COURIER L 26 IFE, OCT. 9-15, 2020
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.
How to determine the
stage of breast cancer
When receiving treatment for
breast cancer, women will learn about
cancer staging. According to the nonprofi
t organization Breastcancer.org,
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
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
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:
This is a measurement of how much
the cancer cells look like normal cells.
Estrogen- and progesteronereceptor
This indicates if the cancer cells
have receptors for the hormones estrogen
and progesterone. If cancer
cells are deemed estrogen-receptorpositive,
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
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.
cancers may be treatable
with medications that reduce hormone
production or block hormones
from supporting the growth and function
of cancer cells.
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 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-receptor-positive
breast cancer recurring and how likely
she is to benefi t from post-surgery chemotherapy.
In addition, the score helps
doctors fi gure 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 fi gure out if such
women will benefi t 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.
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