Breast cancer is a very treatable disease, even in its most aggressive stages. However, it is important to understand what stage you are in so that you can discuss your options with your doctor. Staging is a system that describes how far the cancer has spread in a patient’s body and helps doctors determine which treatments are best for them.
The first thing your physician will do is evaluate your tumor based on its size and whether or not it has spread to nearby lymph nodes. The tumor will also be evaluated for a number of other factors, including its grade (based on how much it looks like normal cells and how fast they are likely to grow), hormone receptors, and HER2 status.
If the tumor is no larger than 5 centimeters and it has not spread to any lymph nodes, your doctor will most likely suggest breast-conserving surgery (BCS; also called lumpectomy or partial mastectomy). Those with more advanced stage 2 breast cancer may need to have a mastectomy instead. If your doctor decides that a mastectomy is needed, it will be followed by radiation therapy. Your doctor will also check nearby lymph nodes, either through a sentinel lymph node biopsy or with an axillary lymph node dissection. This will help them decide if additional chemo is needed before or after surgery.
If your tumor is between 2 centimeters and 5 centimeters in size and has spread to 1-3 lymph nodes in the armpit, it is considered Stage 2A. If you have a larger tumor and no cancer in the lymph nodes, it is referred to as Stage 2B.
In both cases, you will most likely receive neoadjuvant chemotherapy before or after surgery to shrink the tumor and destroy any microscopic cancer cells that are still present. Your doctor may also recommend that you receive the targeted drug trastuzumab (Perjeta) along with chemo, depending on your HER2 status.
Stage 2A breast cancers typically have a good prognosis, but it is important to note that there are no guarantees in cancer treatment. This is why it’s so important to seek medical care from a specialist.
In stage 2B, the cancer is more likely to spread beyond the breast tissue into nearby lymph nodes in the armpit. These lymph nodes are part of the lymphatic system that circulates a fluid called lymph throughout your body. Most often, stage 2B breast cancers will have spread to the lymph nodes in the armpit that are closest to your chest. In some cases, this may be up to nine axillary lymph nodes under the breast bone. This stage can be difficult to treat because the cancer is more likely to recur.