The Truth... What is it?





BREAST CANCER: Pathology STAGING

"Stage" refers to a letter and numerical systematic way of designating how big the breast cancer is and how far it has already spread at the general time of diagnosis. It takes some time and testing to gather the evidence needed to assign stage. Until the stage is accurately defined in a given case, your doctors will make decisions by thinking in terms of "presumptive stage". That is, doctors will presume the stage based on whatever evidence becomes available as they work through the evidence-gathering process of imaging (X-rays; CT, bone, & PET scans) studies, physical exam of the breast and under-arm (axilla), lab work, and pathology exams of cytology or biopsy specimens.

By the AJCC system (American Joint Committee on Cancer), which uses the TNM designation [link below], T refers to invasive tumor size [if multiple tumors, measure the largest], N refers to lymph node status, and M refers to evidence of presence or absence of spread to other organ systems ["distant" metastasis]. If a p precedes the letter, it means "as dtermined by the pathology exam". The AJCC publishes a manual, and the information on this page/file (below) is from the 5th Edition (a 6th edition is effective 1 Jan. 2003; later editions follow over the years)[scroll down to link]. There are other clinics or programs with variant staging systems. Using the guide below, a case with a 1.8 cm. cancer, 2 of 22 lymph nodes positive (without cancerous interconnection...clinical matting...of nodes), and with all studies for distant metastasis being negative, would be designated a T1c N0 M0, stage I.

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SOME SIZE EXAMPLES

  •  10 millimeters (mm.) equals 1.0 centimeter (cm.) 
  • 2.5 cm.= 1.0 inch 
  • a dime is 1.8 cm. across/in diameter 
  • a penny is 1.9 cm. 
  • a nickel is 2.1 cm. 
  • a quarter is 2.4 cm.




[1/1/2003, new 6th edition here]

 

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(posted 7 Dec. 2000; latest update 25 February 2008)