When receiving
treatment for
breast cancer,
women will learn about
cancer staging. According
to the nonprofit organization
Breastcancer.
org, determining the
stage of the cancer helps
patients and their doctors
figure out the prognosis,
develop a treatment plan,
and even decide if clinical
trials are a valid option.
Typically expressed
as a number on a scale of
0 through IV, breast-cancer
stage is determined
after careful consideration
of a host of factors.
The staging system,
sometimes referred to
as the TNM system, is
overseen by the American
Joint Committee on
Cancer and ensures that
all instances of breast
cancer are described in a
uniform way. This helps
to compare treatment
results and gives doctors
and patients a better
understanding of breast
cancer and the ways to
treat it.
Breas t canc er.org
notes that the TNM system
was updated in 2018,
but before then was based
on three clinical characteristics:
T: The size of the tumor
and whether or not
it has grown into nearby
tissue.
N: Whether the cancer
is present in the lymph
nodes.
M: Whether the cancer
has metastasized, or
spread to others parts
of the body beyond the
breast.
Each of those factors
is still considered when
determining breast cancer
stage, but starting in
2018, the AJCC added additional
characteristics
to its staging guidelines,
which make staging
more complex but also
more accurate:
Tumor grade
This is a measurement
of how much the
cancer cells look like normal
cells.
Estrogen- and progesterone
receptor status
This indicates if the
cancer cells have receptors
for the hormones
estrogen and progesterone.
If cancer cells are
deemed estrogen-receptor
positive, then they
may receive signals from
estrogen that promote
their growth. Similarly,
those deemed progesterone
receptor-positive
may receive signals from
progesterone that could
promote their growth.
Testing for hormone
receptors, which roughly
two out of three breast
cancers are positive for,
helps doctors determine
if the cancer will respond
to hormonal therapy or
other treatments. Hormone
receptor-positive
cancers may be treatable
with medications that
reduce hormone production
or block hormones
from supporting the
growth and function of
cancer cells.
HER2 status
This helps doctors
determine if the cancer
cells are making
too much of the HER2
BRONX TIMES REPORTER, O 44 CTOBER 11-17, 2019 BTR
protein. HER2 proteins
are receptors on breast
cells made by the HER2
gene. In about 25 percent
of breast cancers,
the HER2 gene makes
too many copies of itself,
and these extra genes
ultimately make breast
cells grow and divide
in ways that are uncontrollable.
HER2-positive
breast cancers are more
likely to spread and return
than those that are
HER2-negative.
Oncotype DX score
The oncotype DX score
helps doctors determine
a woman’s risk of early
stage, estrogen-receptorpositive
breast cancer
recurring and how likely
she is to benefit from postsurgery
chemotherapy. In
addition, the score helps
doctors figure out if a
woman is at risk of ductal
carcinoma in situ recurring
or at risk for a new invasive
cancer developing
in the same breast. The
score also helps doctors
figure out if such women
will benefit from radiation
therapy or DCIS surgery.
Determining breastcancer
stage is a complex
process, but one that can
help doctors develop the
most effective course of
treatment. More information
is available at www.
breastcancer.org.
Determining breast-cancer stage
Determining the stage of the cancer helps patients and their doctors fi gure out the prognosis,
develop a treatment plan and even decide if clinical trials are a valid option.
/er.org
/www.breastcancer.org
/www.breastcancer.org
/breastcancer.org