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.

Feb. 12, 2020 See more In-depth

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  3. Biopsy procedures
  4. Blood Basics
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  6. Brachytherapy
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  10. Breast Cancer Education Tool
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  12. Breast cancer radiation: Can it cause dry skin?
  13. Infographic: Breast Cancer Risk
  14. Breast cancer supportive therapy and survivorship
  15. Breast cancer surgery
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  23. Breast self-exam for breast awareness
  24. Chemo Targets
  25. Chemotherapy
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  27. Chemotherapy and sex: Is sexual activity OK during treatment?
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  30. Chest X-rays
  31. Complete blood count (CBC)
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  33. Coping with pain after breast surgery
  34. CT scan
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  36. Dense breast tissue
  37. Does soy really affect breast cancer risk?
  38. Dragon Boats and Breast Cancer
  39. Gene expression profiling for breast cancer: What is it?
  40. Genetic Testing for Breast Cancer
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  42. Get ready for possible side effects of chemotherapy
  43. Get the support you need when you have metastatic breast cancer
  44. Ginger for nausea: Does it work?
  45. Hormone therapy for breast cancer
  46. Metastatic breast cancer
  47. Lower your risk of breast cancer
  48. Lumpectomy
  49. Magic mouthwash
  50. Mammogram
  51. Mammogram: Can it find cancer in dense breasts?
  52. Mammogram guidelines: What are they?
  53. Mastectomy
  54. Molecular breast imaging
  55. Infographic: Molecular Breast Imaging
  56. MRI
  57. MRI-guided breast biopsy
  58. Nipple discharge
  59. Palliative care
  60. Palliative care: Who is it for?
  61. PALS (Pets Are Loving Support)
  62. Paulas story A team approach to battling breast cancer
  63. Pink Sisters
  64. Positron emission mammography (PEM)
  65. Positron emission tomography scan
  66. Precision medicine for breast cancer
  67. Preventive (prophylactic) mastectomy
  68. Prophylactic oophorectomy: Preventing cancer by surgically removing your ovaries
  69. Radiation therapy
  70. Radiation therapy for breast cancer
  71. Relationships and metastatic breast cancer
  72. Infographic: Scalp Cooling Therapy for Cancer
  73. Seeing Inside the Heart with MRI
  74. Sentinel node biopsy
  75. Stereotactic breast biopsy
  76. Support groups
  77. Tai chi
  78. The Long Race Beating Cancer
  79. Thyroid guard: Do I need one during a mammogram?
  80. Tomosynthesis-guided breast biopsy
  81. Treatment options for metastatic breast cancer
  82. Ultrasound
  83. Sentinel node biopsy for melanoma
  84. Mammogram for breast cancer — What to expect
  85. MRI
  86. Tai chi
  87. Weight Loss After Breast Cancer
  88. What is metastatic breast cancer?
  89. Working with your doctor when you have metastatic breast cancer: Interview with a Mayo Clinic expert.
  90. X-ray
  91. Your secret weapon during cancer treatment? Exercise!