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Treating Breast Cancer Early

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Early Breast Cancer: Know the Three Stages

Medically Reviewed By William C. Lloyd III, MD, FACS

Generally speaking, early stage breast cancer is breast cancer that hasn’t spread beyond the breast to the axillary lymph nodes, which are the lymph nodes in your underarm area. It’s important to know what each stage entails, as that can affect your treatment options.

a woman wearing a pink shirt is talking to a doctor

As with any type of cancer diagnosis, it’s always better to receive an early stage breast cancer diagnosis rather than a later-stage cancer diagnosis, since it’s typically easier to treat cancer early on. But what qualifies as “early stage” when it comes to breast cancer? Early stage breast cancer is usually broken down into three categories: stage 0, stage 1, and stage 2. Following surgery to remove breast cancer, doctors assign a tumor stage by looking at the size and location of the tumor, and by examining the specimen under the microscope to determine whether or not any lymph nodes are involved, as well as whether or not the cancer has spread beyond its initial location.

Stage 0 breast cancer

Stage 0 cancer is the very earliest stage of breast cancer. It’s a noninvasive cancer that’s found only inside the ducts or lobules of your breast. Your doctor may also call it “carcinoma in situ.”

Ductal carcinoma in situ (DCIS) is a stage 0 breast cancer that has developed within the milk ducts that line the breast. It accounts for about 20% of the breast cancer diagnoses in the U.S. Most women don’t notice any symptoms from this type of cancer, although it’s possible that you might notice a lump or a small amount of nipple discharge. You might not even suspect it’s there until you undergo a mammogram.

Although this type of cancer hasn’t spread beyond the breast, the cells may eventually undergo changes and become invasive cancerous cells that spread. Depending on how many areas of the breast are affected by DCIS, your doctor may suggest one of two possible surgical treatment options: a lumpectomy to remove the tumor and a small amount of surrounding tissue (also sometimes called breast-conserving surgery, or BCS), or a mastectomy. However, some women just undergo radiation therapy alone, which research, including a 2021 study, suggests is effective for standard-risk DCIS cases.

The good news is you can probably expect a very good long-term prognosis. Research suggests that DCIS typically carries a 98% 10-year survival rate Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source and a “normal life expectancy.” That means past data shows 98 out of 100 people with DCIS are alive 10 years after diagnosis.

Stage 1 breast cancer

Stage 1 breast cancer is also considered an early breast cancer stage. However, unlike stage 0 cancer, stage 1 cancer is an invasive form of cancer. That means the cancer has spread into healthy breast tissue. As with stage 0 cancer, you might not experience any symptoms. However, you might be able to feel a lump or notice a slight change in the size or shape of your breast.

With stage 1 breast cancer, the tumors are still pretty small, and there’s either no lymph node involvement at all or it is contained to a very small area of the sentinel lymph node. A small tumor that hasn’t spread to a lymph node will be assigned a stage 1A classification, while a stage 1B cancer means that some cancerous cells have been found in a lymph node near the breast, even if there’s not an actual tumor detected in the breast itself.

This kind of cancer is considered highly treatable. Depending on your specific case, your doctor might recommend surgery or radiation therapy (or both) to treat your early breast cancer. The outlook for people with stage 1 breast cancer is positive. The 5-year survival rate for women with localized breast cancer is 90% Trusted Source American Cancer Society Highly respected international organization Go to source – that means past data shows 90 out of 100 of women with this type of breast cancer were alive 5 years after they received a diagnosis. Keep in mind that current 5-year survival rates are based on data from at least 5 years ago. Because treatments are always changing, your outlook could be better than estimated, so it’s important to talk to your doctor about your specific situation.

Stage 2 breast cancer

Stage 2 breast cancer is also an invasive form of breast cancer. And while stage 2 breast cancer is still considered an early stage breast cancer, it means that your cancer is more advanced than a stage 0 or stage 1 cancer. As with stage 1 cancer, oncologists typically subdivide stage 2 cancers into stage 2A and stage 2B cancers. These subcategories take into account the size of the tumor and how many lymph nodes (and which ones) contain cancerous cells.

The treatments start to become more complex when you get into stage 2 territory. The subcategories will also determine the treatment options that are recommended to you. Sometimes, breast-conserving surgery, followed by radiation, is appropriate, along with a biopsy of the lymph nodes. However, in other cases, a mastectomy, or a mastectomy followed by radiation, may be recommended. And many women with stage 2 breast cancer also receive some type of systemic therapy, like chemotherapy, either before or after surgery. Hormone therapy, targeted drug therapy, and immunotherapy are other examples of possible treatment options.

The 5-year relative survival rate for women with a regional breast cancer — that is, a cancer that has spread outside the breast to nearby lymph nodes or other structures in the body — is about 86% Trusted Source American Cancer Society Highly respected international organization Go to source .

Using knowledge to guide your choices

Understanding these stages of early breast cancer can help you make better decisions for yourself. Although the treatment recommended to you will depend on the stage of your early breast cancer, you do have choices. Don’t hesitate to have an open and honest discussion with your oncologist about your preferences and goals for treatment, and how those dovetail with the treatment options available to you.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Feb 25
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