HER connection
Discover a program designed to support patients with knowledge and information about HER2+ breast cancer.

Three ways to connect:
Receive Updates
Personalized information to support your treatment
Support Line
Call 866.449.HER2 Nurses available 24/7
Online Live Chat
Nurses available 8am EST to 8pm EST.

Breast Cancer Stages

A cancer's stage refers to how much the cancer has grown and where it has spread. Tumors can be noninvasive or invasive. ²

Noninvasive breast cancer, or carcinoma in situ, is a tumor that has not spread beyond the ducts or the lobules, depending on where it started. ²
Ductal carcinoma in situ (DCIS) is cancer that is confined to the ducts.
Lobular carcinoma in situ (LCIS) is a condition that is confined to the lobules or milk-making glands. Although not considered a true cancer, having LCIS increases the risk of getting cancer later
An invasive tumor has spread beyond where it began, and there are three different stages of invasiveness ²:
- Localized stage: The tumor is still only within the breast
- Regional stage: The tumor has spread to the tissue surrounding the breast or there are cancer cells within nearby lymph nodes. Lymph nodes are small masses of tissues found throughout the body that are involved in fighting infection. The more lymph nodes with cancer, the more serious the cancer may be ^1,2
- Distant (advanced/metastatic) stage: The tumor has spread away from the breast to other tissues in the body (eg, lung, liver, bone, or brain)

Breast Cancer Stages - early, spread, metastatic

TNM staging system

Staging systems help describe the cancer, so that the doctor can decide what treatments are appropriate such as whether the tumor is operable (meaning that surgery should be done to remove the tumor). The TNM (Tumor, Nodal, Metastasis) Staging System is the most common method of staging breast cancer. According to the TNM system, breast cancer is grouped into five stages from 0 to IV based on how large the tumor is, the tumor's nodal status (whether or not cancer cells have spread to the lymph nodes), and whether the tumor has spread (metastasis). ³

The terms "early" and "advanced" are sometimes used to describe tumors, but these terms may be used differently by different doctors. Generally, "early" or "early-stage" breast cancer means that the cancer has not spread beyond the breast or lymph nodes under the arm (known as auxiliary lymph nodes).Stage 0,I,and II, as well as some stage III cancers, are usually considered early-stage. Ask your doctor or nurse for more information about the stage of your tumor. Here are brief descriptions of each stage of breast cancer, according to the TNM system. ^4,5

Stages 0-IV ^3,4

Stage 0 is very early breast cancer. The cancer cells are still only in the duct or lobule where they began.

Stage I Means that the tumor is small, 0 to 2 cm (about 1 inch) wide, with negative lymph nodes (no cancer cells in the lymph nodes). The tumor has not spread outside of the breast.

Stage II means one of the following:

The tumor is 2 to 5 cm (about 1 to 2 inches) wide, and lymph nodes under the arm on the same side of the body as the tumor may be positive (meaning that the lymph nodes have cancer cells in them) or
The tumor is more than 5 cm (about 2 inches) wide, but the lymph nodes are still negative

Stage III, sometimes known as locally advanced cancer, means one of the following:

The tumor has grown larger than 5 cm wide, and cancer has spread to lymph nodes under the arm or
The tumor is any size, but more lymph nodes are now positive. These nodes may be under the arm and attached to one another or in the surrounding tissue and enlarged or
The tumor is any size and has spread to the chest wall or the skin or
The tumor is any size and there are positive lymph nodes in the chest above or just below the collar bone

Stage IV means that the breast cancer is metastatic: the cancer has spread to somewhere else in the body.

Who is Herceptin for?

Herceptin is approved for the adjuvant treatment of HER2-overexpressing, node-positive or node-negative (ER/PR-negative or with one high-risk feature)^† breast cancer. Herceptin can be used several different ways:

As part of a treatment regimen including doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel
With docetaxel and carboplatin
As a single agent following multi-modality anthracycline-based therapy

Herceptin in combination with paclitaxel is approved for the first-line treatment of HER2-overexpressing metastatic breast cancer. Herceptin as a single agent is approved for treatment of HER2-overexpressing breast cancer in patients who have received one or more chemotherapy regimens for metastatic disease.

† High-risk is defined as ER/PR positive with one of the following features: tumor size >2 cm, age <35 years, or tumor grade 2 or 3.

What important safety information should I know about Herceptin?

Herceptin treatment can result in heart problems, including those without symptoms (reduced heart function) and those with symptoms (congestive heart failure). The risk and seriousness of these heart problems were highest in people who received both Herceptin and a certain type of chemotherapy (anthracycline). Your doctor will stop or strongly consider stopping Herceptin if you have a significant drop in your heart function.

You should be monitored for decreased heart function before your first dose of Herceptin, and frequently during the time you are receiving Herceptin and after your last dose of Herceptin. If you must permanently or temporarily stop Herceptin due to heart problems, you should be monitored more frequently. In one study with Herceptin and certain types of chemotherapy, an inadequate blood supply to the heart occurred.

Some patients have had serious infusion reactions and lung problems; fatal infusion reactions have been reported. In most cases, these reactions occurred during or within 24 hours of receiving Herceptin. Your Herceptin infusion should be temporarily stopped if you have shortness of breath or very low blood pressure. Your doctor will monitor you until these symptoms go away. If you have a severe allergic reaction, swelling, lung problems, inflammation of the lung, or severe shortness of breath, your doctor may need to completely stop your Herceptin treatment.

Worsening of low white blood cell counts associated with chemotherapy has also occurred.

Herceptin can cause low amniotic fluid levels and harm to the fetus when taken by a pregnant woman.

The most common side effects associated with Herceptin were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, shortness of breath, rash, low white and red blood cells, and muscle pain.

Because everyone is different, it is not possible to predict what side effects any one person will have. If you have questions or concerns about side effects, talk to your doctor.

Please see the Herceptin full Prescribing Information including Boxed WARNINGS and additional important safety information.

References:
1. Altman R, Sarg MJ. The Cancer Dictionary-Revised Edition. New York, NY: Checkmark Books; 2000.
2. American Cancer Society. Breast Cancer Facts & Figures 2005-2006. Atlanta, Ga: American Cancer Society, Inc; 2005.
3. American Cancer Society (ACS)/National Comprehensive Cancer Network (NCCN). Breast Cancer: Treatment Guidelines for Patients. Version VIII/September 2006. ACS/NCCN; 2006.
4. Breast cancer.org Website. Stages of breast cancer. Available at: http://www.breastcancer.org/dia_pict_staging.html. Accessed September 2, 2008.
5. National Cancer Institute/US National Institutes of Health Website. Dictionary of cancer terms. Available at: http://www.cancer.gov/dictionary. Accessed September 2, 2008.

Breast Cancer Stages

TNM staging system

Stages 0-IV 3,4

Who is Herceptin for?

What important safety information should I know about Herceptin?

Herceptin® (trastuzumab)

Share this page

Email this page

Stages 0-IV ^3,4