Doctors use a clinical system developed by the American Joint Committee on Cancer to determine the stage of a patient's cancer. The AJCC system is also called the TNM system. It is based on the size of the tumor, T; the extent of lymph node involvement, N; and the presence or absence of metastasis, M. Staging helps patients understand their diagnosis and physicians decide on the appropriate treatment.
Stage II Breast Cancer
There are two distinct sets of clinical characteristics that signify Stage II Breast cancer. Stage IIA refers to breast cancer in which there is no apparent tumor visible in the breast, but cancer cells are present in the lymph nodes underneath the arm (the axillary lymph nodes). Stage IIA also can refer to breast cancer characterized by a tumor smaller than 2 centimeters accompanied by the presence of cancer cells in the lymph nodes under the arm, or to tumors in the breast between 2 and 5 centimeters that have not yet extended into the axillary lymph nodes.
Stage IIB refers to two situations. The first is characterized by a tumor between 2 and 5 centimeters with spread to the axillary lymph nodes. The second is characterized by a tumor in the breast that is 5 centimeters large or larger, with no cancer cells present in the lymph nodes.
Treatment
The treatments for Stage II breast cancer may involve a lumpectomy or mastectomy to remove the cancer, potentially accompanied by radiation. While Stage I patients who undergo a mastectomy generally do not need radiation, Stage II patients usually benefit from a combination of mastectomy and radiation. Chemotherapy also is usually recommended for Stage II patients. Hormone therapy is an additional treatment prescribed to nearly all patients with hormone receptive cancers.
Lumpectomy or Mastectomy
Lumpectomy involves removing a portion of the breast and tissue surrounding the lump. It is designed to preserve the breast, and is usually accompanied by radiation. In some cases, this is an option for patients with Stage II breast cancer, but mastectomy is generally the recommended treatment. Mastectomy involves removal of the affected breast. With Stage II cancer, if the size of the tumor is larger than 2 inches (or 5 centimeters) in size, the mastectomy is generally accompanied by radiation. Patients with large tumors may be given neoadjuvant chemotherapy (chemotherapy prior to surgery) to shrink the tumor to make it easier to remove.
Chemotherapy
Chemotherapy is recommended for all patients with Stage II breast cancer following their lumpectomy or mastectomy, unless a patient is unable to undergo chemotherapy. Women with large tumors may also receive neoadjuvant chemotherapy prior to their surgery to reduce the size of the tumor. The chemotherapy drugs most commonly used in the treatment of breast cancer include Adriamycin, Cytoxan, Amethopterin, Taxol, Adrucil, Navelbine, Paraplatin, Ellence, Taxotere, Gemzar and Xeloda
Hormone Therapy
Hormone therapy generally follows surgery and chemotherapy and may be recommended for up to five years after the cancer is diagnosed and treated. Hormone therapy is effective as a treatment for Stage II cancer only if the tumor is hormone receptor positive. Tamoxifen is the most common type of hormone therapy prescribed in the treatment of breast cancer. Potential side effects of tamoxifen include an increased risk of uterine cancer and/or blood clots.
Radiation
Radiation usually follows both a lumpectomy and a mastectomy. It is designed to remove any cancer cells that remain after the surgery.
Tags: lymph nodes, cancer cells, accompanied radiation, axillary lymph, axillary lymph nodes, breast cancer, breast cancer
