Stage 3 Breast Cancer

What is stage 3 Breast Cancer?

Stage 3 breast cancer indicates that the cancer has spread to the lymph nodes in close proximity to the breast. It may have also spread to the breast’s skin and the chest wall. Researchers also refer to it as locally advanced breast cancer. Doctors consider various factors before confirming a patient’s final stage.

They may take out a small sample of the cancer to study it for:

• The number of receptors
• Human epidermal growth factor receptors [¹]
• The cancer’s grade

Staging done before surgery is referred to as the clinical stage, and staging after surgery is done is called the pathologic stage.

What are the subtypes of stage 3 Breast Cancer?

There Are several subtypes of stage 3 breast cancer, and the classification has undergone numerous changes over the years. The most widely used staging system studies the tumor size, how far it has spread to other lymph nodes, and if the cancer has reached other parts of the body. The results are then combined to determine the stage of cancer.

Based on these criteria, stage 3 breast cancer has the following subtypes [²]:

Stage 3A: No tumor can be observed in the breast. The tumor may be of any size, but the cancer is found in 4 to 9 axillary lymph nodes. It has not spread to other parts of the body. Aggressive treatment can cure stage 3A breast cancer. However, there is a high risk that it can grow back.

Stage 3B: At this stage, the tumor has made its way to the skin of the breast and chest wall. This includes the structures in close proximity to the lungs, such as the muscles, skin, connective tissue, and muscles. The cancer has also broken down the skin and caused swelling. In addition, the cancer may have spread to up to 9 axillary lymph nodes. It has not spread to other parts of the body.

Stage 3C: At this stage, the tumor may be of any size. However, the cancer can be found within the chest wall, causing swelling and an ulcer. It has also spread to 10 or more axillary lymph nodes around the collarbone, armpit, and breastbone. Stage 3C breast cancer has not spread to other parts of the body.

In addition to the subtypes of stage 3 breast cancer, doctors will also try to determine the tumor type. Tumors are graded based on the appearance of the cells compared to normal cells. Subtypes of tumors include:

• HER2-positive
• ER-positive
• Triple-negative

Stage 3 Breast Cancer staging and diagnosis

Breast Cancer staging

In general, the TNM system is used to describe and classify cancers, including Breast Cancer, where:

T (tumor) describes the size and location of the tumor

N (nodes) indicates whether or not it has spread to lymph nodes that are nearby

M (metastasis) describes if and how far the cancer has spread from its origin

How common is stage 3 Breast Cancer?

Breast cancer in women is highly prevalent and accounts for 15% of all newly reported cases in the US. Nearly 298,000 cases of invasive breast cancer will be diagnosed in women, and about 43.700 women will die from their condition [⁴].

There is a 1 in 8 chance that a woman will develop breast cancer in her lifetime. This also means there is a 7/8 chance that she will never develop breast cancer. More than 70% of women will survive their cancer for five years or more after the diagnosis [⁵]. However, the American Cancer Society pegs the 5-year survival rate for stage 3 breast cancer at 86% [⁶].

How is stage 3 Breast Cancer diagnosed?

Doctors will use a number of tests to diagnose stage breast cancer. Some of the most common procedures include:

• Physical breast exam: The doctor will check under the breast and armpit to feel for any lumps that stand out.
• Mammogram: This is a more comprehensive and accurate test that can provide conclusive results. Mammography are X rays of the breast that can screen for breast cancer. If the doctor detects an abnormality on screening, they may evaluate further diagnostics to learn more.
• Breast ultrasound: An ultrasound is used to produce images of the structures within the body. Ultrasound is primarily used to distinguish between a solid mass and a fluid-filled cyst in breast lumps.
• Biopsy: This procedure involves the removal of a sample of breast cells to diagnose breast cancer. It is the only definitive means of diagnosing breast cancer. During a biopsy. A doctor uses a specialized needle guided by an imaging test such as an X-ray to remove a small sample of tissue from the target area. A small metal marker is left at the site so that the area can be identified in future tests.
• Magnetic resonance imaging (MRI): An MRI machine can be used to create detailed pictures of the interior of the breast. An MRI does not use radiation to create these images and can help make a diagnosis on what type of treatment is needed.
• PET CT scan: This procedure combines a PET scan with a CT scan to provide more detailed information about the cancer. The PET scan uses a radioactive drug to identify areas of the body where the cells are more active than is normal. CT scans take X-rays of the target area.

Note that not all patients will need all of the above tests. Your healthcare provider will identify the most appropriate tests depending on your specific circumstances, along with any symptoms that you may be experiencing.

Stage 3 Breast Cancer symptoms

The most common symptoms of stage 3 breast cancer include:

• Abrupt changes to the skin around the breast, including redness, color changes, dimpling, open sores, and scaliness
• The breast and armpit areas have an unusual lump or swelling that can be felt by the touch
• Nipple discharge (which may be a range of colors including green, yellow, red, and opaque
• Pain and irritation around the breast
• Swollen breasts that are red and warm to the touch
• Flaking and peeling around the nipple
• Flattened or inverted nipple
• Unusual changes to the shape and size of the breast

Stage 3 Breast Cancer Treatment

There are several options for stage 3 breast cancer that include surgery, hormone therapy, targeted therapy, and chemotherapy, among others. Some cases of stage 3 breast cancer are operable but may still be treated with systemic therapy; however, surgery may not be the right option if doctors are not confident in their ability to clear out enough cancerous cells.

Stage 3 Breast Cancer primary/first-line treatment

The primary treatment for stage 3 breast cancer starts with chemotherapy and the use of drugs to kill cancer cells. The primary goal of chemotherapy is to reduce the size of the tumor and decrease the number of cancerous cells in the body. It is worth noting that chemotherapy can also harm normal cells and can cause several side effects, including hair fall.

For instance, damage to cells in the lining of the digestive tract can also cause diarrhea, mouth sores, and nausea.

The patient may also undergo targeted therapies through the use of drugs that target specific characteristics of cancer cells, including proteins and pathways that are used to evade the body's defense. A common example is the prescription of Perjeta and Herceptin drugs [⁷].

The patient then undergoes surgery to remove the breast cancer. This procedure may involve mastectomy, which removes the entire breast. In some cases, a mastectomy may not be required if the medication worked effectively.

This is followed up by radiation therapy to target leftover cancerous cells. The doctor may also prescribe chemotherapy, hormone therapies, and various targeted therapies to treat stage 3 breast cancer.

Finally, patients may be asked to take specific drugs to help minimize the likelihood of cancer recurring.

Other types of treatment for stage 3 Breast Cancer

Second-line treatment for stage 3 breast cancer involves chemotherapy, targeted therapy, and hormonal therapy before or after surgery. These are as follows:

• Chemotherapy: Using drugs to slow or kill cancer cells. The most common drugs include carboplatin, paclitaxel, and doxorubicin.
• Targeted therapy: This treatment focuses on mitigating the harm done by cancerous cells to healthy organs and normal cells. The most commonly used targeted therapies include monoclonal bodies.
• Hormonal therapy: The goal of hormone therapy is to treat advanced hormone-positive breast cancer and to reduce the risk of a recurrence. It is usually prescribed for at least 5 hours.

Can stage 3 Breast Cancer be cured?

Stage 3 breast cancer is curable with aggressive treatment. However, there is a high risk of recurrence after treatment. This is why women are often prescribed hormonal therapy to reduce the risk that the cancer will grow back after surgery.

Studies show that more than 70% of women (70 out of 100) will survive stage 3 breast cancer for five years or more after diagnosis [⁸].

Prognosis: Stage 3 Breast Cancer survival rate

Stage 3 Breast Cancer survival rate

Thanks to improvements in diagnostics and treatment plans, women who have stage 3 breast cancer have an improved outlook on life. The treatments have improved thanks to new clinical trials. It is important to note that the survival rate for stage 3 breast cancer depends mostly on how quickly the condition is diagnosed.

The survival rate for stage 3 breast cancer is 86%, according to the American Cancer society. Note that this figure does not distinguish between the subtype of stage 3 breast cancer. In general, the life expectancy of female patients with breast cancer depends on various factors such as:

• Their overall age
• Their overall health
• The overall size of tumors
• Their response to the treatment

Stage 3 Breast Cancer recurrence rate

It is possible for stage 3 breast cancer to return after treatment. Studies have shown that chemotherapy, along with radiation therapy, leads to a low local, regional recurrence rate of 9% in breast cancer. By comparison, only using chemotherapy leads to a 32% local and regional recurrence [⁹].

In addition, stage 3 breast cancer recurrence rate can be significantly improved by combining hormonal therapy with radiation. Studies have shown that hormonal therapy with radiation leads to an 8% recurrence rate compared to 35% for chromotherapy alone [¹⁰].

Stage 3 Breast Cancer growth rate

Studies have shown that, on average, breast cancer can double in size every six months. However, there is a large interindividual variability in breast cancer growth rate because every person and cancer are different. Some of the most common factors that affect breast cancer growth rate include genetics and age, besides the stage and grade of the cancer.

Lifestyle changes for preventing and managing Breast Cancer

There are several lifestyle changes that a patient can make to prevent breast cancer and manage their symptoms.

• Healthy weight: studies have shown that getting to a healthy weight can reduce the risk of breast cancer. Being overweight has been linked with various forms of cancer and can also increase the risk of dying from breast cancer.
• Being active: Leading a sedentary lifestyle can increase one’s risk of dying from breast cancer. However, being active and working out can allow a person to lead a healthy lifestyle. Physical activity not only improves the immune system but also lowers the odds of dying from breast cancer.
• Eating a healthy diet: research suggests a positive link between a healthy diet and a low cancer recurrence. Although it is not clear what foods should be eaten or avoided, it is helpful to eat fruits, vegetables, whole grains, fish, and chicken compared to those who eat refined sugars, red meats, and processed meats. [¹¹]

Conclusion

Takeaway

Stage 3 breast cancer is one of the leading causes of death in women across the US. However, it is also preventable with early diagnosis and treatment. Improving lifestyle factors, such as eating a balanced diet and maintaining a healthy weight, can improve the symptoms of breast cancer.

It is recommended for patients to follow up with their physicals, radiologists, and pathologists who specialize in stage 3 breast cancer to effectively treat the disease.