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.

Get the latest breast cancer information from Mayo Clinic delivered to your inbox.

Sign up for free and receive the latest on breast cancer treatment, care and management.

We use the data you provide to deliver you the content you requested. To provide you with the most relevant and helpful information, we may combine your email and website data with other information we have about you. If you are a Mayo Clinic patient, we will only use your protected health information as outlined in our Notice of Privacy Practices. You may opt out of email communications at any time by clicking on the unsubscribe link in the email.

Feb. 12, 2022 See more In-depth

See also

  1. 3D mammogram
  2. Accelerated partial breast irradiation (ABPI)
  3. Alternative cancer treatments: 11 options to consider
  4. Axillary (armpit) lymph node dissection
  5. Biopsy procedures
  6. Blood Basics
  7. Bone scan
  8. Brachytherapy
  9. BRCA gene test
  10. Breast cancer
  11. Breast Cancer
  12. Breast cancer chemoprevention
  13. Breast Cancer Education Tool
  14. Common questions about breast cancer treatment
  15. Breast cancer prevention
  16. Infographic: Breast Cancer Risk
  17. Breast cancer risk assessment
  18. Breast cancer supportive therapy and survivorship
  19. Breast cancer surgery
  20. Breast cancer types
  21. Breast cancer-related lymphedema
  22. Breast implants and cancer
  23. Evaluating breast lumps
  24. Breast lumps
  25. Breast MRI
  26. Breast reconstruction with flap surgery
  27. Breast reconstruction with implants
  28. Breast self-exam for breast awareness
  29. Cancer blood tests
  30. Cancer survivorship program
  31. Cancer treatment
  32. Chemo targets
  33. Chemotherapy
  34. Chemotherapy and hair loss: What to expect during treatment
  35. Chemotherapy and sex: Is sexual activity OK during treatment?
  36. Chemotherapy for breast cancer
  37. Chemotherapy nausea and vomiting: Prevention is best defense
  38. Chest X-rays
  39. Complete blood count (CBC)
  40. Contrast-enhanced mammography
  41. Coping with pain after breast surgery
  42. COVID-19 vaccine: Should I reschedule my mammogram?
  43. CT scan
  44. Dense breast tissue
  45. Does soy really affect breast cancer risk?
  46. Dragon Boats and Breast Cancer
  47. Flat aesthetic closure
  48. Genetic Testing for Breast Cancer
  49. Genetic testing for breast cancer: Psychological and social impact
  50. HER2-positive breast cancer: What is it?
  51. Hormone therapy for breast cancer
  52. Intralesional injection therapy
  53. Lumpectomy
  54. Magic mouthwash
  55. Mammogram
  56. Mammogram guidelines: What are they?
  57. Mastectomy
  58. What is breast cancer? An expert explains
  59. Minimally invasive inguinal lymphadenectomy (MILND)
  60. Modified radical mastectomy
  61. Molecular breast imaging
  62. MRI
  63. MRI-guided breast biopsy
  64. Nipple discharge
  65. Nipple-sparing mastectomy
  66. Oncoplastic breast-conserving surgery
  67. PALS (Pets Are Loving Support)
  68. Paulas story A team approach to battling breast cancer
  69. Pink Sisters
  70. Positron emission mammography (PEM)
  71. Positron emission tomography scan
  72. Precision medicine for breast cancer
  73. Prophylactic mastectomy
  74. Radiation therapy
  75. Radiation therapy for breast cancer
  76. Seeing inside the heart with MRI
  77. Sentinel node biopsy
  78. Skin-sparing mastectomy
  79. Stereotactic breast biopsy
  80. Support groups
  81. Surgical biopsy
  82. The Long Race Beating Cancer
  83. Thyroid guard: Do I need one during a mammogram?
  84. Tomosynthesis-guided breast biopsy
  85. Ultrasound
  86. Sentinel node biopsy for melanoma
  87. Mammogram for breast cancer — What to expect
  88. MRI
  89. Weight Loss After Breast Cancer
  90. X-ray