Breast cancer patients may come to see their oncologist when there is a strong suspicion of cancer or after a confirmation of cancer has been made from preliminary tests. They often will come with very little information about their disease but are nervous and anxious for their treatment to begin. Sometimes patients are disappointed to find that treatment doesn’t typically start at their first visit.
In many cases, there is a delay. This gives their doctor time to gather more information about their cancer with blood tests, imaging or other diagnostic procedure. The doctor will order a “staging work-up”. The goal of staging is to determine the location of the original tumor, size and severity of the tumor, whether the lymph nodes contain cancer, and if the cancer is confined to a specific area of the body or has metastasized (spread) to other areas of the body.
When their oncologist has detailed results of their physical examinations, imaging scans, and biopsies, a clinical stage is determined. Pathological staging is based on surgical tumor findings as well as clinical findings. Pathological staging gives the most amount of information to a physician to make a prognosis, but it isn’t always an option depending on the location of the tumor and/or the health of the individual.
Stage I is often referred to as early-stage cancer. It is usually a small cancer or tumor that has not grown deeply into nearby tissues or spread to the lymph nodes or other parts of the body.
Stages II and III cancers have extended beyond the immediate region of the tumor and may have invaded nearby lymph nodes and muscles but has not spread to distant organs. Typically, both stages indicate that larger cancers or tumors that have grown more deeply into nearby tissue.
Stage IV is advanced or metastatic cancer, that has already spread to other distant part of the body from where it was first diagnosed
Sometimes cancer doctors will use the term “restaging”, but it’s important to understand that once a stage is determined, it never changes. The cancer may grow or shrink, spread to other organs or come back after treatment, but it will still be referred to as it was originally staged. Restaging refers to the process of determining the current extent and nature of the cancer, either after treatment or over time. Though the term restaging can be misleading, the information is still highly valuable in determining whether the cancer is stable, has gotten better or worse, or returned. Restaging guides treatment strategies such as when to start or discontinue therapy.