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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017


Breast cancer basics

Cancer stage

Cancer stage

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 (






ommittee on



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

defined as:

Stage IIIA

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.

Figure 5

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.


internal mammary



Copyright © 2017 National Comprehensive Cancer Network