Early stage breast cancer: Symptoms, treatment, and outlook

Via Peters

Staging helps doctors and people make decisions about cancer treatment. Early stage breast cancer involves a tumor that has not spread outside of the breast.

Breast cancer has five different stages ranging from 0 to 4. Each numbered stage has additional letters that indicate lower or higher status within the stage.

According to the National Cancer Institute (NCI), early stage breast cancer can describe several stages from 0 to 3A. Treatment for early stage breast cancer aims to eliminate or cure the cancer.

This article breaks down what it means to have early stage breast cancer, and discusses treatment options and outlook.

According to the NCI, early stage breast cancer includes any form that has not spread beyond the breast tissue or the local lymph nodes. Stages they define as early include:

  • Ductal carcinoma in situ: Also called stage 0, the cancer has not spread from the ducts or lobules but may spread if left untreated.
  • Stage 1: Generally describes a smaller tumor that has not spread to lymph nodes and is usually responsive to treatment
  • Stage 2A: May involve one of the following:
    • no actual tumor and has spread to less than four axillary lymph nodes
    • tumor between 2 and 5 centimeters (cm) and not spread to lymph nodes
    • tumor less than 2 cm and spread to less than 4 lymph nodes
  • Stage 2B: The tumor is either:
    • between 2 and 5 cm, and spread to less than four lymph nodes OR
    • the tumor is greater than 5 cm and not spread to any lymph nodes
  • Stage 3A: This is one of three subcategories of III, and may involve:
    • any size tumor or non-existent and spread to 4 to 9 lymph nodes
    • tumor is larger than 5 cm and breast cancer cells measuring between 0.2 and 2 millimeters (mm) found in lymph nodes
    • tumor larger than 5 cm and cancer has spread to 1 to 3 lymph nodes

Several factors go into how doctors stage cancer. Stages are broken down into five stages, 0 to 4, with sublevels indicated by letters.

According to the American Cancer Institute, doctors started using the TNM system that the American Joint Committee on Cancer put into effect in 2018.

This cancer staging system looks at the following factors:

  • tumor size (T)
  • spread to local lymph nodes (N)
  • spread to distant tissue or metastasis (M)
  • status of estrogen receptor (ER)
  • status of progesterone receptor (PR)
  • HER2 status
  • cancer grade

Staging for breast cancer is more complex than staging for other forms of cancer. A person should talk with their doctor about their stage to find out whether they consider their cancer an early stage or later stage.

Breast cancer can be a challenge to discover for some people because it may not show any obvious signs at all, particularly in the early stages.

The Centers for Disease Control and Prevention notes that many of the symptoms of breast cancer can occur with other diseases and conditions.

They recommend a person talk with their doctor if they experience any of the following symptoms or signs:

  • swelling or thickening of breast
  • pain in any part of the breast
  • new lump under armpit or in breast
  • pain in the nipple area
  • breast skin shows signs of dimpling or irritation
  • redness around the nipple area or the breast in general
  • discharge from the nipple, except for breast milk
  • changes in size or shape of the breast

Treatment varies based on several factors including:

  • stage of cancer
  • person’s age
  • other health conditions
  • overall health

For stage 0 cancer, the American Cancer Society notes that people typically choose between two surgical options. These include:

  • Breast conserving surgery: During this procedure, a surgeon removes only as much of the breast as needed to remove the cancer cells. The doctor will typically recommend radiation therapy following the procedure.
  • Mastectomy: This involves the full removal of the breast. Doctors typically recommend this for larger tumors

When the tumor is hormone receptive, a doctor may recommend hormone therapy for up to 5 years. Hormone therapy can help lower a person’s risk of developing invasive cancer.

Stage 1 cancer may follow a similar treatment path as stage 0. A doctor may recommend surgery, radiation, and hormone therapy depending on the person’s age and overall health. In some cases, they may recommend chemotherapy for larger tumors.

For stage 2, a doctor will also likely recommend surgical options first.

Following surgery a doctor will also likely recommend one or more of the following:

Finally, doctors often recommend starting with chemotherapy or hormone therapy before surgery. These therapies can help shrink the tumor and allow the surgeon to more easily remove it while conserving the breast.

If not, the surgeon will likely need to perform a mastectomy. Following surgery, a doctor will often recommend radiation.

The overall outlook for early stage breast cancer is good, particularly when diagnosed early.

According to the Susan G Komen Foundation, the survival rates for early stage breast cancer are:

  • Localized cancer: 99% chance of 5-year survival compared to the general population.
  • Cancer spread to local lymph nodes: 86% chance of 5-year survival compared to the general population.

Though this is the most current data, it is based on information from the years 2010 to 2016. With advances in treatment, it is possible that the survival rate may be improving.

Also, survival rates are not guaranteed and several factors can influence them. A person should talk with their doctor about their individual prognosis when developing a treatment plan.

People diagnosed with early stage breast cancer often have a positive outlook and may live a normal lifespan.

According to the American Cancer Society, about 80% of people who receive a breast cancer diagnosis survive for at least 15 years following diagnosis and treatment. However, this number is not stage-specific.

Treatments have continued to improve, which can help increase the likelihood that a person diagnosed with any stage of breast cancer may live longer, healthier lives. Treatment is key to helping a person live a longer life, so people should talk with their doctor if they suspect they may have breast cancer.

In early stage breast cancer, doctors often aim to completely remove the cancer or achieve complete remission. Complete remission means that cancer cells are undetectable during testing.

After 5 years of testing negative, a doctor may declare a person cured.

However, several factors can affect how likely the cancer may return. Some factors affecting remission rates include:

  • stage at time of diagnosis
  • biology of the cancer cells
  • original treatments of cancer

Local recurrence typically occurs within 5 years. All stages of breast cancer have a risk of the cancer returning as metastatic or having spread to other areas of the body.

About 20–30% of people diagnosed with early stage breast cancer will go on to develop stage 4 or metastatic breast cancer. This means that their cancer has spread to distant parts of the body.

Left untreated, early stage breast cancer can continue to grow and eventually spread to other areas of the body. Early detection and treatment can help prevent the cancer from progressing, and, in many cases, cure or get rid of it entirely.

Once breast cancer has spread to distant parts of the body, doctors can no longer cure it. Instead, treatment focuses on extending a person’s life, reducing symptoms, and improving quality of life.

A person should talk with their doctor if they develop any unusual symptoms in or around their breasts. Though it is possible the symptoms are related to another condition, a doctor can help rule out other causes and determine what may be causing the issue.

People assigned female at birth should also follow recommendations for screenings. The American Cancer Society recommends the following for screenings:

  • 40 to 44: High-risk people in this age group should get screened.
  • 45 to 54: Yearly screening.
  • Over 55: Screening every 2 years.

Early stage breast cancer often has a positive outlook with many people surviving due to treatment. Early stage breast cancer can include several stages of breast cancer when the cancer has not spread to distant areas of the body.

Treatments can often cure or cause the cancer to go into complete remission. A person should talk with their doctor if they experience any unusual symptoms related to their breasts.


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