Stage 2 breast cancer
Stage 2 breast cancer means that the cancer is either in the breast or in the nearby lymph nodes or both. It is an early stage breast cancer.
The stage of a cancer tells you how big it is and how far it has spread. It helps your doctor decide which treatment you need.
Staging for breast cancer is very complex. Below is a simplified description. Many different factors are considered before doctors can confirm your final stage.
For example, they also use a sample of your cancer to test for:
- receptors for the female hormones (oestrogen and progesterone)
- HER2 status (human epidermal growth factor receptor 2)
- the grade of your cancer
Do speak to your breast doctor or nurse if you have any questions about your staging.
What is stage 2 breast cancer?
Stage 2 breast cancer has two groups: stage 2A and 2B.
Stage 2A means one of the following
- there is no tumour or a tumour 2 centimetres (cm) or smaller in the breast and cancer cells are found in 1 to 3 lymph nodes in the armpit or in the lymph nodes near the breastbone
- the tumour is larger than 2cm but not larger than 5cm and there is no cancer in the lymph nodes
Stage 2B means one of the following
- the tumour is larger than 2cm but not larger than 5cm and there are small areas of cancer cells in the lymph nodes
- the tumour is larger than 2cm but not larger than 5cm and the cancer has spread to 1 to 3 lymph nodes in the armpit or to the lymph nodes near the breastbone
- the tumour is larger than 5cm and hasn't spread to the lymph nodes
The TNM staging system stands for Tumour, Node, Metastasis.
- T describes the size of the tumour
- N describes whether there are any cancer cells in the lymph nodes
- M describes whether the cancer has spread to a different part of the body
Stage 2B is the same as:
- T2 N1 M0
- T3 N0 M0
In the TNM staging system, stage 2A breast cancer is the same as:
- T0 N1 M0
- T1 N1 M0
- T2 N0 M0
Checking the lymph nodes
The usual treatment is surgery to remove the cancer. Before your surgery you have an ultrasound scan to check the lymph nodes in the armpit (axilla) close to the breast. This is to see if they contain cancer cells. If breast cancer spreads, it usually first spreads to the lymph nodes close to the breast.
Depending on the results of your scan you might have:
- a sentinel lymph node biopsy during your breast cancer operation
- surgery to remove your lymph nodes
Treatment to the breast
Your surgeon might remove the cancerous area with a border of normal breast tissue. This is called breast conserving surgery or a wide local excision. After this you usually have radiotherapy to the rest of the breast.
Or you might have the whole breast removed. This is called a mastectomy. You can choose to have a new breast made (breast reconstruction). You might have radiotherapy to the chest wall after having a mastectomy. You might have treatment with radiotherapy to the lymph nodes under your arm or further surgery to remove the nodes if they contain cancer cells.
You can have a breast reconstruction at the same time as surgery to remove the cancer, or at a later time. Having a reconstruction at the same time should not affect you having radiotherapy after surgery if you need it. The plan to have radiotherapy after a reconstruction might affect the reconstruction options you have.
Your surgeon will discuss all the pros and cons with you.
You usually have other treatments too.
You usually have hormone therapy after surgery If your cancer is oestrogen receptor positive. You have it for 5 years or more. But exactly how long depends on the type of drug you have and your individual situation.
You might have chemotherapy after surgery, this is called adjuvant chemotherapy. Your doctor may use an online tool to look at the benefits of chemotherapy after surgery for early breast cancer. For some people the benefit of chemotherapy is clear, for others it’s not so clear.
In this situation your doctor may do another test called a genomic test or tumour profiling test. This helps them decide who needs extra treatment with chemotherapy to lower the risk of the cancer coming back.
You might have chemotherapy or hormone therapy before surgery. These treatments can sometimes shrink a cancer down and make it possible to have breast conserving surgery instead of a mastectomy.
Targeted drug treatment
You have a targeted cancer drug called trastuzumab (Herceptin) as well as chemotherapy if your cancer cells have particular proteins called HER2 receptors. You usually have this treatment for a year.
Bone strengthening treatment
You may also have treatment with a group of drugs that strengthen the bones. These are called bisphosphonates. For some people, this treatment can help reduce the risk of their breast cancer spreading to the bones. You may have this if you have early stage breast cancer and no longer have periods (post menopausal).