BREAST CANCER STAGING AND DETERMINATION OF BREAST CANCER

What is breast cancer?

A collection of cancer cells within the breast tissue which is most likely to get malignant with time i.e. the tumor cells may spread across the entire breast or to other parts of the body, is commonly called as breast cancer. 

Breast cancer is one of the most common types of cancer among women. It differs in the location and size of the tumor growth, while there are also mixed types of tumor observed. The rate of cure largely depends upon non malignancy and early breast cancer diagnosis.

What is staging system?

The process of determining the degree of breast cancer proliferation and its multiplication in other parts of the body is known as breast cancer staging. 

After the type of cancer is diagnosed staging is used to plan the treatment approach and also predict the chances of patient’s survival.

Description about staging system

TNM staging is used by health care professionals to recapitulate all the information from diagnostic tests and surgical procedures. After the breast cancer surgery, the pathologist examines the cells from breast and lymph nodes. This information is further incorporated into staging and is seen to have more propensity than imaging and physical examination alone.

T – Denotes tumor size.

•          TX is primary tumor which cannot be identified.
•          T0 is no evidence of tumor.
•          T1 is a tumor less than 2cms.
•          T2 is a tumor 2-5cms.
•          T3 is tumor more than 5cms.
•          T4 is a large sized tumor growing into the skin or chest wall.

N- Denotes spread of tumor to the nearest lymph node to breast.

•          NX is no identification of nearby lymph node.
•          N0 is there is no spread to the lymph node.
•          N1 is the spread of tumor to internal mammary lymph node or one of the three lymph nodes of axilla.
•          N2 is the presence of enlarged lymph nodes of internal mammary gland and the spread of cancerous cells to at least 4-9 lymph nodes.
•          N3 is the spread of cancer to more than ten lymph nodes with at least one area more than 2 mm.

M denotes malignancy

•          MX is no assessment of metastasis.
•          M0 is no spread found in diagnostic procedures.
•          M1 is the spread of cancer to other body organs.

Investigations for breast cancer

Physical examination: For any lumps, swelling or pain.

Mammography: Clinical x ray of breasts to determine the cancerous areas which are not felt by hands.

Biopsy: Small quantity of tissue fluid is extracted from breast and examined pathologically.

Ultrasound: Suspected presence of a cyst is confirmed using ultrasound.

MRI: An important non invasive technique to determine dense masses of breast tissue and localize the cysts along with its edges.

PET scan: Positron emission tomography is useful to locate cancer cells in various other sites of the body. A radioactive material is injected which is taken up by the active cancer cells hence confirming the metastasis.