NCCN Guidelines for Patients
Breast Cancer – Locally Advanced (STAGE III)
Breast cancer basics
A cancer stage is your doctors’ rating of the extent
of the cancer. It is used to plan which tests may
be needed and which treatments are best for you.
The AJCC (
staging system is used to stage breast cancer.
In this system, the letters T, N, and M describe
a different area of cancer growth. The T score
describes the growth of the primary tumor. The N
score describes cancer growth within nearby lymph
nodes. Nearby nodes are on the same side of the
chest as the breast tumor. The M score tells if the
cancer has spread to distant sites. The T, N, and M
scores are combined to assign the cancer a stage.
Rating of the cancer stage is often done twice. The
first rating is called the clinical stage. It is based on
tests received before surgery. Exactly how far the
cancer has spread and how many 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 is described as stage 0, 1 (I), 2 (II),
3 (III), or 4 (IV). The focus of this book is on stage
III. Stage III cancers have grown into the stroma but
haven’t spread to distant sites. Most have spread to
nearby lymph nodes. Clinical stage III cancers are
These cancers do not involve the breast skin or chest
wall. The size of the in-breast tumor varies across
ratings. The cancer has spread to nearby lymph
Cancers rated T3, N1, M0 consist of breast
tumors that are larger than 5 cm. There are
signs of cancer in axillary nodes. These nodes
aren’t stuck together or to the chest wall.
Nearby lymph nodes
Nearby lymph nodes includes
4 groups. The axillary lymph
nodes are near your armpit.
Internal mammary lymph nodes
are next to your breastbone.
Infraclavicular lymph nodes are
below your collarbone, and above
are the supraclavicular nodes.
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