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BREAST CANCER:

 staging

 

 

Staging tests determine the size and location of the cancer and whether it has spread. They also help with treatment planning.

Sentinel Node Biopsy
The standard treatment for breast cancer involves removal of the lymph nodes on the affected side to determine if the cancer has spread. Saint John’s Breast Center Director, Dr. Armando Giuliano, pioneered an innovative technique called sentinel node biopsy, now used in cancer centers worldwide, which helps to more accurately determine the stage of the patient's cancer by detecting if it has spread to nearby lymph nodes - without using radical surgery.

By injecting blue dye or radioisotope into the primary tumor and following it to the lymph nodes under the arm, the blue or radioactive node can be removed. This is the same lymph node to which the cancer would have spread if it indeed did spread. By looking at this blue or radioactive lymph node, the stage of the cancer can be determined without radical surgery.

Sentinel node biopsy (lymphatic mapping) identifies, with extraordinary accuracy, the lymph node most likely to contain cancer cells that have migrated from the primary tumor. If that lymph node is cancer-free, it is highly likely that the other lymph nodes are also cancer-free and therefore there is no need to remove them. If that sentinel node is cancerous, then the surgeon and medical oncologist know that more aggressive treatment is required.

Breast Cancer Stages
Breast cancer is staged using the numbers 0 through IV.

  • Stage 0. These cancers are called noninvasive, or in situ (in one place). Although Stage 0 cancers do not have the ability to invade normal breast tissue or spread to other parts of the body, it is important to have them removed because they eventually can become invasive cancers.
  • Stage I to IV.  These cancers are invasive tumors that have the ability to invade normal breast tissue or spread to other areas. A stage I cancer is small and well localized and has a high cure rate. But the higher the stage number, the lower the chances of cure. By stage IV, the cancer has spread beyond the breast to other organs, such as to bones, lungs or the liver. Although it is not possible to cure cancer at this stage, it may still respond well to various treatments, which could effectively shrink and control the cancer for an extended period of time.