Staging and grading breast cancer

Staging describes where the cancer is in your body - its size and if it has spread.

Grading describes the cancer cells - what they look like under a microscope and how they might grow. 

Staging and grading your cancer will help your doctor to plan the best treatment for you.

The staging system normally used in breast cancer is called TNM.
This stands for:

• Tumour (T): How big is the tumour?
• Node (N): Is there cancer in your lymph nodes? N0 means no lymph nodes are affected. If the cancer has spread to the lymph nodes (positive lymph nodes) the N will have a number to describe how many lymph nodes are affected. NX means the doctors cannot tell if the nodes are affected.
• Metastasis (M): Has the cancer spread to other parts of your body? M1 means the cancer has spread (metastasised) to other parts of your body. M0 means it hasn't.

Your doctor often uses this information to give your cancer a number stage – from 0 to 4.

A higher number, such as stage 4, means the cancer has spread to other parts of the body.

• Stage 0: Non-invasive breast cancer, such as ductal carcinoma in situ (DCIS)
• Stage 1: The cancer is found only in your breast
• Stage 2: The cancer is found your breast and nearby lymph nodes
• Stage 3: The cancer has spread to more lymph nodes
• Stage 4: The cancer has spread to other organs in your body. This is called metastatic breast cancer
   

Breast cancer cells can be graded as 1, 2 or 3, depending on how different they are to normal breast cells and how quickly they are growing. The grade gives your doctor information about how quickly the cancer may grow and spread. 

In general, grade 1-2 means a slower growing cancer and grade 3 is faster growing.