An Overview of Stage 2 Breast Cancer

In This Article

It is fairly common for people to be diagnosed with stage 2 breast cancer. Stage 2 tumors are usually between 2 and 5 centimeters (cm) in diameter (1 to 2.5 inches) and may or may not have spread to lymph nodes. Treatment usually includes surgery (either a lumpectomy or mastectomy), and adjuvant chemotherapy is often recommended. Radiation therapy is given following a lumpectomy, but may or may not be needed after a mastectomy.

If the tumor is estrogen receptor-positive, hormonal therapy is usually given for five to 10 years, and for those who are postmenopausal, bisphosphonate therapy may be recommended as well to reduce the risk of recurrence. If the cancer is HER2-positive, targeted therapy is often used after primary treatment.

stage 2 breast cancer
 Verywell / Jessica Olah

Overview

Stage 2 breast cancer is considered "invasive," meaning that cancer cells have broken out of the ducts or lobules of the breast. This is not the same as metastatic (stage 4) breast cancer. It simply means that abnormal cells have passed through a thin layer of tissue called the basement membrane and have the potential to spread.

Staging

Cancers are scored and divided into stages by something called the TNM system. Stage 2 cancer can be either 2A or 2B.

In this system:

  • T stands for tumor size: In stage 2, the T score can range from zero to three. T0 means that a tumor cannot be detected in the breast. T1 includes tumors that have a diameter of 2 centimeters or less (an inch or less). T2 includes tumors that are between 2 centimeters and 5 centimeters in diameter. T3 includes tumors larger than 5 centimeters in diameter.
  • N stands for lymph node involvement: Stage 2 can be either zero or one. N0 (N-zero) would mean that cancer has not spread to any lymph nodes. N1mi describes cancers that have spread to lymph nodes but the spread can only be detected under a microscope (micrometastases). N1 is used to describe tumors that have spread to at least one lymph node near the tumor.
  • M stands for metastasis: All stage 2 cancer is M0, meaning no metastases are present.
Stage 2 Breast Cancers
Stage 2A: T0, N1, M0 No tumor has been found in breast tissue, but cancer cells have lodged in lymph nodes near your breast.
Stage 2A: T1, N1, M0 You have a tumor of 2 cm or smaller that has spread to at least one lymph node.
—OR—
Your tumor has invaded nearby tissue at least 0.1 cm and has spread to at least one lymph node.
Stage 2A: T2, N0, M0 Your tumor is over 2 cm or less than 5 cm, but hasn't affected any lymph nodes.
Stage 2B: T2, N1, M0 Your tumor is bigger than 2 cm and less than 5 cm, and has involved nearby lymph nodes.
Stage 2B: T3, N0, M0 Your tumor is more than 5 cm, but has not reached your chest wall or skin, and has not traveled to any lymph nodes.

Treatment

Your oncologist will compile all the test results on your cancer and give you a comprehensive diagnosis. Treatment options will be very similar to those for stage 1 breast cancer, with some variations for larger tumors or high-grade types of cancer.

  • Local treatments: Surgical choices will include a lumpectomy or a mastectomy, which may be followed by radiation treatments to the breast or chest wall. If radiation is recommended, that will affect the timing of any breast reconstruction that you may have. If you opt for a mastectomy, it will also be important to consider the pros and cons of having a single vs. a double mastectomy.
  • Systemic treatments (adjuvant): These therapies will affect cells all over your body and will help prevent a recurrence. Depending on your age, general health, hormone receptor status, lymph node involvement, and HER2 testing results, you may be given chemotherapy, hormonal therapy including either tamoxifen or an aromatase inhibitor, or a HER2 targeted therapy such as Herceptin.
  • Neoadjuvant treatment: You may prefer breast-conserving surgery but have a tumor that is too large to have a good result after a lumpectomy. In this case, your oncologist may suggest having systemic treatments before surgery, in hopes of shrinking the tumor. When this approach is successful, the smaller tumor can be removed and local treatment may be given if needed. Some tumors don't respond well to pre-treatment; when that happens, a mastectomy will be necessary. You may then consider breast reconstruction.

    You may spend three to 18 months or longer in the active treatment of stage 2 breast cancer. It may be as simple as surgery and six weeks of radiation or involve the full array of chemo, radiation, and biologic therapies.

    Survival Rates

    At the onset, it is important to understand that survival rates are not a direct indication of how long you will live following the diagnosis and treatment of breast cancer. Rather, rates reflect how many people on average will survive for the prescribed period of time at that stage.

    Clearly, some will live for less than the prescribed time and others for far longer. Each case is individual.

    According to the American Cancer Society, the five-year survival rate for stage 2 breast cancer is 93% for women who have completed treatment. By contrast, women with stage 3 cancer have a five-year survival rate of 72%.

    Treatments have improved greatly over that time, so you may hope for longer-term survival if you are newly diagnosed.

    Follow-Up Care

    Irrespective of the course of treatment you undergo, you will have a five-year minimum follow-up period with your oncologist; check-ups will take place every three then every six months.

    During this time, you may need to take hormone therapy if your tumor was hormone sensitive. Some oncologists are now recommending hormonal therapy that goes beyond five years for those with estrogen receptor-positive tumors.

    If your tumor is estrogen-receptor positive, your oncologist may also recommend that you use bisphosphonate therapy if you are postmenopausal. Bisphosphonates are medications that are used for osteoporosis but appear to help reduce the chance that breast cancer will spread to bones (the most common site of metastases).

    Unlike some cancers, routine scans are not usually done after primary treatment for stage 2 breast cancer has been completed. The reason for this, even though recurrence is a possibility, is that finding a recurrence early (before symptoms appear) does not improve survival. For those who have finished treatment, it's important to be familiar with the potential signs and symptoms of a recurrence and to contact your doctor with any concerns.

    After five years, you may only need to see your oncologist annually, but these visits most often continue throughout your life. Check-ups are important to make sure that recovery is going smoothly and that treatment for recurrence won't be needed. 

    Coping

    If you've been recently diagnosed with stage 2 breast cancer you may feel overwhelmed with all there is to learn.

    Thankfully, you have a multitude of resources for receiving support and learning more about your diagnosis. Ask for help and reach out to your loved ones. Even if you are used to being "the strong one," lean on others for support. Become involved in one of the active breast cancer support groups or support communities available.

    Most importantly, learn how to be your own advocate in your cancer care. Cancer treatments are changing rapidly, and it's important to understand the options available so you can be an active member of your cancer treatment team.

    While it may seem frightening to be diagnosed with stage 2 breast cancer, remember that it is still considered early-stage cancer. Most women diagnosed at this stage do extremely well with treatment and go on to live normal lifespans.

    A Word From Verywell

    If you've been diagnosed with stage 2 breast cancer, the outlook is very good. You are more likely to have chemotherapy and/or radiation therapy than if your tumor was stage 1, but these tumors are still very treatable. Make sure you understand your treatment plan and remember that you are the most important person on your cancer care team.

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