Breast Cancer Stage 2 Treatment

First What Exactly Does Stage Ii Mean

Breast cancer has traditionally been classified in five stages, from 0 to IV, based on how large the tumor is and how far it has spread in the rest of your body. Stage 0 generally means you have noninvasive cancer or pre-cancer that has not moved outside the breast as you go up the scale, the tumor generally gets larger and the cancer becomes more invasive all the way to Stage IV, which means the cancer has spread to other parts of the body, such as the liver, bones or brain.

Breast cancer stages have historically been based on three different factors, Dr. Larkin. explains. The first is the size of the tumor, the second is whether or not the tumor has metastasized to any lymph nodes and the third is whether the tumor has spread to any other places in the body, which is known as metastatic breast cancer. This staging system is known as TNM, for Tumor, Nodes and Metastasis.

Stage II breast cancer is broken down further into stage IIA and IIB, with these criteria:

Stage IIA: Either there is no tumor found in the breast, or there is a tumor up to 2 cm AND cancer has spread to 1 to 3 lymph nodes

There is a tumor of 2 to 5 cm , but the cancer has NOT spread to the lymph nodes

Stage IIB:

There is a tumor of 2 to 5 cm, AND cancer has spread to between 1 and 3 lymph nodes

There is a tumor larger than 5 cm, but cancer has NOT spread to the lymph nodes or reached the chest wall or skin.

What else do I need to know about cancer staging?

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Hormone Therapy After Breast Surgery

If the DCIS is hormone receptor-positive , treatment with tamoxifen or an aromatase inhibitor for 5 years after surgery can lower the risk of another DCIS or invasive cancer developing in either breast. If you have hormone receptor-positive DCIS, discuss the reasons for and against hormone therapy with your doctors.

Tumor Profiling And Chemotherapy

Some women who have hormone receptor-positive breast cancer should consider getting a tumor profiling test, such as Oncotype DX®, to see if chemotherapy is needed in addition to hormone therapy .

Tumor profiling can be used to help guide chemotherapy for early breast cancers that are all of the following :

• Estrogen receptor-positive
• Tumor size smaller than 5 cm
• Lymph node-negative or 1-3 positive lymph nodes

Tumor profiling may also be called genomic testing or molecular profiling.

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Physical Emotional And Social Effects Of Cancer

In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Supportive care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Supportive care treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies.

• Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.

• Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.

• Meditation and yoga to improve general quality of life.

• Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.

Playing An Active Role

You play an active role in making treatment decisions by understanding your breast cancer diagnosis, your treatment options and possible side effects.

Together, you and your health care provider can choose treatments that fit your values and lifestyle.

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Radiation Therapy And Mastectomy

Most people who have mastectomy dont need radiation therapy if theres no cancer in the lymph nodes.

In some cases, radiation therapy is used after mastectomy to treat the chest wall, the axillary lymph nodes and/or the lymph nodes around the collarbone.

Breast Cancer Staging Guidelines

The TNM system is the most widely used cancer staging system and looks at the following cancer characteristics:

• Tumor The size of the tumor and whether it has grown into nearby tissue.
• Node Whether the cancer has spread to nearby lymph nodes. And if so, how many.
• Metastasis Indicates whether the cancer has spread to distant organs, like the lungs or liver.

But when it comes to breast cancer staging, the TNM system was expanded to include additional cancer characteristics, including:

• Estrogen-receptor status or progesterone-receptor status Whether the cancer has estrogen or progesterone receptors. A positive status means the cancer can use either hormone to grow.
• HER2 status Whether the cancer produces HER2, a protein that promotes the growth of cancer cells.
• Grade Indicates how much the cancer cells look like healthy cells.
• Oncotype DX recurrence score Indicates how likely a group of genes may respond to treatment, depending on ER, PR and HER2 status.

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Stage 2 Breast Cancer: Treatment And Prognosis

• Breast cancer is diagnosed as stage 2 if theres a tumor greater than 20 millimeters in size, if cancer cells are found in the lymph nodes, or both.
• Stage 2 breast cancer treatment may include some combination of surgery, lymph node dissection, chemotherapy, hormonal therapy, targeted therapy, and immunotherapy.
• The prognosis for stage 2 breast cancer is favorable, with a five-year-survival rate of 86 percent.

Cancers, including breast cancer, are classified into stages, based on how far the cancer has progressed. Doctors determine the stage of a persons breast cancer to help select the best treatment options and estimate a prognosis . Stage 2 breast cancer is a form of early-stage breast cancer, meaning the cancer has not yet metastasized to distant organs.

In this article, well look at what it means to have stage 2 breast cancer, what treatment options are available for this type of cancer, and what the prognosis is for people with the condition.

What Is The Survival Rate For Stage Ii Breast Cancer

If you are diagnosed with stage II breast cancer, you have an excellent chance of being cured and living a long and healthy life. According to the Susan G. Komen Foundation, the five-year survival rate for stage II is 90-99%.

I always tell patients that there are certain things that we have to do to get the cancer treated. but overall, the goal for treatment for stage II breast cancer is to be disease-free and to live a long and healthy life afterwards and there is a very excellent chance that that can happen, says Dr. Maxwell.

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Stage 2 Breast Cancer Treatment

Stage 2 breast cancers are typically treated with multiple types of therapies to kill as much of the cancer as possible and lower the risk of it recurring These therapies include:

• Surgery to remove the primary tumor
• Surgery to remove or biopsy lymph nodes
• Other therapies based on the characteristics of the tumor

For stage 2 breast cancer, surgery may involve either breast-conserving surgery or a total mastectomy, which removes the entire breast and related structures. Many patients decide to have breast reconstruction surgery during or after a mastectomy to maintain the look of symmetry between the breasts.

Your doctor will test your lymph nodes for cancer, likely during the same surgery. Lymph node testing may be performed with a sentinel lymph node biopsy or an axial lymph node dissection. A sentinel lymph node is the first lymph node where the cancer is likely to spread. An axial lymph node dissection removes a greater number of lymph nodes and may be needed if a biopsy shows signs of cancer spread.

Many patients with stage 2 breast cancer have radiation therapy, especially those who have breast-conserving surgery. If testing on the removed lymph nodes finds signs of cancer, those undergoing mastectomy will also require radiation therapy.

After Breast Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Breast Or To Other Parts Of The Body

The process used to find out whether the cancer has spread within the breast or to other parts of the body is called staging. The information gathered from the staging process determines thestage of the disease. It is important to know the stage in order to plan treatment. The results of some of the tests used to diagnosebreast cancer are also used to stage the disease.

The following tests and procedures also may be used in the staging process:

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What Is Stage Ii Breast Cancer

Stage II describes cancer that is in a limited region of the breast but has grown larger. It reflects how many lymph nodes may contain cancer cells. This stage is divided into two subcategories.

Stage IIA is based on one of the following:

• Either there is no tumor in the breast or there is a breast tumor up to 20 millimeters , plus cancer has spread to the lymph nodes under the arm.
• A tumor of 20 to 50 millimeters is present in the breast, but cancer has not spread to the lymph nodes.

Stage IIB is based on one of these criteria:

• A tumor of 20 to 50 millimeters is present in the breast, along with cancer that has spread to between one and three nearby lymph nodes.
• A tumor in the breast is larger than 50 millimeters, but cancer has not spread to any lymph nodes.

Why Is Staging Important For Cancer

Staging is an important factor in determining cancer treatment options, since it establishes the tumors size and spread within the body. Staging is used for most cancers, but not all. Cancers in and near the brain, for example, dont use a defined staging system because their likelihood of spreading is low.

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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 . 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.

What Is Terminal Cancer

Terminal cancer refers to cancer that cant be cured or treated. Its sometimes also called end-stage cancer. Any type of cancer can become terminal cancer. Terminal cancer is different from advanced cancer. Like terminal cancer, advanced cancer isnt curable. But it does respond to treatment, which may slow down its progression.

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Breast Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Breast

The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes. Each lobe has many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless, watery fluid called lymph. Lymph vessels carry lymph between lymph nodes. Lymph nodes are small, bean-shaped structures found throughout the body. They filter lymph and store white blood cells that help fightinfection and disease. Groups of lymph nodes are found near the breast in theaxilla , above thecollarbone, and in the chest.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Cancer that begins in the lobes or lobules is called lobular carcinoma and is more often found in both breasts than are other types of breast cancer. Inflammatory breast cancer is an uncommon type of breast cancer in which the breast is warm, red, and swollen.

For more information about breast cancer, see:

• Childhood Breast Cancer Treatment

If Cancer Is Found Tests Are Done To Study The Cancer Cells

• how quickly the cancer may grow.
• how likely it is that the cancer will spread through the body.
• how well certain treatments might work.
• how likely the cancer is to recur .

Tests include the following:

Based on these tests, breast cancer is described as one of the following types:

• HER2/neu positive or HER2/neu negative.
• Triple negative .

This information helps the doctor decide which treatments will work best for your cancer.

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Breast Cancer Support And Resources

There are many resources and support groups for breast cancer survivors. Theres no obligation to stick with a group. You can try it out and move on whenever youre ready. You might be surprised to learn that you have a lot to offer others as well.

The American Cancer Society has a variety of support services and programs. You can call the 24/7 helpline at 800-227-2345, visit the

Treatment For Breast Cancer May Cause Side Effects

For information about side effects that begin during treatment for cancer, see our Side Effects page.

Some treatments for breast cancer may cause side effects that continue or appear months or years after treatment has ended. These are called late effects.

Late effects of radiation therapy are not common, but may include:

• Inflammation of the lung after radiation therapy to the breast, especially when chemotherapy is given at the same time.
• Arm lymphedema, especially when radiation therapy is given after lymph node dissection. For more information, see Lymphedema.
• In women younger than 45 years who receive radiation therapy to the chest wall after mastectomy, there may be a higher risk of developing breast cancer in the other breast.

Late effects of chemotherapy depend on the drugs used, but may include:

Late effects of targeted therapy with trastuzumab, lapatinib, or pertuzumab may include:

• Heart problems such as heart failure.

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How Much Do Tamoxifen And Raloxifene Lower The Risk Of Breast Cancer

Multiple studies have shown that both tamoxifen and raloxifene can reduce the risk of developing estrogen receptor-positive breast cancer in healthy postmenopausal women who are at high risk of developing the disease. Tamoxifen lowered the risk by 50 percent. Raloxifene lowered the risk by 38 percent. Overall, the combined results of these studies showed that taking tamoxifen or raloxifene daily for five years reduced the risk of developing breast cancer by at least one-third. In one trial directly comparing tamoxifen with raloxifene, raloxifene was found to be slightly less effective than tamoxifen for preventing breast cancer.

Both tamoxifen and raloxifene have been approved for use to reduce the risk of developing breast cancer in women at high risk of the disease. Tamoxifen is approved for use in both premenopausal women and postmenopausal women . Raloxifene is approved for use only in postmenopausal women.

Less common but more serious side effects of tamoxifen and raloxifene include blood clots to the lungs or legs. Other serious side effects of tamoxifen are an increased risk for cataracts and endometrial cancers. Other common, less serious shared side effects of tamoxifen and raloxifene include hot flashes, night sweats, and vaginal dryness.

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Treatment Of Breast Cancer Stages I

The stage of your breast cancer is an important factor in making decisions about your treatment.

Most women with breast cancer in stages I, II, or III are treated with surgery, often followed by radiation therapy. Many women also get some kind of systemic drug therapy . In general, the more the breast cancer has spread, the more treatment you will likely need. But your treatment options are affected by your personal preferences and other information about your breast cancer, such as:

• If the cancer cells have hormone receptors. That is, if the cancer is estrogen receptor -positive or progesterone receptor -positive.
• If the cancer cells have large amounts of the HER2 protein
• How fast the cancer is growing
• Your overall health
• If you have gone through menopause or not

Talk with your doctor about how these factors can affect your treatment options.

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