Staging

Staging is a way of describing a cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis. There are different stage descriptions for different types of cancer.

One tool that doctors use to describe the stage is the TNM system. This system uses three criteria to judge the stage of the cancer: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to other parts of the body. The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer so doctors can work together to plan the best treatments.

TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:

• How large is the primary tumor and where is it located? (Tumor, T)
  
  
• Has the tumor spread to the lymph nodes? (Node, N)
  
  
• Has the cancer metastasized (spread) to other parts of the body? (Metastasis, M)

Inflammatory breast cancer is generally considered stage IIIb breast cancer at a minimum at the time of diagnosis. For more complete breast cancer staging information, see the Staging section of the Cancer.Net Guide to Breast Cancer.

Stage IIIb: The cancer has spread to the chest wall or caused swelling or ulceration of the breast. It may or may not have spread to the lymph nodes under the arm, but it has not spread to other parts of the body (T4, N0, N1, N2, M0).

Stage IV: The cancer can be any size and has spread to distant sites in the body, usually the bones, lung, liver, or brain (any T, any N, M1).

Recurrent breast cancer

Recurrent cancer is cancer that comes back after treatment. Inflammatory breast cancer may come back in the breast (called a local recurrence), in the chest wall, or in another part of the body (called a distant metastasis), including distant organs (such as the lungs or liver), bones, or other lymph nodes.

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Sixth Edition (2002) published by Springer-Verlag New York, www.springer-ny.com.