34 THE QUEENS COURIER • BREAST CANCER AWARENESS • OCTOBER 3, 2019 FOR BREAKING NEWS VISIT WWW.QNS.COM
breast cancer awareness
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.
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 option.
Typically expressed as a number on a
scale of 0 through IV, breast-cancer stage
is determined aft er careful consideration
of a host of factors. Th e 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. Th is 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: Th e 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
Th is is a measurement of how much the
cancer cells look like normal cells.
Estrogen- and progesterone
receptor status
Th is 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. Hormonereceptor
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
Th is 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
Th e 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. Th e
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 eff ective course
of treatment. More information is available
at www.breastcancer.org.
/Breastcancer.org
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/Breastcancer.org
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