Lung Cancer and Coughing Up Blood: When to See a Doctor
Katie Thurston Shares She Sobbed In Chemo Class Amid Stage 4 Cancer Diagnosis
Bachelorette's Katie Thurston Shares Cancer Treatment Plan After Stage 4 Diagnosis
Katie Thurston is sharing a difficult moment amid her cancer battle.
The Bachelorette alum, who recently shared her breast cancer has been upgraded to a stage 4 diagnosis after doctors found spots on her liver, detailed the emotional impact the health battle has had on her.
"Today I had 'chemo class'—and I sobbed the second it started," Katie, 34, said on her Instagram Boobie Broadcast channel March 31. "Not because of anything she said—idk if I heard much of anything she said for the next 25 min. Sometimes I think 'wtf is my life?' But whether I like it or not, this is my life and I have to make the best of it."
After all, she's still contending with her new reality.
"They say live like you're dying, but now that I am, it's easier said than done. And don't get me wrong, every day, we are all closer to death," she added. "Not in a morbid way but in the undeniable circle of life. So cancer or not, I am blessed with today. So while I have sad moments or days, I want to do my best to cherish my time, cancer or not."
Katie revealed that after her class, she was too sad to go out to dinner with her husband Jeff Arcuri—whom she married March 22—but pushed ahead as she knew she needed to find a sense of normalcy after her emotional day.
"A reminder on what really matters in our moment on this planet," Katie said. "I felt too tired and too sad for dinner tonight. But husband @jarcuri wanted to take me on a date. And it was this entire reality check for myself to get off the couch and keep living and loving."
Gilbert Flores/Variety via Getty Images
Since sharing her initial cancer diagnosis in February, the reality star has been candid about all aspects of her journey. And that's included the fertility treatments she's undergone, like in-vitro fertilization (IVF) with the hopes that she and Jeff can start a family after her cancer battle.
"I thought I'd share the outcome of embryo freezing," Katie on her Instagram Story March 31. "We retrieved 17 eggs and attempted to fertilize them. Of the 17, only 6 were successfully fertilized."
"And after genetic testing," she continued, "we have 2 embryos we were able to freeze, one Grade B and one Grade C. This is the reality of IVF."
One thing Katie has remained hopeful and inspired by is her husband's dedication to sticking by her through her health battle. In fact, the couple revealed how her diagnosis encouraged them to say "I do" sooner than expected.
"We'll still will have a wedding in the future," Katie told Us Weekly in a joint interview with Jeff March 23. "But it was kinda just this really kind gesture of just him saying like truly, in sickness and in health. He's proving that he's here to stay."
Keep reading for more stars who has shared insight into their cancer battles…
Paul Archuleta/Getty Images
The All My Children alum announced in January 2025 that he had been diagnosed with prostate cancer, his third cancer diagnosis throughout his life.
Despite the devastating news, he announced (for the third time) in February 2025 he was cancer-free following successful surgery and treatments.
"Remember, you're not defined by any of your challenges," he wrote in his February 2025 Instagram update. "You're grander than it all. I'm not my fear, my anxiousness or my scars but I embrace it all because the only way to transform it is to own it."
Taylor Hill/WireImage
The former Golden Bachelor star shared in Dec. 2024 that he had been diagnosed with Waldenström's macroglobulinemia, a bone cancer.
"Unfortunately, there's no cure for it," Gerry noted to People at the time. "So that weighs heavily in every decision I make. It was like 10 tons of concrete were just dropped on me. And I was a bit in denial for a while, I didn't want to admit to it."
Albert L. Ortega/Getty Images
Jim Beaver
The actor, known for roles in The Boys and Supernatural, shared on Feb. 3, 2023, that he had battled prostate cancer for years and was cancer free.
Tommy Garcia/Bravo
Ariana Madix
"I had to have a lil bit o'cancer removed from my body and lymph nodes biopsied," the Vanderpump Rules star revealed to fans at the close of 2018. "(In the clear now!)"
Paul Archuleta/FilmMagic
Marcia Cross
The Desperate Housewives star revealed to fans in September 2018 that she survived anal cancer. "After posting a picture of myself here and uttering the words #cancer and #hairloss, I feel liberated, deliriously free and completely me," she shared on Instagram.
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Dustin Hoffman
The two-time Oscar winner underwent successful treatment for cancer, and his rep confirmed to E! News that doctors deemed Hoffman "surgically cured."
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Hugh Jackman
The X-Men star was treated for his third basal cell carcinoma back in 2014, and after his third treatment, Jackman's rep told E! News that he's "all good" now.
In April 2023, Hugh had two biopsies for additional basal cell carcinoma. At the time, he told fans, "If I can just take this opportunity to remind you summer is coming for those of us in the northern hemisphere, please wear sunscreen."
Adam Olszweski/Bravo/NBCU Photo Bank
The former Real Housewives of Beverly Hills star celebrated one year of being cancer-free in January. The mother of two was diagnosed with endometrial cancer back in 2013 and underwent a radical hysterectomy.
Then in 2017, Camille had surgery to remove Squamous Cell Carcinoma, a type of skin cancer.
Jordan Strauss/Invision/AP
Cobie Smulders
The Avengers: Age of Ultron actress battled ovarian cancer at the age of 25 and overcome odds when she welcomed two children with husband Taran Killam.
Michael Buckner/Getty Images
Dr. Drew Pinsky
TV host reveals he underwent surgery for prostate cancer in July 2013 and has since been given a clean bill of health.
Frederick M. Brown/Getty Images
Brooke Burke
The Dancing with the Stars cohost underwent successful surgery for thyroid cancer. The mother of four tweeted, "Thx for all the twitter love. I'm [home] recovering & resting."
Alberto E. Rodriguez/Getty Images
Angie Everhart
"MY DR CALLED ME ON A SAT. MORNING TO TELL ME I AM CANCER FREE!!!!! #wootothemotherf--kinhoo," the actress tweeted after receiving the good news.
Ethan Miller/Getty Images
Christina Applegate
The Up All Night star was declared "100-percent clear" of breast cancer after treatment and a double mastectomy.
Albert L. Ortega/Getty Images
Michael C. Hall
The Dexter star used a hiatus from his hit series to slay Hodgkin's lymphoma.
Michael Loccisano/Getty Images
Michelle Monaghan
The Australian actress revealed in October 2011 that she had a cancerous mole removed from her calf after her hubby encouraged her to get the suspicious-looking mark checked out.
Alberto E. Rodriguez/Getty Images for Disney
The Scot is trainspotting just fine these days after having a cancerous mole removed from beneath his right eye.
Brad Barket/Getty Images for Happy Hearts Fund
Sheryl Crow
The singer beat breast cancer in 2004 with a "minimally invasive" lumpectomy and radiation therapy.
Grant Lamos IV/Getty Images
Michael Douglas
The Oscar winner declared in early 2011 that his tumor was gone and he had throat cancer "beat."
Dimitrios Kambouris/Getty Images
Edie Falco
The Emmy winner whacked breast cancer in 2004.
Doug Meszler / Splash News
Anderson Cooper
Surely the CNN veteran wears his SPF when he's braving the elements now after having a cancerous growth removed from under his left eye in 2008.
Alberto E. Rodriguez/WireImage
Kylie Minogue
The Australian pop star underwent successful surgery for breast cancer in 2005.
Stefanie Keenan/Getty Images
Barry Watson
The 7th Heaven star was diagnosed with Hodgkin's disease when he was only 28. He's 50 now and looking good!
Jason Merritt/Getty Images
Maura Tierney
The ER fave had to abandon her role in Parenthood to fight breast cancer in 2009—but her treatment was a success and she was back on the red carpet in no time.
CBS
Sharon Osbourne
The America's Got Talent judge was diagnosed with colon cancer while shooting The Osbournes in 2002 and used the opportunity to stress the importance of regular screenings while attacking the #@%! With chemotherapy. She was declared cancer-free the following year.
Jemal Countess/Getty Images for the 2014 Tribeca Film Festival
Robert De Niro
The Oscar winner took prostate cancer down, down to Chinatown, in 2003, and has been in about 400 movies since then.
Jason Merritt/Getty Images
Robin Roberts
The Good Morning America cohost proudly flaunted her smooth scalp while undergoing chemotherapy to treat breast cancer in 2007.
Robert Laberge/Getty Images
Lance Armstrong
The champion cyclist battled back from stage-four testicular cancer before winning seven straight Tour de France titles.
Richard Shotwell/Invision/AP
Melissa Etheridge
The Grammy and Oscar winner became an inspiring activist after a lumpectomy and chemotherapy cleared her of breast cancer in 2005.
Imeh Akpanudosen/Getty Images for LA Times
Julia Sweeney
The former Saturday Night Live standout mined her breast cancer battle for comedic material that turned into God Said Ha!, her successful one-woman show that eventually went to Broadway.
Dimitrios Kambouris/Getty Images
Cynthia Nixon
The Sex and the City star was diagnosed with breast cancer in 2006, and after surgery and radiation treatments, she was given the clear.
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How Breast Cancer Staging Affects Your Treatment
When actress Christina Applegate revealed her stage 1 breast cancer diagnosis in 2008, she made a bold decision to undergo a double mastectomy despite having cancer in only one breast. Years later, she explained that understanding her specific diagnosis empowered her to make the choice that felt right for her situation. This knowledge proves equally valuable for anyone facing breast cancer, as treatment options and outcomes vary significantly depending on the stage at diagnosis.
Breast cancer remains one of the most common cancers worldwide, with more than 300,000 new cases diagnosed annually in the United States alone. Despite this prevalence, many people lack a clear understanding of how breast cancer progresses through various stages and what each stage means for treatment decisions. This knowledge gap can leave newly diagnosed patients feeling overwhelmed when trying to comprehend their medical options.
Healthcare providers use a detailed staging system to classify breast cancer based on its progression. This staging guides treatment planning and helps predict potential outcomes. By understanding these stages, patients can better participate in treatment discussions and make informed decisions about their care path.
How doctors determine breast cancer stagesWhen oncologists evaluate breast cancer, they assess several key factors to determine its stage. This comprehensive evaluation goes far beyond simply identifying the presence of cancer cells. The staging process involves sophisticated imaging techniques, laboratory testing, and tissue examination to create a complete picture of the disease.
Physical examination serves as the starting point, with healthcare providers checking the breast tissue and surrounding areas for abnormalities. They also review medical history and symptoms to identify risk factors and potential patterns of disease progression. This hands-on assessment provides initial clues about the cancer's extent before more detailed testing begins.
Imaging tests play a critical role in visualizing the cancer and determining its spread. Mammograms, often the first test to detect breast abnormalities, use X-rays to identify suspicious areas in breast tissue. Ultrasounds help distinguish between solid tumors and fluid-filled cysts. MRIs provide detailed images of soft tissues to assess tumor size and location. CT scans and PET scans help evaluate whether cancer has spread beyond the breast to other organs.
Blood tests check for specific proteins that may indicate cancer activity and assess organ function to determine overall health status. These tests help oncologists understand how the body is responding to the cancer and evaluate which treatment options might be most appropriate.
Tissue biopsy remains the definitive method for diagnosing breast cancer. During this procedure, doctors remove a small sample of breast tissue for laboratory examination. This analysis confirms the presence of cancer cells and provides crucial information about the cancer's characteristics, including hormone receptor status and genetic markers that influence treatment decisions.
The five stages of breast cancer explainedStage 0 breast cancer, also called ductal carcinoma in situ (DCIS), represents the earliest form of breast cancer. At this stage, abnormal cells remain confined within the milk ducts and have not invaded surrounding breast tissue. Many women with stage 0 breast cancer experience no symptoms, and the condition is typically discovered during routine mammograms.
Although stage 0 breast cancer is non-invasive, treatment remains important to prevent progression to invasive cancer. Treatment options typically include breast-conserving surgery (lumpectomy) to remove the affected area, often followed by radiation therapy to eliminate any remaining cancer cells. Some patients, especially those with extensive DCIS or high risk factors, might consider mastectomy. Hormone therapy may be recommended for hormone receptor-positive DCIS to reduce recurrence risk.
Stage 1 breast cancer indicates that cancer has become invasive but remains relatively small and localized. It divides into two subcategories: Stage 1A involves tumors measuring up to 2 centimeters with no lymph node involvement, while Stage 1B involves microscopic cancer spread to nearby lymph nodes with very small or no detectable primary tumor.
Women with stage 1 breast cancer may notice a small lump or nipple discharge, though many cases remain asymptomatic and are detected through screening. Treatment typically involves surgical removal of the tumor through lumpectomy or mastectomy, depending on factors like tumor location and patient preference. Lymph node evaluation determines whether cancer cells have spread beyond the breast. Additional treatments may include radiation therapy, chemotherapy, hormone therapy, or targeted therapy based on specific cancer characteristics.
Stage 2 breast cancer represents a moderate progression where the cancer remains relatively contained but shows additional growth or spread. Stage 2A includes tumors up to 2 centimeters that have spread to 1-3 axillary lymph nodes, or tumors between 2-5 centimeters without lymph node involvement. Stage 2B encompasses tumors between 2-5 centimeters with spread to 1-3 axillary lymph nodes, or tumors larger than 5 centimeters without lymph node involvement.
Symptoms at this stage may include a palpable breast lump, skin changes, or nipple abnormalities. Treatment typically combines surgery (lumpectomy or mastectomy with lymph node removal) with additional therapies. Chemotherapy might be recommended before surgery to shrink the tumor or after surgery to eliminate remaining cancer cells. Radiation therapy usually follows breast-conserving surgery. Hormone therapy or targeted therapy may be prescribed based on the cancer's specific biological characteristics.
Stage 3 breast cancer indicates more extensive disease but has not spread to distant organs. This stage divides into three subcategories with increasing severity. Stage 3A involves tumors of any size with cancer in 4-9 axillary lymph nodes. Stage 3B includes tumors that have invaded the chest wall or skin, possibly causing visible swelling or ulceration. Stage 3C involves tumors of any size with cancer in 10 or more axillary lymph nodes, lymph nodes near the collarbone, or internal mammary lymph nodes.
People with stage 3 breast cancer often experience noticeable symptoms including breast pain, skin changes, nipple retraction, or swollen lymph nodes. Treatment typically begins with systemic therapy to target cancer throughout the body. Neoadjuvant chemotherapy (administered before surgery) aims to shrink tumors to make surgery more effective. Extensive surgery often follows, frequently involving mastectomy and axillary lymph node dissection. Post-surgical treatments include radiation therapy, hormone therapy, targeted therapy, and sometimes additional chemotherapy.
Stage 4 breast cancer, also called metastatic breast cancer, indicates that cancer has spread beyond the breast and nearby lymph nodes to distant organs such as the bones, lungs, liver, or brain. This represents the most advanced stage of breast cancer but does not mean treatment options are exhausted.
Symptoms vary depending on where the cancer has spread but may include bone pain, persistent cough, headaches, seizures, or unexplained weight loss. Treatment focuses on controlling cancer growth and managing symptoms to maintain quality of life. Systemic therapies form the foundation of treatment, including hormone therapy for hormone receptor-positive cancers, targeted therapies for HER2-positive cancers, chemotherapy, and immunotherapy. Localized treatments like surgery or radiation therapy may help manage symptoms in specific areas. Clinical trials often provide access to innovative treatments not yet widely available.
What the TNM system means for your diagnosisWhen doctors discuss breast cancer staging, they frequently reference the TNM system developed by the American Joint Committee on Cancer. This comprehensive classification method evaluates three key components to determine the overall cancer stage.
The "T" component assesses the primary tumor's size and extent. Classifications range from TX (primary tumor cannot be assessed) to T4 (tumor of any size with extension to chest wall or skin). Larger tumors generally indicate more advanced disease, though size alone does not determine overall staging.
The "N" component evaluates nearby lymph node involvement. Classifications range from NX (nearby lymph nodes cannot be assessed) to N3 (cancer in numerous lymph nodes or in lymph nodes near the collarbone). Lymph node involvement provides important information about cancer spread beyond the primary site.
The "M" component indicates whether the cancer has metastasized to distant parts of the body. Classifications include M0 (no distant metastasis) and M1 (distant metastasis present). The presence of metastasis automatically classifies cancer as stage 4 regardless of tumor size or lymph node status.
Recent updates to this system now incorporate biological factors beyond physical spread. Hormone receptor status indicates whether cancer cells contain receptors for estrogen or progesterone, which can fuel cancer growth. Targeted hormone therapies can block these receptors in hormone-positive cancers. HER2 status determines whether cancer cells produce excess HER2 protein, which promotes cancer cell growth. HER2-positive cancers can be treated with specific targeted therapies. Tumor grade assesses how abnormal cancer cells appear under a microscope, with higher grades indicating more aggressive disease.
How treatment approaches differ by stageEarly-stage breast cancer treatment aims for complete elimination of cancer with curative intent. Stage 0 and stage 1 breast cancers typically respond well to less intensive treatments. Breast-conserving surgery often proves sufficient for removing visible cancer while preserving normal breast appearance. Radiation therapy frequently follows to destroy any remaining microscopic cancer cells. Depending on biological factors like hormone receptor status, additional treatments such as hormone therapy may be recommended to reduce recurrence risk.
Intermediate-stage breast cancer requires more comprehensive treatment approaches. Stage 2 and some stage 3 cancers typically involve multimodal therapy combining local treatments (surgery and radiation) with systemic treatments (chemotherapy, hormone therapy, or targeted therapy). Treatment sequencing becomes important, with chemotherapy sometimes administered before surgery to shrink tumors and improve surgical outcomes. More extensive surgery may be necessary, potentially including mastectomy and removal of multiple lymph nodes. Reconstruction options are typically discussed for those undergoing mastectomy.
Advanced-stage breast cancer treatment focuses on prolonging life while maintaining quality of life. Stage 4 breast cancer generally requires ongoing treatment to control cancer growth. Systemic therapies form the foundation of treatment, with specific approaches determined by cancer subtype. Hormone therapy may be used for hormone receptor-positive cancers, while targeted therapies benefit those with HER2-positive disease. Chemotherapy may be recommended when cancer grows despite other treatments. Palliative treatments address specific symptoms and complications without necessarily targeting the cancer itself.
Treatment decisions consider multiple patient-specific factors beyond cancer stage. Age and overall health influence treatment tolerance and recommendations. Personal preferences regarding treatment intensity, side effects, and body image impact decisions between treatment options. Genetic factors, including mutations in genes like BRCA1 or BRCA2, may influence surgical decisions and treatment planning. Family history and reproductive factors can affect risk assessment and preventive strategies.
Life beyond diagnosis: Managing expectations and finding supportReceiving a breast cancer diagnosis understandably creates significant emotional challenges. Many patients experience fear, anxiety, sadness, or anger following diagnosis. Processing these emotions represents an important part of the cancer journey. Mental health support from therapists, counselors, or support groups can provide valuable tools for managing emotional responses.
Support systems play crucial roles in breast cancer recovery. Family members and friends provide practical assistance with daily responsibilities and emotional encouragement during difficult moments. Peer support groups connect patients with others sharing similar experiences, reducing isolation and providing practical coping strategies. Healthcare teams extending beyond oncologists may include nurses, social workers, nutritionists, and rehabilitation specialists who address different aspects of cancer care.
Lifestyle considerations can support overall health during and after treatment. Nutritional needs may change during treatment, with some therapies affecting appetite or taste preferences. Working with a nutritionist helps develop eating strategies that maintain strength during treatment. Physical activity, adjusted to current capabilities, improves energy levels, reduces side effects, and supports recovery. Adequate rest balances activity, with many patients experiencing increased fatigue during treatment periods.
Long-term surveillance remains important even after completing primary treatment. Follow-up schedules vary based on cancer stage and treatment history but typically include regular clinical examinations and imaging studies. Ongoing monitoring helps detect potential recurrence early when additional treatment would be most effective. Side effect management continues beyond active treatment, with some effects resolving quickly while others require longer-term strategies.
Many patients find that cancer experiences shift life perspectives in meaningful ways. Revisiting priorities and recognizing personal strength through adversity represent common themes in cancer survivorship. Finding meaning in cancer experiences helps many integrate their diagnosis into their life story in ways that acknowledge challenges while embracing future possibilities.
When to consider getting a second opinionSeeking additional medical perspectives proves particularly valuable in certain situations. Uncertain diagnosis or staging creates legitimate reasons to consult another specialist. Pathology results sometimes contain ambiguities or borderline findings that benefit from expert review. Complex cases with unusual features or multiple treatment options warrant diverse perspectives to ensure all possibilities receive consideration.
The process for obtaining second opinions follows several standard steps. Request medical records including pathology slides, imaging studies, and treatment recommendations from your current provider. Research specialists with expertise in your specific type of breast cancer, possibly at major cancer centers or academic medical institutions. Prepare questions addressing specific concerns about diagnosis, staging, or treatment options. During the consultation, provide complete information about your medical history and previous recommendations.
Insurance typically covers second opinion consultations when properly documented as medically necessary. Contact your insurance provider to understand specific requirements and potential out-of-pocket costs. Many cancer centers offer remote second opinion services reviewing records without requiring in-person visits, expanding access to expert consultations regardless of location.
Most importantly, remember that seeking additional perspectives demonstrates appropriate self-advocacy rather than distrust of your current provider. Healthcare professionals routinely consult colleagues on complex cases and generally support patients gathering comprehensive information. Second opinions sometimes confirm original recommendations, providing reassurance about your treatment path. Other times, they present alternative approaches worth considering, ensuring you make fully informed decisions about your care.
The outlook for breast cancer patients todayBreast cancer survival rates have improved significantly in recent decades due to advances in early detection and treatment. Five-year survival rates now exceed 90% for breast cancers diagnosed at stages 0, 1, or 2. Even with stage 3 breast cancer, five-year survival rates approach 70%. Stage 4 breast cancer, while still challenging, has seen improved outcomes with modern therapies, with many patients living years beyond diagnosis with good quality of life.
Research continues advancing treatment options across all breast cancer stages. Targeted therapies addressing specific genetic mutations expand treatment possibilities beyond traditional approaches. Immunotherapy harnessing the body's immune system shows promise for certain breast cancer subtypes. Minimally invasive surgical techniques reduce recovery time and improve cosmetic outcomes. Clinical trials explore novel treatment combinations and sequences to optimize effectiveness while minimizing side effects.
The breast cancer experience extends beyond medical treatments to encompass broader life adjustments. Many survivors describe finding strength they never knew they possessed. Connections with others sharing similar experiences create lasting support networks. Perspective shifts often include greater appreciation for daily joys and clearer recognition of personal priorities.
Most importantly, receiving a breast cancer diagnosis today means joining a community of millions of survivors who have navigated similar journeys. Their collective experience demonstrates that while cancer irrevocably changes life's path, it need not define life's meaning or limit its possibilities. With appropriate medical care, emotional support, and personal resilience, many breast cancer patients move beyond their diagnosis to embrace rich, fulfilling futures.
Breast Cancer Staging: Understanding Stages 0-4
Breast cancer is a type of cancer that starts growing in the breast tissue. Healthcare providers classify breast cancer into five stages, stage 0 to stage 4. The stage indicates how advanced the cancer is depending on several factors, such as the size of the tumor and the extent the cancer has spread. Stage 0 is the earliest, and stage 4 is the most advanced.
Understanding your cancer stage helps your healthcare team determine the ideal treatment plan and predict the outlook of your cancer.
After your healthcare provider has diagnosed breast cancer, they will typically do tests to determine the cancer stage. These tests include: Physical examination: This may involve examining your breast and surrounding areas as well as asking questions about your personal and family medical history. Imaging tests: Tests—such as X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI), positron emission tomography (PET) scans, and ultrasounds—can help give more information about your cancer and whether it may have spread in your body. Blood tests: Your healthcare provider may order blood tests to check for specific proteins and the function of organs such as your liver. Biopsy: Different forms of breast biopsy, such as the sentinel lymph node biopsy (SLNB), may also be helpful. The SLNB involves removing a sample from the sentinel lymph node—which is the first lymph node (a small organ that's part of your immune system) the cancer is likely to spread to—and examining it under a microscope to look for cancer cells. Healthcare providers may also test a biopsy for the presence, absence, or amount of hormone receptor proteins and human epidermal growth factor receptor 2 (HER2) proteins. The TNM Staging System The American Joint Committee on Cancer (AJCC), a team of cancer experts who oversee how cancer is classified, created the TNM staging system that most healthcare providers use to stage cancer. This system involves: T staging categories: The T categories consider the size of the primary tumor. They are designated by numbers 0-4, depending on tumor size and whether it has spread to the chest wall, skin, or underneath the breast. N staging categories: This category, which uses numbers 0-3, explains if and how much cancer has spread to nearby lymph nodes. M staging categories: This factor assesses whether and how much the cancer has spread (metastasized) to areas and organs farther from the breast tissue (distant organs), such as your liver and bones. An update to the AJCC's staging system means the TNM system also now assesses: Hormone receptor status: Whether or not the cancer cells have proteins called estrogen receptors or progesterone receptors HER2 status: How much HER2 protein the tumor makes Grade: How much the cancer cells look like normal cells Oncologists, or doctors specializing in diagnosing and treating cancer, use the information in the TNM staging system to determine a stage 0-4. Because it considers so many factors, staging breast cancer is a complex process. It's best to speak with your healthcare team to understand your cancer stage. Below is a table that summarizes these stages of breast cancer and what they may mean. Stage of Breast Cancer What It Means Stage 0 This is known as noninvasive breast cancer. The tumor is only present within the breast lobules (glands that can make milk) and ducts (tubes that can carry breast milk to the nipple). Stage 1 The cancer is now invasive, may measure up to 2 centimeters (cm), and may be found in the lymph node. Stage 2 This describes when breast cancer is up to 2-5 cm (or larger) or has spread to one to three lymph nodes. Stage 3 The cancer has spread to four to nine lymph nodes, or the tumor is larger than 5 cm and has spread to one to three lymph nodes, or the tumor is any size but has spread to the chest wall. Stage 4 This is the most advanced stage of breast cancer. The cancer has spread beyond the breast and nearby tissues to distant organs like the liver, bone, and brain. Cancer at this stage is noninvasive, meaning it is only within cells that line the breast ducts or lobules. Stage 0 breast cancer is also known ductal carcinoma in situ (DCIS). In-situ disease usually can't spread to the lymph nodes or other areas like invasive cancer can. Symptoms: You may not have any noticeable symptoms with stage 0 cancer, but you may have abnormal findings on a mammogram. Treatment: Your healthcare provider may recommend breast-conserving surgery (a partial mastectomy, in which a part of the breast rather than all of the breast tissue is removed). You may also need radiation in some cases. Outlook: DCIS is very treatable, and nearly everyone with this early-stage cancer can be cured with treatment. Stage 1 breast cancer is divided into substages: 1A: Tumors have not spread outside the breast but measure up to 2 centimeters. 1B: The tumor is less than 2 centimeters but has spread to the nearby lymph nodes in small groups. Tumors that meet the condition of stage 1B may still be classified as stage 1A if hormone receptor proteins are present because these proteins make the cancer less aggressive. Symptoms: Cancer at this stage may or may not cause symptoms. Symptoms that may occur include: Lumps in your breast Nipple discharge Skin dimpling Inverted nipple (the nipple goes inward) Treatment: Surgery to remove the cancer is the go-to treatment for stage 1 breast cancer. Healthcare providers sometimes also recommend chemotherapy and hormone therapy. Outlook: Stage 1 breast cancer is also considered early-stage, localized cancer (the cancer hasn't spread outside of the tissue where it began except for to nearby nodes). Localized breast cancers have a five-year relative survival rate of nearly 100%—meaning people who have it are, on average, nearly 100% as likely as those without it to live for at least five years after diagnosis. The subcategories of this invasive breast cancer include: Stage 2A: There's a tumor larger than 2 centimeters (but less than 5 centimeters) in the breast tissue that has not spread to the lymph nodes. Less commonly, this stage means there's no tumor in the breast, but smaller ones appear in lymph nodes in the underarm or by the breast bone. Stage 2B: The tumor is larger than 2 centimeters but less than 5 centimeters and has spread to nearby lymph nodes, or the tumor is larger than 5 centimeters but with no lymph node involvement. Symptoms: Stage 2 breast cancer may cause similar breast symptoms as stage 1 cancer. Treatment: Treatment for stage 2 breast cancer typically involves the use of medications (chemotherapy and other drugs) and surgery to remove part or all of the breast, followed by radiation therapy. The goal is to cure the cancer. Outlook: The five-year survival rate after treatment is about 93%. Stage 3 breast cancer is invasive. It's divided into these subcategories: Stage 3A: The breast tumor is larger than 5 centimeters and has spread to one to three lymph nodes, or the tumor is any size and has spread to four to nine lymph nodes. Stage 3B: Cancer has spread to the chest wall and may be found in up to nine lymph nodes. Stage 3C: The tumor is any size and has spread to the skin of the breast, chest wall, and 10 or more lymph nodes. Symptoms: You're more likely to have symptoms in stage 3 than earlier stages. Symptoms affect the breast and may include: A lump Skin texture changes, including dimpling or scaliness Open sores Itchiness Swelling Nipple discharge Treatment: Healthcare providers also aim for a cure when treating stage 3 breast cancer. They may recommend chemotherapy to help shrink the tumor before doing surgery. You may also need radiation therapy and additional medication after surgery. Outlook: While treatment is more challenging at this stage, the five-year relative survival is about 75%. This is also known as metastatic breast cancer. Cancer at this stage has spread to organs and parts of the body farther away from the breast. Symptoms: Stage 4 breast cancer symptoms vary depending on where the cancer has spread. For instance, cancer that has spread to the bones may cause fractures and pain. Cancer in the lungs may cause shortness of breath and difficulty breathing. Cancer in the brain may cause headaches and seizures. Cancer that has spread to the liver may cause jaundice, which is yellowing of the skin or white areas of the eyes. Treatment: This stage of breast cancer is considered incurable. However, treatments may help improve symptoms, slow cancer growth, and help you live longer. Outlook: The five-year survival rate is about 32%. Cancer may sometimes progress to a more advanced stage, especially if you don't treat it. How breast cancer may progress from one stage to another can also vary depending on factors like the activity of hormone receptor proteins and your family history of breast cancer. Still, feeling empowered to control what's in your control is important. Strategies that may be helpful in preventing or slowing down the progression of your cancer include: Reach and maintain a weight that you and your provider decided is optimal for you. Opt for a diet rich in fruits, vegetables, fish, lean protein, and whole grains instead of processed and ultra-processed foods like cakes, sausages, and sweetened beverages. Be physically active. You can speak with your healthcare provider about safe exercises for you and their intensity. Avoid alcohol. Evidence suggests its consumption increases the risk of developing breast cancer in the first place. Quit cigarette smoking, which has been linked to increased risk of death with breast cancer. Speak with your healthcare provider about dietary supplements that may help, such as vitamin D. Restaging Sometimes, breast cancer may be staged again after the initial staging. Your healthcare provider may suggest restaging your cancer if it worsens or recurs or to check how it has responded to treatment. Restaging uses the same tests your healthcare provider used to initially stage the cancer. Restaging can help healthcare providers understand your current health and guide future treatments, but the new stage classification doesn't replace the initial stage. The initial stage remains the most important when discussing statistics such as survival rates. The new stage may indicate your prognosis (outlook), though. Living with any stage of breast cancer can be challenging, as the different stages often require various forms of treatment that may come with unwanted side effects. It's important to talk to your healthcare provider about any side effects you experience so they can help you manage them. Depending on your breast cancer stage, you may want to consider enrolling in a clinical trial to try out new treatments. This may be particularly beneficial for people with stage 4 breast cancer, which is less treatable with current therapies. You can speak with your healthcare provider about eligibility and recommendations or search for trials on databases like ClinicalTrials.Gov. Having a support system in addition to your healthcare team can be helpful in navigating breast cancer. A strong support system may include family, friends, and a support group made up of others who have been diagnosed with breast cancer. If you've received a breast cancer diagnosis, your healthcare team will follow up with tests to determine the stage. The five stages of breast cancer, stages 0-4, help describe how advanced the cancer is and what treatment plan may be most effective. Healthcare providers most commonly use the TNM system to stage cancer. This system categorizes breast cancer into different stages using key factors like tumor size, spread of disease, lymph node involvement, and the presence of specific biomarkers. 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