Staging and grading for breast cancer

Once a definite diagnosis of cancer has been made and your healthcare team has the information it needs, the cancer will be given a stage and a grade.

The cancer stage describes the tumour size and tells whether it has spread beyond the place where it started to grow.

In the earliest stage of breast cancer, cancer cells are found only in the milk ducts or lobules. This is called in situ cancer. If in situ cancer is diagnosed before the cells have spread to the surrounding tissue, there is no risk of them spreading after they have been removed.

When breast cancer spreads out of the duct or lobule, it is called invasive cancer. It can still be treated effectively if diagnosed early.

For breast cancer, there are five stages.

Stage	Description
0	There are two kinds of stage 0 breast cancer: Ductal carcinoma in situ (DCIS): Abnormal cells are in the lining of a milk duct and have not spread outside the duct. Lobular carcinoma in situ (LCIS): Abnormal cells are in the lining of a lobule.
1	Tumour is 2 cm or smaller and the cancer has not spread outside the breast.
2	Tumour is 2 to 5 cm, or cancer has spread to the lymph nodes, or both.
3	Cancer has spread to the lymph nodes and may have spread to nearby tissues such as the muscle or skin.
4	Cancer has spread to distant parts of the body.

To find out the grade of a tumour, the biopsy sample is examined under a microscope. A grade is given based on how the cancer cells look and behave compared with normal cells. This can give your healthcare team an idea of how quickly the cancer may be growing. There are three grades.

Grade	Description
1	Low grade – slow growing, less likely to spread
2	Moderate grade
3	High grade – tend to grow quickly, more likely to spread

It is important to know the stage and grade of the cancer. This information helps you and your healthcare team choose the best treatment for you.

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