Estrogen receptor (ER) positive breast cancer

Request an Appointment

Stages

Breast cancer staging describes how much cancer is in the body and whether it has spread. Knowing the stage helps your healthcare team understand the cancer and plan treatment.

Breast cancer stages range from 0 to 4. In general, a lower number means the cancer is smaller or has spread less. Stage 4 means the cancer has spread to a distant part of the body.

It can take time to determine the stage. Your healthcare team may not know the final stage until after surgery, when more information about the cancer is available.

Not everyone needs imaging tests to find out whether breast cancer has spread. Depending on your situation, tests may include:

Your healthcare team chooses which tests you need based on your cancer and your situation.

Types of staging

Your healthcare team may describe breast cancer stage in different ways.

  • Anatomic stage. This is based on the size of the cancer and whether it has spread to nearby lymph nodes or other parts of the body.
  • Prognostic stage. This combines the anatomic stage with other information about the cancer, including tumor grade and ER, PR and HER2 status.

Breast cancer stages

Breast cancer stages are:

  • Stage 0. Stage 0 breast cancer is called ductal carcinoma in situ (DCIS). In DCIS, abnormal cells are found inside a breast duct. They haven't spread into the surrounding breast tissue. Some DCIS has hormone receptors.
  • Stage 1. The cancer is small and may only be in the breast. In some cases, a small amount of cancer is found in nearby lymph nodes. The cancer hasn't spread to distant parts of the body.
  • Stage 2. The cancer may be larger than stage 1 cancer or may have spread to nearby lymph nodes. It hasn't spread to distant parts of the body.
  • Stage 3. The cancer has spread further within the breast, to nearby lymph nodes or to nearby tissues. It hasn't spread to distant parts of the body.
  • Stage 4. The cancer has spread to a distant part of the body. This is called metastatic breast cancer.

Stage isn't the same as tumor grade. Stage describes how much cancer is in the body and whether it has spread. Grade describes how different the cancer cells look from healthy cells and can help show how quickly the cancer may grow.

Request an appointment
Diagnosis & treatmentSurvival rates
Aug. 26, 2026
  1. Breast cancer biomarkers: Hormone receptors, HER2, and others. National Cancer Institute. https://www.cancer.gov/types/breast/diagnosis/breast-cancer-biomarker-tests. Accessed Aug. 4, 2026.
  2. Breast cancer. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1419. Accessed Aug. 4, 2026.
  3. Signs and symptoms of breast cancer. National Cancer Institute. https://www.cancer.gov/types/breast/symptoms. Accessed Aug. 4, 2026.
  4. Breast cancer causes and risk factors. National Cancer Institute. https://www.cancer.gov/types/breast/causes-risk-factors. Accessed Aug. 4, 2026.
  5. Breast cancer risk reduction. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=2&id=1420. Accessed Aug. 4, 2026.
  6. Genetic/familial high-risk assessment: Breast, ovarian, pancreatic and prostate. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=2&id=1503. Accessed Aug. 4, 2026.
  7. Hormone therapy for breast cancer. National Cancer Institute. https://www.cancer.gov/types/breast/breast-hormone-therapy-fact-sheet. Accessed Aug. 4, 2026.
  8. Chua AV Jr, et al. Epidemiology of early vs late recurrence among women with early-stage estrogen receptor-positive breast cancer in the Pathways Study. Journal of the National Cancer Institute. 2024; doi:10.1093/jnci/djae128.
  9. Fertility issues in girls and women with cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/fertility-women. Accessed Aug. 4, 2026.
  10. Lymphedema and cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema. Accessed Aug. 4, 2026.
  11. Su HI, et al. Fertility preservation in people with cancer: ASCO guideline update. Journal of Clinical Oncology. 2025; doi:10.1200/JCO-24-02782.
  12. Andre F, et al. Biomarkers for adjuvant endocrine and chemotherapy in early-stage breast cancer: ASCO guideline update. Journal of Clinical Oncology. 2022; doi:10.1200/JCO.22.00069.
  13. Breast cancer screening and diagnosis. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=2&id=565. Accessed Aug. 4, 2026.
  14. Protocol for the examination of biopsy specimens from patients with invasive carcinoma of the breast. College of American Pathologists. https://www.cap.org/protocols-and-guidelines/cancer-protocols/current-cancer-protocols. Accessed Aug. 13, 2026.
  15. Allison KH, et al. Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update. Journal of Clinical Oncology. 2020; doi:10.1200/JCO.19.02309.
  16. Burstein HJ, et al. Endocrine and targeted therapy for hormone receptor-positive, HER2-negative metastatic breast cancer—Capivasertib-fulvestrant: ASCO rapid recommendation update. Journal of Clinical Oncology. 2024; doi:10.1200/JCO.24.00248.
  17. Stages of breast cancer. National Cancer Institute. https://www.cancer.gov/types/breast/stages. Accessed Aug. 12, 2026.
  18. Treatment of breast cancer by stage. National Cancer Institute. https://www.cancer.gov/types/breast/treatment/by-stage. Accessed Aug. 12, 2026.
  19. American College of Surgeons. Breast. In: AJCC Cancer Staging System. American College of Surgeons; 2026. https://online.statref.com. Accessed Aug. 12, 2026.
  20. Kellerman RD, et al. Breast cancer. In: Conn's Current Therapy 2026. Elsevier; 2026. https://www.clinicalkey.com. Accessed Aug. 12, 2026.
  21. Targeted therapy for breast cancer. National Cancer Institute. https://www.cancer.gov/types/breast/treatment/targeted-therapy. Accessed Aug. 12, 2026.
  22. Chemotherapy for breast cancer. National Cancer Institute. https://www.cancer.gov/types/breast/treatment/chemotherapy. Accessed Aug. 12, 2026.
  23. Surgery for breast cancer. National Cancer Institute. https://www.cancer.gov/types/breast/treatment/surgery. Accessed Aug. 12, 2026.
  24. Radiation therapy for breast cancer. National Cancer Institute. https://www.cancer.gov/types/breast/treatment/radiation. Accessed Aug. 12, 2026.
  25. Freedman RA, et al. Optimal adjuvant chemotherapy and targeted therapy for early breast cancer—Cyclin-dependent kinase 4 and 6 inhibitors: ASCO guideline rapid recommendation update. Journal of Clinical Oncology. 2024; doi:10.1200/JCO.24.00886.
  26. McDonald ES, et al. ACR appropriateness criteria imaging of invasive breast cancer. Journal of the American College of Radiology. 2024; doi:10.1016/j.jacr.2024.02.021.
  27. How is breast cancer diagnosed? National Cancer Institute. https://www.cancer.gov/types/breast/diagnosis. Accessed Aug. 13, 2026.
  28. Ductal carcinoma in situ (DCIS). National Cancer Institute. https://www.cancer.gov/types/breast/breast-cancer-types/dcis. Accessed Aug. 13, 2026.
  29. Cancer stat facts: Female breast cancer subtypes. National Cancer Institute. https://seer.cancer.gov/statfacts/html/breast-subtypes.html. Accessed Aug. 13, 2026.
  30. Breast cancer prognosis and survival rates. National Cancer Institute. https://www.cancer.gov/types/breast/survival. Accessed Aug. 13, 2026.
  31. Sparano JA, et al. Clinical and genomic risk for late breast cancer recurrence and survival. NEJM Evidence. 2024; doi:10.1056/EVIDoa2300267.
  32. Popular diets, supplements and cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/cam/diets-supplements. Accessed Aug. 14, 2026.
  33. Van Die D, et al. Phytonutrients and outcomes following breast cancer: A systematic review and meta-analysis of observational studies. JNCI Cancer Spectrum. 2023; doi:10.1093/jncics/pkad104.
  34. Mastectomy. National Cancer Institute. https://www.cancer.gov/types/breast/treatment/surgery/mastectomy. Accessed Aug. 15, 2026.
  35. Cancer therapy interactions with foods and dietary supplements (PDQ). National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/cam/patient/dietary-interactions-pdq. Accessed Aug. 16, 2026.
  36. Messina M, et al. A review of the clinical and epidemiologic evidence relevant to the impact of postdiagnosis isoflavone intake on breast cancer outcomes. Current Nutrition Reports. 2025; doi:10.1007/s13668-025-00640-5.
  37. Bower JE, et al. Management of fatigue in adult survivors of cancer: ASCO–Society for Integrative Oncology guideline update. Journal of Clinical Oncology. 2024; doi:10.1200/JCO.24.00541.

Related

Associated Procedures

Estrogen receptor (ER) positive breast cancer