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.
Breastcancer.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
Caribbean L 10 ife, Oct. 9-15, 2020
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 progesteronereceptor
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 progesteronereceptor
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-receptorpositive
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
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
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.
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, estrogenreceptor
positive breast cancer
recurring and how likely she
is to benefit from post-surgery
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 breast-cancer
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
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