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How does tumor size affect breast cancer stage?


The size of a breast tumor can give doctors an idea of the severity of a breast cancer case. Staging cancer based on this information, the condition of the lymph nodes, and metastases are essential for determining the disease extent, treatment options, and prognosis. Other factors which help to plan the cancer treatment include the tumor’s location, whether it has spread outside the breast, the appearance of cancer cells, and the presence of hormone receptors.

Let us discuss breast cancer tumor size and stages through the tumor size chart in this article and also how tumour size can affect cancer staging? We will also highlight other factors contributing to cancer staging, its treatment, and a person’s outlook.

The TNM Staging System for Breast Cancer

TNM is the most popularly used staging system for breast cancer, where;

• T = the size of the primary tumor
• N = if cancer has spread to close neighbouring lymph nodes
• M = if the cancer is metastatic (cancer has spread to distant parts of the body)

T=Tumor Size

To measure the tumor size before surgery, doctors rely on imaging examinations.

Standard breast imaging methods are:

• Mammogram: It is the film mammography used to image breast tissue. If you’ve been postmenopausal, have fatty breast tissue, or have been pregnant, this can be much accurate. With dense breast tissue, digital mammography is more reliable.

• Breast ultrasound: Ultrasound used to help diagnose breast lumps or other abnormalities. In ultrasound imaging, sound waves produce pictures of the breast. It is deemed less accurate than mammography.

• Breast MRI: A breast MRI is needed to measure if the breast tissue is dense or if your biopsy shows the mass is extensive than expected. Although MRI can give a clear picture of your tumor, it tends to exaggerate its actual three-dimensional size.

After analysing imaging examinations, a breast surgeon can approximate the tumor’s size. In some breast cancer cases determining the tumor’s size can be easy, but it can be more challenging in others. Not all breast tumours are easy and circular in shape. For example, the tumor could be in a potato shape, with hard to see all the dimensions. Some even have more irregular edges making it hard to estimate the total diameter.

In the TNM system, tumour size is divided into four classes:

T-1 0 to 2 cm
T-2 2 to 5 cm
T-3 Bigger than 5 cm
T-4 The tumour can be of any size which is growing into the chest wall. This category covers inflammatory breast cancer.


N=Lymph Node Status

Because cancer can get into your lymphatic system, the lymph nodes closest to your tumor must examine for cancer and micrometastasis.

Your surgeon can check your lymph nodes by palpating (touching) the skin just above the lymph node and noting what they notice.

N-0 Can not feel swollen nodes.
N-1 Can feel some swelling that can be cancerous nodes.
N-2 The lymph nodes are lumpy, swollen, and bunched together.
N-3 Swollen lymph nodes are close to the collarbone.



Metastasis indicates that cancer spreads to a different body part from where it started and further affects cancer stages.

M-0 A sample of the lymph nodes was surgically removed and analyzed, and they are cancer-free.
M-1 Nodes contain cancer cells or micrometastases. The tumour has lost cells beyond its original location, and cancer is found in other parts of the body.


Tumour size

Through biopsies and imaging examinations, a surgeon can identify the approximate measurement of the tumor. It is necessary to have the actual tumor size to make the best treatment decisions.

After the lumpectomy or mastectomy process, combine the removed breast tissue with the biopsy tissue to examine the actual size of the lump. The pathological measure of the tumor is the standard for tumor size. Your post-operative pathology report summarizes your complete diagnosis of breast cancer.

Factors affecting breast cancer stages

1. Hormone receptor status

While breast cancer staging, doctors examine tumor cells for the presence of hormone receptors. Receptors are proteins that respond to the estrogen and progesterone hormones. Doctors describe breast cancer as estrogen receptors (either estrogen receptor-positive or ER-positive). They also refer to breast cancer as progesterone receptors (either positive progesterone receptors or PR positive). Hormone therapy is usually the most effective treatment for cases with hormone receptors.

2. HER2 status

The next factor to include in breast cancer staging is HER2 status. The human epidermal growth factor receptor 2 (HER2) gene could play a role in breast cancer development.
HER2 receptors protein helps in controlling the growth, division, and repair of healthy breast cells. Doctors test HER2 status to see if this receptor is above normal levels and then call it HER2 positive cancer. Targeted therapies generally work best in such cases.

3. Cancer cell appearance

How the cancer cells appear or differentiate is another factor in cancer staging. Under the microscope, doctors group cancer cells according to their appearance to noncancerous cells. Those cancer cells that are close to matching healthy cells are considered low grade. These cancer cells grow more slowly. Cancer cells that appear very different from normal cells are acknowledged as a high grade, and they tend to grow faster.

Tumor size is an essential factor to determine the breast cancer stage. Despite this factor, doctors also consider several other factors, including:
• Age

• General health

• Personal preferences when suggesting treatment options

Early breast cancer diagnosis and treatment can significantly improve a person’s outlook. However, different people have different experiences with breast cancer.

Final Thought

Breast cancer tumor size is one of the most important determining factors for breast cancer staging. Early diagnosis of breast cancer helps your doctor to prepare more efficient and effective treatment for you. If you have any further queries related to signs or symptoms of breast cancer, book an appointment with our breast cancer surgeon or call us at +91 124 4882248.

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