Stage 2 breast cancer: diagnosis, treatment, survival

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Stage 2 breast cancer is a fairly common stage in the diagnosis of breast cancer. Stage 2 tumors are at least 1 centimeter (cm) in size and have spread to the lymph nodes. Treatment usually includes surgery (either lumpectomy or mastectomy), and adjuvant chemotherapy is often recommended. Radiation therapy is necessary after a lumpectomy, but may or may not be necessary after a mastectomy.

If the tumor is estrogen receptor positive, hormone therapy is usually given for five to 10 years, and bisphosphonate therapy may also be recommended for postmenopausal patients to reduce the risk of recurrence. If the cancer is HER2 positive, targeted therapy is often used before surgery.

Get Medical Information / Jessica Olah

Overview

Stage 2 breast cancer is considered invasive, which means that cancer cells have emerged from the ducts or lobes of the breast. This is not the same as metastatic breast cancer (stage 4). This means that the abnormal cells have broken through a thin layer of tissue called the basement membrane and can spread.

Breast cancer treatment options

Staging

Cancerous tumors are classified and staged using the TNM system . Stage 2 cancer can be 2A or 2B.

In this system:

  • T stands for tumor size: In stage 2, the T score can range from zero to three. T0 means that the tumor cannot be found in the breast. T1 includes tumors 2 cm or less (one inch or less) in diameter. T2 includes tumors with a diameter of 2 to 5 cm, T3 includes tumors greater than 5 cm in diameter.
  • N stands for lymph node involvement: stage 2 can be zero or one. N0 (N-zero) means that the cancer has not spread to the lymph nodes. N1mi describes cancer that has spread to the lymph nodes, but can only be detected microscopically ( micrometastases ). N1 is used to describe tumors that have spread to at least one lymph node near the tumor.
  • M stands for metastasis – All stage 2 cancers are M0, which means there is no metastasis.
Stage 2 breast cancer
Stage 2A: T0, N1, M0 No tumor has been found in breast tissue, but cancer cells have lodged in lymph nodes near the breast.
Stage 2A: T1, N1, M0 You have a tumor 2 cm or smaller that has spread to at least one lymph node. —OR— Your tumor has invaded nearby tissues and has spread to at least one lymph node.
Stage 2A: T2, N0, M0 His tumor is larger than 2 cm and up to 5 cm, but it has not affected the lymph nodes.
Stage 2B: T2, N1, M0 Your tumor is larger than 2 cm and smaller than 5 cm and affects nearby lymph nodes.
Stage 2B: T3, N0, M0 His tumor is larger than 5 cm, but has not reached the chest wall, skin, or lymph nodes.

Watch out

Your treatment may include a combination of approaches.

Treatment options include:

  • Local treatments: Surgical options will include lumpectomy or mastectomy, which may be followed by radiation therapy to the chest or chest wall. If radiation is recommended, it will affect the timing of any possible breast reconstruction. If you are opting for a mastectomy, it is also important to consider the pros and cons of a simple versus a double mastectomy .
  • Systemic (adjuvant) treatment: These treatments will affect your entire body and help prevent relapse. Depending on your age, general health, hormone receptor status , lymph node involvement, and HER2 test results, you may be prescribed chemotherapy , hormonal therapy that includes tamoxifen or an aromatase inhibitor , or targeted therapy . HER2 like Herceptin. For triple negative breast cancer, immunotherapy can sometimes be part of systemic therapy. The drug olaparib (a PARP inhibitor) is currently used as part of systemic therapy for people who test positive for BRCA.
  • Neoadjuvant treatment: Your oncologist may recommend a systemic treatment before surgery to shrink the tumor. When this approach is successful, the smallest tumor can be removed and, if necessary, a topical treatment can be prescribed. Some tumors do not respond well to preliminary treatment; When this happens, a mastectomy will be required. Then you can consider breast reconstruction .

You can spend three to 18 months or more actively treating stage 2 breast cancer. It can range from surgery and six weeks of radiation therapy to a full range of chemotherapy, radiation, and biologic treatments.

Survival

It is important to understand early on that survival rates are not a direct indicator of how long you will live after being diagnosed and treated for breast cancer. Rather, the ratios reflect how many people, on average, will survive during a given period of time.

According to the American Cancer Society , the five-year survival rate for stage 2 breast cancer for women who complete treatment is 93%. Women with stage 3 cancer have a 5-year survival rate of 72%.

During this time, treatment has improved significantly, so you can expect long-term survival if you receive a recent diagnosis.

Follow-up care

After completing your treatment, you will have a minimum five-year follow-up period with your oncologist; The inspections will be carried out every three months and then every six months.

During this time, you may need hormone therapy if your tumor was sensitive to hormones. Hormone therapy for more than five years is sometimes recommended for patients with estrogen receptor-positive tumors.

If your tumor is estrogen receptor positive, your oncologist may also recommend that you use bisphosphonate therapy in postmenopausal women. Bisphosphonates are drugs used to treat osteoporosis and can also help reduce the chances of breast cancer spreading to the bones (the most common site of metastasis).

Unlike some cancers, routine scans are generally not done after primary treatment for stage 2 breast cancer has been completed. The reason for this, even if relapse is possible, is that early detection of relapse (before symptoms appear) does not improve survival. It is important for those who have completed treatment to be aware of the possible signs and symptoms of a relapse and to contact their doctor if they have any concerns.

After five years, you may only need to see your oncologist once a year, but these visits will generally continue throughout your life. Assessments are important to ensure that recovery runs smoothly and that no treatment is required for a relapse.

Discussion Guide for Breast Cancer Treatment Providers

Get our printed guide to your next doctor's appointment to help you ask the right questions.

Front facing

If you've recently been diagnosed with stage 2 breast cancer, you may be overwhelmed with everything there is to know.

It has many supportive resources and more information about your diagnosis. Ask for help and contact your loved ones. Consider joining one of the active breast cancer support groups or support communities available.

The most important thing is to learn to advocate for your own interests in cancer treatment . Cancer treatments are changing rapidly and it is important to understand the options available so that you can be an active member of your cancer treatment team.

While it may seem intimidating to diagnose stage 2 breast cancer, remember that it is still considered early-stage cancer. Most women diagnosed at this stage tolerate treatment well and continue with normal lives.

Frequently asked questions

When is radiation commonly used to treat stage 2 breast cancer?

Radiation therapy may be used after lumpectomy (breast-conserving surgery) to reduce the risk of cancer cells coming back in the same breast or in nearby lymph nodes, according to the American Cancer Society. After a mastectomy, the oncologist may determine that radiation is needed if the tumor is larger than 5 cm, if the lymph nodes have been affected, or if the cancer is outside the surgical field.

How fast do breast cancer tumors grow from one stage to another?

Cancer cells divide and multiply rapidly, so as the tumor grows, it divides and grows even faster. The average doubling time for breast cancer is 50 to 200 days. The growth rate of breast cancer tumors is influenced by hormonal factors such as hormone receptor status and HER2 status.

What are the chances that breast cancer will come back after treatment for stage 2 breast cancer?

In women undergoing breast-conserving treatment, the probability of recurrence is approximately 3% to 15% after 10 years, depending on the characteristics and limits of the tumor. Long-term relapses in those who have undergone a mastectomy are most affected by damage to the axillary lymph nodes. If the axillary lymph nodes are not cancerous, the recurrence rate is 6% after 5 years. When the axillary lymph nodes are malignant, the recurrence rate is 23% 5 years after mastectomy, but without radiation therapy.

Get the word of drug information

If you have been diagnosed with stage 2 breast cancer, the outlook is very good. You are more likely to receive chemotherapy and / or radiation therapy than if your tumor were stage 1, but these tumors still respond well to treatment. … Make sure you understand your treatment plan and remember that you are the most important person on your cancer treatment team.

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