Breast Cancer Staging and Pathology

Planning for care

Timely treatment after a breast cancer diagnosis provides you with the best shot at a complete recovery. At the Breast Center at Adventist Health Bakersfield, every person we care for is offered services as soon as they have a positive mammogram. That means no delays—and quicker care—so you can get back on your feet as fast as possible.

When your mammogram shows something unusual, we'll spring into action and provide you with follow-up tests that can confirm your diagnosis. We'll use those test results to help us understand how your breast cancer developed—and what your team will need to do to fight it.

Cancer Staging

Cancer staging is the process of finding out whether your cancer has spread, and if so, how far. There is more than one system for staging different types of cancer. The TNM staging system, which is used at the Breast Center, gives you three key pieces of information:

T refers to the size of the tumor.
N describes whether the cancer has spread to nearby lymph nodes, and if so, how many.
M shows whether the cancer has spread (metastasized) to other organs of the body.

Letters or numbers after the T, N, and M provide more details. To make this information clearer, the TNM descriptions can be grouped together into a simpler set of stages, labeled with Roman numerals (usually from I to IV). In general, the lower the number, the less the cancer has spread. A higher number means a more serious cancer.

The two main types of staging are clinical and pathologic.

• Clinical staging is an estimate of the extent of cancer based on physical exam, biopsy results, and imaging tests.
• Pathologic staging is an estimate of the extent of cancer by studying the tissue removed during surgery.

Breast Pathology

The breast tissue is composed of the milk-making areas called the lobules and the tissue that brings the milk to the nipple called the ducts. Most cancers are ductal in origin.

Carcinoma in situ

When the tumor is contained within the walls of the structure.

• Ductal carcinoma in situ is an early stage cancer which has very little metastatic potential.
• Lobular carcinoma in situ is a marker of increased risk for breast cancer in the future, but is not treated as a true cancer and may not require surgery.

Invasive carcinoma

When a tumor has broken through the wall of the structure, the ducts or the lobules, then it is called an invasive cancer. When a tumor is invasive, it can acquire the ability to spread either through the lymphatic system or the blood stream. This is why lymph node evaluation is so important in staging breast cancer as to determine the best type of treatment.

Hormone status

Your tumor will likely be tested for different components such as hormone receptor and HER-2 status. Your medical oncologist will use this information to decide on your best treatment options.