Understanding Breast Cancer Staging

N.B This topic will make you understand why it is important to do monthly breast exam. The earlier the cancer is detected, the better the prognosis.

Breast cancer staging
To stage cancer, the American Joint Committee on Cancer, first places the cancer in a letter category using the tumor, nodes, metastasis (TNM) classification system. The stage of a breast cancer describes its size and the extent to which it has spread. The staging system ranges from stage 0 to stage IV according to tumor size, lymph nodes involved, and distant metastasis.

T indicates tumor size. The letter T is followed by a number from 0 to 4, which describes the size of the tumor and whether it has spread to the skin or chest wall under the breast. Higher T numbers indicate a larger tumor and/or more extensive spread to tissues surrounding the breast.

TX: The tumor cannot be assessed.
T0: No evidence of a tumor is present.
Tis: The cancer may be LCIS, DCIS, or Paget disease.
T1: The tumor is 2 cm or smaller in diameter.
T2: The tumor is 2-5 cm in diameter.
T3: The tumor is more than 5 cm in diameter.
T4: The tumor is any size, and it has attached itself to the chest wall and spread to the pectoral (chest) lymph nodes.

N indicates palpable nodes. The letter N is followed by a number from 0 to 3, which indicates whether the cancer has spread to lymph nodes near the breast and, if so, whether the affected nodes are fixed to other structures under the arm.

NX: Lymph nodes cannot be assessed (eg, lymph nodes were previously removed).
N0: Cancer has not spread to lymph nodes.
N1: Cancer has spread to the movable ipsilateral axillary lymph nodes (underarm lymph nodes on the same side as the breast cancer).
N2: Cancer has spread to ipsilateral lymph nodes (on the same side of the body as the breast cancer), fixed to one another or to other structures under the arm.
N3: Cancer has spread to the ipsilateral mammary lymph nodes or the ipsilateral supraclavicular lymph nodes (on the same side of the body as the breast cancer).

M indicates metastasis. The letter M is followed by a 0 or 1, which indicates whether the cancer has metastasized (spread) to distant organs (eg, lungs or bones) or to lymph nodes that are not next to the breast, such as those above the collarbone.

MX: Metastasis cannot be assessed.
M0: No distant metastasis to other organs is present.
M1: Distant metastasis to other organs has occurred.

Obesity and breast cancer:

•Obesity affects both the development and progression of breast cancer.
•Post menopausal cancer risk is higher among obese women.
•Breast cancer mortality is higher in obese women.
•Body weight measured at different times during life also causes breast cancer.