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We’ve all been confused by lab results, and one of the first lab results you get after being diagnosed with breast cancer, is the stage of your tumor. The problem is, you are under such stress at the time of diagnosis, you don’t always understand exactly what your staging is or what it may mean.
I am a great example of this. I was diagnosed in 1995 at age 26 with breast cancer. No one thought someone my age would have breast cancer- I was too young. (Don’t I wish). The reality is, I did have breast cancer and I am happily celebrating 25 years cancer free in 2020.
I realized how much I missed during my treatment phase when I recently saw a medical document that stated “Colleen is s/p (status post, it just means “after” for medical folks) stage 3 breast cancer” I thought to myself, I didn’t have stage 3, did I?
I decided that it was time that I faced my fear of knowing exactly what I had. I know I had breast cancer but I was honestly scared to hear and talk about it. So I put in to get copies of all of my breast cancer records and I have just finished going through them.
I decided to break down my diagnosis so that anyone who doesn’t know how to decipher that information can benefit from what I have recently learned. Remember, this is just an example for purposes of education, so that you better understand what goes into staging a breast cancer. Check with your doctor for any questions or anything specific about your particular case.
Knowledge is Power
It wasn’t as scary as I had thought it would be to know my staging and tumor size and type. I was actually a bit relieved to read some information, and other information made me determined to take extra good care of myself and my body, which has been through so much already. So here goes…
The stage is determined by multiple factors. The pathologist is the doctor who looks for cancer in the tissue samples he is provided, and based on what he finds, determines the stage. The stage of breast cancer is based on tumor size, grade, lymph node involvement, metastasis, and ER (Estrogen Receptor), PR (Progesterone receptor) and HER2 status.
The staging system used when I was diagnosed in 1995 was called the TNM system. This system was put in place to be sure that all the doctors and specialists are communicating about cancer in a consistent way, and it was pretty straight forward. The stage was based on Tumor Size (T), Lymph Node involvement (N) and if the cancer has metastasized to distant areas (M).
Let’s start with the diagnosis I was given in 1995 at the age of 26, and then we can break it down. My diagnosis was, “T2N2M0 Right-sided breast cancer stage IIIB”. Here is why I fell into that category. (There are multiple options for each category).
- T2 means I had a tumor that was larger than 2cm but no larger than 5cm.
- N2 means that my axillary (underarm) lymph nodes have cancer and they are matted together
- MO means no metastases (It has not spread beyond the breast and lymph node area)
In 1995, I was determined to be a stage IIIB. My cancer was considered to be locally advanced and based on the old system, I would have been IIIA but my cancer spread to the skin on the top of my breast, pushing me to a IIIB. My staging was done with an initial biopsy and a physical exam because I was given neoadjuvant chemotherapy, which means I had chemotherapy before surgery, before my mastectomy.
In 2018, the AJCC updated the breast cancer staging guidelines to add other cancer characteristics to the T, N, and M system to determine a cancer’s stage:
- Tumor Grade: how much do the cancer cells look like normal cells?
- Estrogen and Progesterone Receptor Status: do the cancer cells have receptors for the hormones estrogen and progesterone?
- HER2 Status: are the cancer cells making too much of the HER2 protein?
These guidelines weren’t changed until 2018, but my doctors had documented most of this information anyway. I had a Tumor Grade of III, which means, according to the American Cancer Society, that my cancer was fast growing and more likely to spread. My Estrogen and Progesterone Receptor Status were both negative. This means that the hormone therapy drugs were not going to be useful with my cancer, and again, the cancer grows faster. Back in 1995, when I was diagnosed, HER2 testing was not completed, so I do not have results as to whether I am positive or negative in that regard.
Well, that was quite a mouthful.
The tests used to determine my stage of breast cancer in 1995 are a fraction of the information that doctors and specialist’s use now to determine where you are in your cancer battle.
The information used is constantly being updated and improved upon. My diagnosis was not fabulous, but here I am, and I am thankful every day to be able to share my breast cancer battle to give others hope for the future.
The information that goes into determining your cancer stage is huge, but, the more information that there is, the more accurate the doctors can be with treatment recommendations. That is my big takeaway. I’d love to hear what your big takeaway was! Shoot me an email or respond to this post. I look forward to hearing from you.
This information is being provided to you for educational and informational purposes only. It is being provided to you to educate you about general breast cancer information and as a self-help tool for your own use. It is not a substitute for professional, medical advice. This information is to be used at your own risk based on your own judgment. For my full Disclaimer, please go to ConsultColleen.com