When the doctor tells you that you have breast cancer, it is very normal to feel scared, shocked, and have a lot of questions. When the doctor says, "This is Stage 2 cancer" or "Grade 3," you may wonder what these words really mean. It is normal to feel even more scared when you hear words like these. However, being clearly informed about these things will help you and your family to be mentally strong and make decisions about future treatment. So let's talk about this very simply today.
Are there two different types of cancer: 'Stage' and 'Grade'?
Yes, this is about two things. Both of these give doctors important information about the nature of your cancer.
Simply put:
- Cancer Stage: Think of cancer as a small fire that starts in a house. The 'stage' refers to how far the fire has spread inside the house, whether it has spread beyond the breast to lymph nodes in the armpits or to other organs. The lower the stage number, the less the cancer has spread.
- Cancer Grade: Think of that fire again. The 'grade' refers to how severe the fire is and how fast it is spreading. Doctors look at cancer cells under a microscope to see how similar they are to healthy cells and how fast they are dividing. The higher the grade, the more aggressive the cancer may be.
Both of these pieces of information are very important for the doctor to choose the treatment method that is most suitable for you.
What are the stages of breast cancer?
The stages of breast cancer are mainly designated by numbers from 0 to 4. Sometimes letters such as A, B, and C are used to further describe these stages.
| Stage | Simply meaning |
|---|---|
| Stage 0 | This is the earliest stage of breast cancer. The abnormal cells are only inside the milk-carrying ducts of the breast. They have not spread to the surrounding tissue. This is also called `Ductal Carcinoma In Situ (DCIS)`. |
| Stage I (Stage 1) | The cancer is now invasive, meaning it has spread into the surrounding healthy breast tissue. But the tumor is still very small (less than 2 centimeters) and has not spread to nearby lymph nodes, or has spread very little. At this point, the chances of a cure are much higher. |
| Stage II (Stage 2) | The cancer may be a little larger (between 2-5 centimeters) or have spread to a few nearby lymph nodes in the armpit. But the cancer is still confined to the breast and armpit area. |
| Stage III (Stage 3) | This is a more locally advanced stage. The cancer may have spread outside the breast, to the chest wall, skin, or lymph nodes in the armpit. But it has not yet spread to distant organs such as the liver or lungs. |
| Stage IV (Stage 4) | This stage is called Metastatic Breast Cancer . This is when the cancer has spread beyond the breast and nearby lymph nodes to distant organs such as the bones, lungs, liver, or brain . |
Cancer grade and other important tests
The doctor determines the grade by examining cancer cells obtained through surgery or biopsy.
- Grade 1: Cancer cells are very similar to healthy cells. They grow slowly.
- Grade 2: The cancer cells are slightly different from healthy cells. They grow at a moderate rate.
- Grade 3: Cancer cells are very different from healthy cells and look messy. They can grow and spread quickly.
Most importantly, knowing this grade will greatly help your doctor determine the need and type of treatment, such as chemotherapy, you need.
In addition, the doctor is performing several other important tests.
- Hormone Receptor Status: Some breast cancer cells use the hormones estrogen and progesterone to grow.
- ER-positive (ER+) means that the cancer uses the hormone estrogen to grow.
- PR-positive (PR+) means that the hormone progesterone is used.
- If these are positive, the cancer can be controlled by administering hormone therapy.
- HER2 Status: `HER2` is a protein that controls cell growth. Some cancer cells produce too much of this `HER2` protein (`HER2-positive`). Then the cancer can grow quickly. For `HER2-positive` cancers, there are specific drugs (Targeted Therapy) that target that protein.
What is the TNM system?
This is the internationally accepted method that doctors use to accurately determine the stage of cancer. While it may seem a bit complicated, it can provide a very accurate picture of your cancer.
- T (Tumor): Measures the size of the cancer and whether it has spread to surrounding tissues.
- N (Nodes): Measures whether the cancer has spread to nearby lymph nodes , and if so, to what extent.
- M (Metastasis): Measures whether the cancer has spread to distant organs outside the breast.
The overall stage of your cancer is determined by adding up the numbers associated with each of these letters (e.g. T1, N0, M0). If you see any of these symbols on your report, don't be afraid to ask your doctor for an explanation.
Should we really be worried about the 5-Year Survival Rate?
These words strike fear into anyone's mind. This refers to how many out of 100 people diagnosed with cancer at a certain stage will be alive after 5 years.
But keep this in mind: These are just general statistics based on data from thousands of patients. They cannot predict your individual situation.
- For early-stage (localized) cancers, this rate is as high as 99% .
- Although this rate is lower when the cancer has spread to distant organs (Distant/Stage 4), thanks to today's modern treatments, many people have been able to maintain a good quality of life and live for many years even with Stage 4 cancer .
So, don't get discouraged by the statistics on the internet. Your focus should be on sticking to your own unique treatment plan. Talk to your doctor about it openly.
Take-Home Message
- The 'stage' of breast cancer refers to how far the cancer has spread. The 'grade' refers to how aggressive the cancer is.
- Knowing the exact stage and grade of your cancer is essential to determining the best treatment plan for you.
- Stage 4 (Metastatic) cancer is not the end of life. With today's advanced treatments, the condition can be managed and lived well.
- If you don't understand something in your report, don't be afraid or hesitant to ask your doctor again and again. It's your right.
- Don't go through this journey alone. Seek the support of your family, friends, and, if necessary, support groups. It will give you a lot of mental strength.
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