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NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016


Breast cancer basics

Cancer stage | Treatment options

Cancer stage

A cancer stage is a rating by your doctors of the

extent of the cancer. It is used to plan which tests may

be needed and which treatments are best for you. The







ommittee on


ancer) staging

system is used to stage breast cancer.

Rating of the cancer stage is often done twice. The

first rating is based on tests before treatment and is

called the clinical stage. Exactly how far the cancer

has spread and how many axillary lymph nodes have

cancer can’t be known until after surgery. Thus, your

doctors will rate the cancer again after surgery. This

rating is called the pathologic stage.

Breast cancer has 5 stages ranging from 0 to IV. The

focus of this book is on stages I and II. These breast

cancers have grown into the stroma but not into the

breast skin or chest wall. The cancer hasn’t spread to

distant sites. Clinical stages I and II are defined as:

Stage I

• Breast tumors are 2 cm (




eters) or

smaller in size and appear not to have spread

to any lymph nodes.

Stage IIA

• Breast tumors are no larger than 2 cm or no

breast tumor has been found. The cancer

appears to have spread to a few axillary

lymph nodes.

• Breast tumors are larger than 2 cm but no

larger than 5 cm. There are no signs of cancer

in any lymph nodes.

Stage IIB

• Breast tumors are larger than 2 cm but no

larger than 5 cm. The cancer appears to have

spread to a few axillary lymph nodes.

• Breast tumors are larger than 5 cm with no

signs of cancer in any lymph nodes.

Treatment options

You will be making many choices about your

treatment for breast cancer. One choice may be

whether to join a clinical trial. Clinical trials assess

how safe and helpful tests and treatments are. When

found to be safe and helpful, tests and treatments

from a clinical trial may become tomorrow’s standard

of care. Clinical trials are the treatment option that is

preferred by NCCN experts. Ask your treatment team

if there is an open clinical trial that you can join. You

can also find clinical trials through the websites listed

in Part 9.

If you will not be joining a trial, other options are

briefly described next. As shown in

Figure 1.5


treatment for stage I or II breast cancer has many

parts. First, the cancer and your health will need to be

assessed as discussed in

Part 2 Treatment planning


Your treatment options will be based on test results.

This book focuses on cancer treatment, but

supportive care is also important. Supportive care

doesn’t aim to treat cancer but aims to improve

quality of life. It can address many needs. One

example is treatment for physical and emotional

symptoms. Supportive care can also help with

treatment decisions as you may have more than

one option. It can also help with coordination of care

between health providers. Talk with your treatment

team to plan the best supportive care for you.