Determining breast-cancer stage
When receiving treatment for
breast cancer, women will
learn about cancer staging.
According to the nonprofit
organization Breastcancer.org, determining
the stage of the cancer helps
patients and their doctors figure out the
prognosis, develop a treatment plan, and
even decide if clinical trials are a valid
option.
Typically expressed as a number on a
scale of 0 through IV, breast-cancer stage
is determined after careful consideration
of a host of factors. The staging system,
sometimes referred to as the TNM system,
is overseen by the American Joint Committee
on Cancer and ensures that all
instances of breast cancer are described
in a uniform way. This helps to compare
treatment results and gives doctors and
patients a better understanding of breast
cancer and the ways to treat it.
Breastcancer.org notes that the TNM
system was updated in 2018, but before
then was based on three clinical characteristics:
T: The size of the tumor and whether
or not it has grown into nearby tissue.
N: Whether the cancer is present in
the lymph nodes.
M: Whether the cancer has metastasized,
or spread to others parts of the
body beyond the breast.
Each of those factors is still considered
when determining breast cancer stage,
but starting in 2018, the AJCC added
additional characteristics to its staging
guidelines, which make staging more
complex but also more accurate:
Tumor grade
This is a measurement of how much
the cancer cells look like normal cells.
Estrogen- and progesteronereceptor
status
This indicates if the cancer cells have
receptors for the hormones estrogen and
Caribbean L 32 ife, Oct. 11-17, 2019 BQ
progesterone. If cancer cells are deemed
estrogen-receptor-positive, then they
may receive signals from estrogen that
promote their growth. Similarly, those
deemed progesterone-receptor-positive
may receive signals from progesterone
that could promote their growth.
Testing for hormone receptors, which
roughly two out of three breast cancers
are positive for, helps doctors determine
if the cancer will respond to hormonal
therapy or other treatments. Hormonereceptor
positive cancers may be treatable
with medications that
reduce hormone production
or block hormones from supporting
the growth and function
of cancer cells.
HER2 status
This
helps doctors determine if the
cells are making too much of
HER2 protein. HER2 proteins
receptors on breast cells made
the HER2 gene. In about
25 percent of breast cancers,
the HER2 gene makes too
many copies of itself, and
these extra genes ultimately
breast cells grow and divide in
ways that are uncontrollable. HER2-
positive breast cancers are more likely to
spread and return than those that are
HER2-negative.
Oncotype DX score
The oncotype DX score helps doctors
determine a woman’s risk of early stage,
estrogen-receptor-positive breast cancer
recurring and how likely she is to benefit
from post-surgery chemotherapy. In
addition, the score helps doctors figure
out if a woman is at risk of ductal carcinoma
in situ recurring or at risk for
a new invasive cancer developing in the
same breast. The score also helps doctors
figure out if such women will benefit
from radiation therapy or DCIS surgery.
Female doctor looking at test results of her patient. Breast examination.
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