodes; or (2) the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.
stage IIB breast cancer (... brest KAN-ser)
Stage II breast cancer is divided into stages IIA and IIB. In stage IIB, (1) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary (under the arm) lymph nodes; or (2) the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes.
stage IIIA breast cancer (... brest KAN-ser)
Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIA, (1) no tumor is found in the breast, but cancer is found in axillary (under the arm) lymph nodes that are attached to each other or to other structures, or cancer may be found in lymph nodes near the breastbone; or (2) the tumor is 2 centimeters or smaller and cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or the cancer may have spread to lymph nodes near the breastbone; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and cancer has spread to axillary lymph nodes that are attached to each other or to other structures
stage IIIB breast cancer (... brest KAN-ser)
Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIB, the tumor may be any size and cancer (1) has spread to the chest wall and/or the skin of the breast; and (2) may have spread to axillary (under the arm) lymph nodes that may be attached to each other or to other structures, or the cancer may have spread to lymph nodes near the breastbone.
stage IIIC breast cancer (... brest KAN-ser)
Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIC, there may be no sign of cancer in the breast or the tumor may be any size and may have spread to the chest wall and/or the skin of the breast. Also, cancer (1) has spread to lymph nodes above or below the collarbone and (2) may have spread to axillary (under the arm) lymph nodes or to lymph nodes near the breastbone. In operable stage IIIC, the cancer is found (1) in ten or more axillary lymph nodes; or (2) in the lymph nodes below the collarbone; or (3) in axillary lymph nodes and in lymph nodes near the breastbone. In inoperable stage IIIC, the cancer has spread to the lymph nodes above the collarbone.
stage IV breast cancer (... brest KAN-ser)
Cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.
staging (STAY-jing)
Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
vein (vayn)
A blood vessel that carries blood to the heart from tissues and organs in the body.
x-ray (EX-ray)
A type of radiation used in the diagnosis and treatment of cancer and other diseases. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.

Table of Links

1http://www.cancer.gov/PublishedContent/MediaLinks/290263.html
2http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/Page3#Section_1
81