Stage I and Stage II
- Stage I. Cancer cells have not spread beyond the breast, and the tumor is no more than 2 cm (about 3/4 of an inch) across.
- Stage II. One of the following conditions apply: the tumor is less than 2 cm across, and the cancer has spread to the lymph nodes under the arm; the tumor is between 2 and 5 cm (about 3/4 inch to 2 inches) with or without spreading to the lymph nodes under the arm; the tumor is larger than 5 cm but has not spread to the lymph nodes under the arm.
Primary Treatment Options for Stage I and II Breast Cancers. Choice of (1) Breast-sparing surgery (typically lumpectomy, usually with lymph node sampling) followed by external beam radiation therapy. (2) Modified or radical mastectomy with or without breast reconstruction. (3) Removal or radiation of lymph nodes. Choice between (1) and (2) depends mostly on the size and location of the tumor, the size of the breast, certain features of the cancer, and how the woman feels about preserving her breast. Considerations by tumor size are as follows:
- Tumors under 2 cm: Women can generally choose lumpectomy followed by radiation.
- Tumors between 2 cm and 5 cm. Even if tumors are up to 5 cm, a 2000 international study suggested that lumpectomy and mastectomy offer equivalent survival rates (about 66%) and time to metastasis at 10 years. In the study, however, local recurrence occurred in 20% of lumpectomy and 12% of mastectomy patients.
- Tumors over 5 cm: Women generally choose mastectomy.
Other considerations: If women choose breast-sparing procedures, the risk for recurrence is lower with removal of as much breast tissue as possible. In women who experience a local recurrence after treatment, those who have chosen lumpectomy and radiation tend to have a better outlook than women who chose mastectomy, since cancers in the latter case would develop in the chest wall.
Adjuvant and Neoadjuvant Treatment Options. Adjuvant therapy is administered in addition to surgery or radiation therapy to prevent recurrence.
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