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Undertsanding Your Pathology Report - Page 4 Print
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Undertsanding Your Pathology Report
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Stage of the Tumor

The staging system most commonly used for breast cancers is the American Joint Committee on Cancer (AJCC) staging system. This system utilizes the extent of the primary tumor (Tis-4), the absence or presence of cancer in the lymph nodes (N0-3), and the existence of metastasis (M0 or 1) to assign a TNM rating, which corresponds to a stage. The TNM rating is broken down as follows:

T Stages

* Tis: This stage is also called carcinoma in situ.

* T1: The tumor is 2 centimeters or less.

* T2: The tumor is greater then 2 centimeters, but less than 5 centimeters.

* T3: The tumor is greater than 5 centimeters.

* T4: The tumor can be any size, but extends to the chest wall or skin, or is inflammatory breast cancer.

* Tx is used if the tumor cannot be assessed and T0 is used if no evidence of tumor is seen.

N Stages (lymph node status may be assessed by the physician before the surgery, which is called clinical lymph node staging. The chart below is using the pathologist staging of lymph nodes after surgery).

* N0 is used if no tumor is seen and Nx is used if the lymph nodes cannot be assessed.

* N1: Cancer is seen in 1 to 3 axillary or mammary lymph nodes or the sentinel node(s).

* N2: Cancer is seen in 4 to 9 axillary lymph nodes.

* N3: Cancer is seen in 10 or more lymph nodes.

M Stages

* M0: The cancer does not appear to have spread to other organs such as lung, liver and bone.

* M1: The cancer has spread to other organs such as lung, liver and bone (called distant metastases).

* Mx: Spread of the cancer has not been evaluated.

Now these ratings are combined to come up with a stage for the cancer.

* Stage 0: Carcinoma in Situ (Tis, N0, M0)

* Stage 1: T1, N0, M0

* Stage IIA: T0-1, N1, M0 or T2, N0, M0

* Stage IIB: T2, N1, M0 or T3, N0, M0

* Stage IIIA: T0-2, N2, M0 or T3, N1-2, M0

* Stage IIIB: T4, N0-2, M0

* Stage IIIC: Any T, N3, M0

* Stage IV: Any T, Any N, M1

Putting it all together

Some pieces of the report are used to determine the stage of the cancer and most pieces play a role in deciding what treatment is needed. By understanding the basics of the report, you will be better able to discuss your treatment options with your healthcare team.

Read OncoLink's Overview of Breast Cancer.

Last Updated on Thursday, 21 January 2010 10:13