Stage 2 breast cancer indicates that cancer has not progressed beyond the breast tissue or adjacent lymph nodes.
Cancer is not a single illness. Breast cancer is one of a larger range of disorders. Because of the variety of kinds, not all stage 2 breast cancers are treated in the same manner. In this post, we’ll look at how breast cancer is diagnosed and treated, as well as the overall prognosis.
What exactly is stage 2 breast cancer?
Your doctor will assign a clinical-stage to your cancer diagnosis when it is initially verified that you have breast cancer. This is known as clinical staging, and it is based on:
- a physical examination
- imaging examinations
- results of a biopsy
Laboratory test findings on the tissue and lymph nodes will be able to offer additional information if surgery is performed to evaluate the breast tissue. Your doctor will be able to establish the pathologic stage, or surgical stage, of cancer-based on these data. This is more precise than a clinical stage.
The TNM method is used in breast cancer staging, and it offers particular information about:
- T: The tumor’s size is denoted by the letter T
- N: involvement of lymph nodes
- M: how far has the cancer spread? (metastasized)
The main tumor’s size (T)
The letter T followed by a number indicates the size of the main tumor. A bigger number indicates a larger tumor.
- TX: the tumor cannot be quantified.
- T0: The main tumor cannot be found.
- T1, T2, T3, T4: tumor sizes from smallest to biggest
Involvement of lymph nodes (N)
The letter N followed by a number indicates if the malignancy has progressed to the lymph nodes. If this is the case, the number represents the number of lymph nodes where the cancer cells have disseminated.
- NX: Cancer cells in adjacent nodes cannot be counted.
- N0: the malignancy has not spread to any neighboring lymph nodes.
- N1, N2, N3: the number of cancerous nodes.
This indicates whether or not the cancer cells have spread to other organs in the body.
- M0: There is no evidence of malignancy spreading to other regions of the body (stage 2 breast cancer is always M0)
- MX :Spread cannot be quantified.
- M1: cancer has progressed to other regions of the body such as the lungs, liver, or bones.
The cancer stage is determined by combining these characteristics. Breast cancer is graded on a scale of 1 to 4.
There are two subtypes of stage 2 breast cancer.
Breast cancer is classified as stage 2A if one of the following conditions is met:
- Although there is no tumor in the breast, breast cancer cells have been identified in surrounding lymph nodes.
- The main tumor is 2 centimeters (cm) or less in size, and cancer cells are identified in no more than four axillary lymph nodes.
- The breast tumor is between 2 and 5 cm in size, but no lymph nodes are involved.
Breast cancer is classified as stage 2B if one of the following conditions is met:
- The breast tumor is 2 to 5 cm in size, and the malignancy has spread to four or fewer lymph nodes.
- The tumor is more than 5 cm in diameter, but no lymph nodes are involved.
Other factors to consider
Breast cancer staging is difficult. A tumor grading system and the presence of specific receptors in breast cancer cells are two more elements that might influence the overall staging diagnosis. A tumor grading system indicates how quickly cancer cells are expected to develop and spread. The cancer is regarded as more aggressive at higher grades.
- G1: differentiated or low grade
- G2 is for the moderately differentiated or intermediate grade.
- G3: scarcely differentiated or of great quality
Furthermore, the tumor will be examined for receptors that may alter your treatment choices and give you a clearer understanding of what to anticipate.
The receptor status
- Status of the estrogen receptor (ER): ER+ or ER-
- Status of progesterone receptors (PR): PR+ or PR-
- HER2 status (a protein present on the surface of breast cells that promotes growth): HER2+ or HER2-
- Hormone receptor (HR) state is another term for ER and PR status.
Because various tumors behave differently, these characteristics may also be used in staging. As an example:
- HR+/HER2- breast cancer grows slowly and is less aggressive than other kinds.
- HR-/HER2- cancers, often known as triple-negative cancers, are more aggressive.
- Another variety that may be aggressive is HR+ or -/HER2+.
What kind of care can you expect?
Some of your therapy choices will be determined by the tumor’s HR and HER2 status. Your doctor will also take into account:
- any other medical issues you may be suffering from
- your age
- your menopausal condition
Treatment usually consists of a mix of therapy. Here are some of the most frequent treatments for stage 2 breast cancer.
Surgical options may include: depending on the size and location of the tumor:
- breast preservation surgery (lumpectomy)
- With or without reconstruction, a modified radical mastectomy is performed.
The surgeon will also do a sentinel lymph node biopsy during each of these operations to see whether cancer has spread.
Radiation treatment is usually administered after surgery, particularly if you have a lumpectomy. Certain criteria will assist decide if you require radiation therapy after a mastectomy. These elements are as follows:
- tumor size
- how many lymph nodes cancer has spread to
Radiation is used to reduce the likelihood of recurrence. Radiation treatment works by causing DNA damage in cancer cells. This contributes to their demise.
Radiation therapy is primarily used as a localized treatment. This implies that it is exclusively directed at the region that is radiated. It does not affect your whole body, like chemotherapy or certain medications do. Radiation comes in a variety of forms. Some regimens last 5 days, others 3 to 4 weeks, and yet others 5 to 6 weeks. The most prevalent adverse effects include weariness, as well as redness, skin peeling, and swelling in the treated region.
Chemotherapy may be used to decrease tumors before to surgery or to reduce the likelihood of recurrence following surgery. Because triple-negative breast cancer lacks HR and HER2 receptors, therapeutic choices are limited. It does, however, react favourably to treatment. Chemotherapy medications are often administered intravenously via a vein in the case of breast cancer (IV). This might be in the form of a few-minute injection or an infusion lasting many hours or more.
Chemotherapy for breast cancer is commonly administered in rounds of 1 to 2 weeks. On one day of the week, or for a few days in a row, you will be administered chemotherapy by IV. After that, you’ll be given time to recuperate from the medicines before beginning your next cycle. One downside of chemotherapy is that the medications cannot distinguish between malignant and healthy cells. As a consequence, in addition to malignant cells, some healthy cells may be temporarily harmed. As a consequence, you may experience the following negative effects:
- hair thinning
- mouth ulcers
- Appetite loss
- constipation or diarrhea
Some forms of chemotherapy may also result in premature menopause.
Targeted or biological treatments utilize medications that can distinguish between cancer cells and normal cells somewhat better than chemotherapy. These medications have the capacity to impact cancer cells while causing little damage to other cells. Targeted treatments are a relatively new therapy method, and new medications are being created as scientists discover more about how cancer cells grow and proliferate, as well as what distinguishes them from normal cells.
Targeted hormone treatment for estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+) breast cancers may be beneficial for stage 2 breast cancer. Therapies may include the following:
Hot flashes and vaginal dryness may be side effects of hormone treatment. Other methods of targeted treatment may identify certain proteins or enzymes linked with cancer cells. Targeted treatment, for example, may disrupt the high quantities of growth-promoting protein on the surface of HER2-positive breast cancer cells.
Among the therapy available for stage 2 HER2-positive breast cancer are:
- ado-trastuzumab emtansine
Trials in humans
Participating in a clinical study may allow you to get access to novel targeted medicines or chemotherapeutic medications. Consult your doctor to see whether there is a study that might be a suitable match for you.
Complications and side consequences
All therapies have some degree of adverse effect, ranging from minor to severe. Most clear up after therapy, but there may be some long-term consequences. It’s critical to inform your oncologist about any symptoms, no matter how small they seem. Your healthcare team will collaborate with you to manage side effects and problems.
What happens after treatment is completed?
Hormone therapy might last anywhere from 5 to 15 years after main treatment is completed. And breast reconstruction may be a multi-step, months-long procedure. Your first post-treatment appointment will most likely be in a few months. Your doctor will want to know how you’re doing and whether you need assistance with medication side effects. Eventually, you’ll go from six-month appointments to annual visits. Breast imaging will be included in annual checks. Your doctor will devise a plan depending on the degree of care you need.
The conclusion of your therapy might be a difficult adjustment. Relief and excitement might be followed by tension and despair. The fear of recurrence is widespread. All of these feelings and anxieties are entirely natural. When your primary attention has been on treatment, side effects, and appointment scheduling, it may take some time to adjust to life on the other side of those intricacies.
Also, loved ones may be so delighted for you that they are unaware you are still battling with the physical and emotional consequences of your cancer treatment. You are not required to live up to anyone’s standards other than your own. When or if you return to your former habit is determined by circumstances specific to you. It’s critical to stick to your own schedule and to go at your own speed.
What is the survival rate?
The prognosis for stage 2 breast cancer is typically favorable. The 5-year relative survival rate, according to the American Cancer Society, is:
- For localized breast cancer, the rate is 99 percent (has not spread outside the breast)
- 86 percent for localized breast cancer (spread to nearby lymph nodes)
These data reflect people who were diagnosed between 2010 and 2016, prior to the availability of certain new targeted medicines. Furthermore, these percentages vary somewhat depending on ER/PR and HER2 status. Certain forms of breast cancer are more likely to be cured than others.
This might be because certain tumors, such as HR+/HER2-, respond better to hormonal treatment, while HER2-positive breast cancers respond better to anti-HER2 targeted therapy. Some, such as triple-negative breast cancer, have fewer treatment choices and a greater recurrence rate in the early stages. Your oncologist may go through your whole medical history with you to give you a better understanding of what to anticipate.
Breast cancer resources and support
There are several services and support organizations available to breast cancer survivors. There is no need to remain with a group. You may experiment with it and move on whenever you’re ready. You may be shocked to discover that you have a lot to give others as well.
The American Cancer Society offers a number of different support services and activities. You may contact the hotline at 800-227-2345, visit the website, or download the Life After Treatment Guide.
Download the free Breast Cancer Healthline app if you prefer having information at your fingertips. The app connects you with individuals who have a similar illness and can relate to what you’re going through.
Other support options
- Check out the Breastcancer.org Community Discussion Boards Trusted Source.
- Living Beyond Breast Cancer offers in-person, online, and phone assistance.
- Through the Young Survival Coalition, you may connect with other young breast cancer survivors.
- Search through the titles of almost 400 episodes of Breast Cancer Update, a podcast hosted by oncologist Dr. Neil Love.
- Examine the themes covered in the Breastcancer.org podcast.
- On the CDC’s breast cancer podcasts Trusted Source, you may get critical health information as well as listen to human stories.
Providing support to a breast cancer patient
You’re already being supportive if you’re reading this because you know a breast cancer survivor. Perhaps you don’t know what to say or are afraid of speaking the incorrect thing. Regardless, say something. Don’t go unmentioned when it comes to breast cancer. The greatest thing you can do right now is to just be there and let them lead the way. People suffering from breast cancer may feel forced to behave confidently and with a good attitude. This might be masking what’s truly going on. Allow them to be honest with you, and then listen without judgment.
Make a specific offer to assist. Can you cook a meal? Do you have any chores? Do you want to see a movie together? Inform them of your willingness to help. But take their word for it. Don’t force it if they don’t want it. Simply making the offer shows that you care. The completion of therapy does not always mean the end of the experience. There will be numerous changes in the future. Some things may never be the same again, but change isn’t necessarily a negative thing.
Cancer cells in stage 2 breast cancer have not migrated beyond the breast or adjacent lymph nodes. Knowing your stage 2 breast cancer’s HR and HER2 status might assist your oncologist to evaluate which therapies are most likely to be helpful. Stage 2 breast cancer is very curable, with a favorable prognosis. The sooner your cancer is discovered and treated, as with most forms of cancer, the better the result.