Cancer stages describe cancer progression. Different stages typically have different symptoms and treatment options, with earlier stages requiring less intervention. The outlook for a person at an earlier stage of breast cancer may be better.
After diagnosis, a doctor will identify the stage of a person’s breast cancer and talk with them about which treatment options are most suitable.
They may also explain what the person’s outlook is likely to be, taking into account other considerations such as the cancer grade and type, hormone receptivity, and the person’s overall health.
Each case of breast cancer will be different. However, a doctor can help an individual understand how the condition may affect them and what to expect from treatment.
To determine the stage of breast cancer, a doctor may perform various tests, including a physical exam, biopsies, imaging scans, and other tests.
However, while initial tests can be helpful, doctors may revise their determination of the cancer stage and grade as more information becomes available.
For example, lab tests on a tumor after surgery may provide information that is different from biopsy results because there is more tissue to analyze.
TNM staging
The system doctors in the United States
- Tumor: The extent or size of the tumor and how much breast tissue it involves.
- Nodes: Whether cancer has spread to the lymph nodes and, if so, how many.
- Metastasis: Whether cancer has spread to other parts of the body, such as other tissues, bones, or distant organs.
In the TNM staging system, breast cancer stages
Doctors consider stage 0 breast cancer “noninvasive,” which means cancer cells are present but they
Ductal carcinoma in situ (DCIS) is a stage 0 breast tumor. It involves cancer cells that are limited to the inside of the milk duct.
Doctors also used to classify lobular carcinoma in situ (LCIS) as a stage 0 tumor. However, this is no longer the case.
In LCIS, cell cells that look like cancer cells
Symptoms of stage 0 breast cancer
Stage 0 breast cancer often displays no symptoms. Doctors usually only discover it during a routine mammogram screening or other imaging test.
However, a person may experience a lump or unusual nipple discharge, including blood.
Early diagnosis of stage 0 breast cancer allows for prompt treatment, which might prevent cancer from spreading outside its location of origin.
Treatment for stage 0 breast cancer
Not everyone with stage 0 breast cancer needs treatment. If tests suggest that treatment is a good idea,
If the cells remain in one area, doctors may perform a relatively short and simple procedure called a lumpectomy to remove the cells from the breast.
If cancerous cells appear throughout the breast, a doctor may recommend a mastectomy, which involves removing the entire breast. A person may choose to undergo a breast reconstruction during the same procedure or in a second surgery, often 6 to 12 months later, or they may decide not to have a reconstruction.
A doctor may suggest hormone treatment in addition to surgery if the cancer responds to hormone levels.
In stage 1 breast cancer, cancerous cells have spread into the surrounding breast tissue.
Breast cancer at stage 1 is still relatively small. It
Doctors refer to a tumor that is large but has not spread to other areas as locally advanced breast cancer.
Stage 1 breast cancer symptoms
Stage 1 breast cancer is still early and a person may or may not notice symptoms.
A person who displays symptoms may experience:
- a lump in the breast
- abnormal nipple discharge, including blood
- breast changes, such as changes in shape or size or new asymmetry
- a change in skin texture or color on the breast
Treatment for stage 1 breast cancer
Doctors can offer a variety of
A doctor will decide which surgery is most appropriate depending on the following factors:
- location and size of the primary tumor
- breast size
- family history
- the person’s preference
A doctor may also recommend radiation therapy, hormone therapy, or chemotherapy.
Learn moreLearn more about treatments for breast cancer.
Stage 2 breast cancer is more advanced than stage 1. The cancer is likely to have spread to a few nearby lymph nodes.
Learn more about stage 2 breast cancer.
Symptoms of stage 2 breast cancer
Stage 2 breast cancer may not cause any symptoms. If symptoms are present, they may include:
- a lump in the breast
- breast changes, such as changes in shape or size
- dimpling or puckering of the skin on the breast
- an inverted nipple, which means it is turned inward
- discharge from the nipple
- a change in the skin texture, such as discoloration, swelling, or enlarged pores
Treatment for stage 2 breast cancer
The most common
A doctor may recommend a combination of radiation therapy, chemotherapy, and hormone therapy (if the cancer is hormone-receptive).
In some cases, a doctor may recommend neoadjuvant therapy, which is chemotherapy before surgery to reduce the size of a tumor.
The tumors in stage 3 breast cancer are larger and have spread into nearby tissues, such as the skin over the breast or the muscle underneath. The cancer may also have spread to multiple nearby lymph nodes.
Find out more about stage 3 breast cancer.
Symptoms of stage 3 breast cancer
Symptoms of stage 3 breast cancer may include the symptoms of previous stages, such as a new lump or changes to the nipples, breast size, breast shape, or skin texture.
Additionally, breast cancer at this stage may cause:
- breast pain, itchiness, or irritation
- an open sore or ulcer on the breast
Treatment for stage 3 breast cancer
Depending on the type of cancer and other factors,
- chemotherapy
- surgery
- radiation, in some cases
- targeted therapy
- hormone therapy
- neoadjuvant chemotherapy before surgery to shrink a tumor
Stage 4 breast cancer, also called metastatic breast cancer, has spread to nearby lymph nodes, more distant lymph nodes, and other organs in the body. This is the most advanced stage of breast cancer.
It may also refer to previously treated breast cancer that returns to affect other parts of the body. Cancer that has returned in other parts of the body is called recurrent metastatic breast cancer.
Symptoms of stage 4 breast cancer
Stage 4 breast cancer can cause symptoms in other parts of the body, depending where the cancer has spread to:
- Bones: Breast cancer that has spread to the bones may cause bone pain, joint swelling, weak or fragile bones, and weakness in the arms or legs.
- Lungs: Breast cancer in the lungs can cause lung complications such as chronic coughing, shortness of breath, and chest pain.
- Liver: Breast cancer that spreads to the liver can cause jaundice (yellowing of the skin and the whites of the eyes). It can also cause itchy skin, abdominal pain, nausea, and vomiting.
- Brain: Cancer can spread to the brain, causing neurological symptoms such as memory loss and behavioral changes. It can also cause severe headaches and seizures.
Treatment for stage 4 breast cancer
Treatment for stage 4 breast cancer
- chemotherapy
- hormone therapy
- targeted therapy, which targets the protein that allows cancer cells to grow
- immunotherapy, which boosts the body’s ability to fight cancer
In rare cases, a surgeon will operate to try and remove tumors at stage 4. This is not usually the first option, but a doctor may recommend surgery to help relieve pain or other issues that can develop at this stage, such as:
- spinal cord compression
- removing single masses caused by metastasis
- fixing any broken bones
A doctor may also prescribe medication to treat related symptoms, such as pain.
New treatments and therapies are emerging all the time, and anyone who has breast cancer at any stage can volunteer to try out these new treatments. People can ask their doctor whether any clinical trials are available in their area.
The stages of breast cancer help doctors and individuals understand how cancer is affecting the body and which treatment options may be effective.
However, other factors also play a role in treatment decisions,
- a person’s age, overall health, and preferences
- the presence of specific gene mutations
- how fast the cancer is growing
- whether the person is pre- or post-menopause, if applicable
Learn more about how age and other factors affect breast cancer risk.
The outlook for a person with breast cancer will depend on the stage at diagnosis, the type of cancer, and other factors.
The National Institute of Health’s
The SEER program categorizes cancer outlook using a 5-year relative survival rate. This describes the number of people with a certain stage of cancer that are alive 5 years after diagnosis compared with the general population.
Between 2014 and 2020, the average survival rates according to the stage at diagnosis were:
| Stage | 5-year relative survival rate |
| Localized: Cancer has not yet spread beyond the breast | 99.6% |
| Regional: Cancer has reached nearby lymph nodes | 86.7% |
| Distant: Cancer has spread to other parts of the body | 31.9% |
| Unknown stage | 69.7% |
However, outlooks for people with cancer vary widely, depending on the type of cancer, stage at diagnosis, treatment, and other factors. A doctor can provide more personalized advice.
Learn more about survival rates for breast cancer.
Breast cancer resources
Visit our dedicated hub for more research-backed information and in-depth resources on breast cancer.
The staging of breast cancer takes various factors into consideration, including the size and type of any tumors, whether cancer has spread, and the grade, which affects how quickly cancer can grow.
The stage of breast cancer helps guide treatment decisions options and may provide an idea of a person’s outlook. However, each case is different. A doctor can help explain all the factors involved.
