Staging Explained

Staging Explained

December 14, 2021
Everett Bonner, MD
Everett Bonner, MD

Breast Surgery



A very common question that patients will ask you at the time of diagnosis: “Doc, what’s my stage?” Well, there’s a lot of factors that go into staging.


Traditionally, staging has always been the size of the tumor, lymph node metastasis plus or minus, or if there’s distal metastasis, which means, has the cancer spread to other parts of the body? Breast cancer has actually taken it a little step further. We now start looking at the tumor markers.


You’ll hear the terms estrogen receptor, progesterone receptor, and HER2 neu status. Those are considered biomarkers, and those also help guide the staging of breast cancers. We also look at grade. And there’s high grade, intermediate grade and low grade. And all those factors are determined for breast cancer now on your staging. And so now we look at size, lymph node metastasis, distal metastasis, your tumor markers, your grade. And there is some testing called oncotyping, which we’ll discuss in some later videos.


All those are incorporated in formulating your staging. The importance of staging determines prognosis. Some of it determines your treatment course on surgery, on chemotherapy, and even in radiation.


Key Takeaways

1. Staging has always been determined based on the size of the tumor, lymph node metastasis, or if there’s distal metastasis.

2. With breast cancer, we now look at the tumor markers and grade.

3. There’s high grade, intermediate grade and low grade.

4. Staging will determine your prognosis, and whether you get surgery, chemotherapy, or radiation in treatment.