|Whether you detect a lump on your own or from another test method, further testing will be needed for diagnosis. Often all of the above modalities are used leading up to a diagnosis. In addition a biopsy may also be required. There are several ways this can be performed. Your doctor may elect to choose one of the following methods; Breast Cyst Aspiration, Stereotactic Biopsy, Needle/Wire Guided and/or Ultra Sound guided biopsy.
Once a diagnosis has been made from a biopsy the next step(s) will be determined by the information received.
What is staging?
Staging describes the severity of a person's cancer based on the size and/or extent (reach) of the original (primary) tumor and whether or not cancer has spread in the body. Staging is important for several reasons:
- Staging helps the doctor plan the appropriate treatment.
- Cancer stage can be used in estimating a person's prognosis.
- Knowing the stage of cancer is important in identifying clinical trials that may be a suitable treatment option for a patient.
- Staging helps healthcare providers and researchers exchange information about patients; it also gives them a common terminology for evaluating the results of clinical trials and comparing the results of different trials.
Staging is based on knowledge of the way cancer progresses. Cancer cells grow and divide without control or order, and they do not die when they should. As a result, they often form a mass of tissue called a tumor. As a tumor grows, it can invade nearby tissues and organs. Cancer cells can also break away from a tumor and enter the bloodstream or the lymphatic system. By moving through the bloodstream or lymphatic system, cancer cells can spread from the primary site to lymph nodes or to other organs, where they may form new tumors. The spread of cancer is called metastasis.
All cancers are staged when they are first diagnosed. This stage classification, which is typically assigned before treatment, is called the clinical stage. A cancer may be further staged after surgery or biopsy, when the extent of the cancer is better known. This stage designation (called the pathologic stage) combines the results of the clinical staging with the surgical results.
A cancer is always referred to by the stage it was given at diagnosis, even if it gets worse or spreads. New information about how a cancer changes over time simply gets added onto the original stage designation. The cancer stage designation doesn't change (even though the cancer itself might) because survival statistics and information on treatment by stage for specific cancer types are based on the original cancer stage at diagnosis.
*Above information provided by Oncology Nurse Advisor
The TNM system is one of the most widely used cancer staging systems. This system has been accepted by the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC). Most medical facilities use the TNM system as their main method for cancer reporting.
The TNM system is based on the size and/or extent (reach) of the primary tumor (T), the amount of spread to nearby lymph nodes (N), and the presence of metastasis (M) or secondary tumors formed by the spread of cancer cells to other parts of the body. A number is added to each letter to indicate the size and/or extent of the primary tumor and the degree of cancer spread.
Primary Tumor (T)
TX: Primary tumor cannot be evaluated
T0: No evidence of primary tumor
Tis: Carcinoma in situ (CIS; abnormal cells are present but have not spread to neighboring tissue; although not cancer, CIS may become cancer and is sometimes called preinvasive cancer)
T1, T2, T3, T4: Size and/or extent of the primary tumor
Regional Lymph Nodes (N)
NX: Regional lymph nodes cannot be evaluated
N0: No regional lymph node involvement
N1, N2, N3: Degree of regional lymph node involvement (number and location of lymph nodes)
Distant Metastasis (M)
MX: Distant metastasis cannot be evaluated
M0: No distant metastasis
M1: Distant metastasis is present
For example, breast cancer classified as T3 N2 M0 refers to a large tumor that has spread outside the breast to nearby lymph nodes but not to other parts of the body. Prostate cancer T2 N0 M0 means that the tumor is located only in the prostate and has not spread to the lymph nodes or any other part of the body.
For many cancers, TNM combinations correspond to one of five stages. Criteria for stages differ for different types of cancer. For example, bladder cancer T3 N0 M0 is stage III, whereas colon cancer T3 N0 M0 is stage II.
||Carcinoma in situ
|Stage I, Stage II, and Stage III
||Higher numbers indicate more extensive disease: Larger tumor size and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or tissues or organs adjacent to the location of the primary tumor
||The cancer has spread to distant tissues or organs
*Above Information from NIH- National Cancer Institute