Breast cancer staging

Classifying your breast cancer by stage helps predict your chance of cure and helps identify the best treatment options for your particular cancer.

By Mayo Clinic Staff

After discovering that you have breast cancer, your doctor will decide what additional tests may be helpful to find out if the disease has spread outside the breast. Called breast cancer staging, this process provides information about the extent of the disease.

Your breast cancer stage helps your doctor determine which treatments are most likely to benefit you.

The stages of breast cancer

The stages of breast cancer are indicated using Roman numerals ranging from 0 to IV, with 0 indicating cancer that is noninvasive or contained within the milk ducts. Greater numerals indicate a more invasive cancer. By stage IV breast cancer, also called metastatic breast cancer, the cancer has spread to other areas of the body.

The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment.

Information that helps determine your breast cancer stage

Your doctor determines your breast cancer stage by considering:

  • The size of your tumor
  • Whether cancer cells have spread to lymph nodes under your arm (axillary lymph nodes)
  • Whether cancer cells have spread to other parts of your body
  • How aggressive your cells appear when viewed under a microscope (tumor grade)
  • Whether your cancer cells have receptors for the hormones estrogen and progesterone
  • Whether your cancer cells have a gene mutation that causes them to make excess HER2 protein
  • Results of gene expression profiling tests (Oncotype DX, MammaPrint, others)

Tests and procedures used to stage your breast cancer

To gather information about your cancer, your doctor uses a variety of sources, including:

  • Physical exam. To gather the necessary information, your doctor will ask questions about your medical history, do a careful physical examination and review all the tests you've had. This can also include a review of the results from the biopsy of the tumor or suspicious area.
  • Pathology report. If you've already had surgery to remove your cancer and nearby lymph nodes, your doctor will use your pathology report to help determine your stage and plan your treatment.
  • Tests that evaluate your cancer cells. Cells from your cancer, collected during a biopsy procedure or during surgery to remove the cancer, are tested in a laboratory to help determine the aggressiveness of the cells and whether they are sensitive to hormones. Other sophisticated tests can determine what gene mutations are present in the cells. Not all of these tests are necessary in every case. Your doctor will help determine which tests are needed based on your particular situation.
  • Blood tests. No blood test can tell you your cancer stage, but blood tests may give your doctor an idea of your overall health and clues about which other staging tests may be useful. Blood tests might include a complete blood count and a blood chemistry test, which assess your kidney and liver function.
  • Breast-imaging tests. Mammogram, ultrasound and breast MRI give your doctor more information about your cancer and help determine if additional imaging tests may be necessary.
  • Additional imaging tests. Additional imaging can be used to look for breast cancer cells that have spread to other areas of your body. Not everyone with breast cancer needs these tests, though, so ask your doctor what's best for you.

    Additional imaging tests include a bone scan, computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).

Most people with a new diagnosis of breast cancer don't need all the diagnostic tests available. Your doctor will select the necessary tests based on your situation. Particularly if your cancer is small and hasn't spread to nearby lymph nodes, additional tests may offer little benefit, but lead to additional costs and carry a risk of complications.

Nov. 01, 2018 See more In-depth

See also

  1. 3D mammogram
  2. Biopsy procedures
  3. Blood Basics
  4. Bone scan
  5. Brachytherapy
  6. BRCA gene test
  7. Breast cancer
  8. Breast cancer chemoprevention
  9. Breast Cancer Education Tool
  10. Breast cancer prevention
  11. Breast cancer radiation: Can it cause dry skin?
  12. Infographic: Breast Cancer Risk
  13. Breast cancer supportive therapy and survivorship
  14. Breast cancer surgery
  15. Breast cancer types
  16. Breast implants and cancer
  17. Breast implants: Do they interfere with mammograms?
  18. Evaluating breast lumps
  19. Breast lumps
  20. Breast MRI
  21. Infographic: Breast Reconstruction Options
  22. Breast self-exam for breast awareness
  23. Chemo Targets
  24. Chemotherapy
  25. Chemotherapy and hair loss: What to expect during treatment
  26. Chemotherapy and sex: Is sexual activity OK during treatment?
  27. Chemotherapy for breast cancer
  28. Chemotherapy nausea and vomiting: Prevention is best defense
  29. Chest X-rays
  30. Complete blood count (CBC)
  31. Conflicting mammogram results: What can I do?
  32. Coping with pain after breast surgery
  33. CT scan
  34. CT scans: Are they safe?
  35. Dense breast tissue
  36. Does soy affect breast cancer risk?
  37. Dragon Boats and Breast Cancer
  38. Gene expression profiling for breast cancer: What is it?
  39. Genetic Testing for Breast Cancer
  40. Genetic testing for breast cancer: Psychological and social impact
  41. Get ready for possible side effects of chemotherapy
  42. Ginger for nausea: Does it work?
  43. Hormone therapy for breast cancer
  44. Lower your risk of breast cancer
  45. Lumpectomy
  46. Magic mouthwash
  47. Mammogram
  48. Mammogram: Can it find cancer in dense breasts?
  49. Mammogram guidelines: What are they?
  50. Mastectomy
  51. Molecular breast imaging
  52. Infographic: Molecular Breast Imaging
  53. MRI
  54. MRI-guided breast biopsy
  55. Nipple discharge
  56. Palliative care
  57. Palliative care: Who is it for?
  58. PALS (Pets Are Loving Support)
  59. Paulas story A team approach to battling breast cancer
  60. Pink Sisters
  61. Positron emission mammography (PEM)
  62. Positron emission tomography scan
  63. Precision medicine for breast cancer
  64. Preventive (prophylactic) mastectomy
  65. Prophylactic oophorectomy: Preventing cancer by surgically removing your ovaries
  66. Radiation therapy
  67. Radiation therapy for breast cancer
  68. Infographic: Scalp Cooling Therapy for Cancer
  69. Seeing Inside the Heart with MRI
  70. Sentinel node biopsy
  71. Stereotactic breast biopsy
  72. Support groups
  73. Tai chi
  74. The Long Race Beating Cancer
  75. Thyroid guard: Do I need one during a mammogram?
  76. Tomosynthesis-guided breast biopsy
  77. Ultrasound
  78. Sentinel node biopsy for melanoma
  79. Mammogram for breast cancer — What to expect
  80. MRI
  81. Tai chi
  82. Weight Loss After Breast Cancer
  83. X-ray
  84. Your secret weapon during cancer treatment? Exercise!