Understanding your diagnosis
Stage and biomarkers turn a diagnosis into a treatment plan.
A diagnosis of breast cancer is only the starting point. The stage describes how extensive the disease is, and biomarkers describe how it is likely to behave and respond to treatment.
Together they help a multidisciplinary team decide which treatments to consider and in what order.
What staging describes
Staging describes the extent of the cancer. It generally considers the size and extent of the tumor, whether lymph nodes are involved and whether the disease has spread beyond the breast.
Staging is used to compare treatment options and to plan the sequence of care. It is determined from examination, imaging and pathology together.
Biomarkers
Breast cancer is not a single disease. Biomarkers help determine which systemic treatments may be effective. Commonly reported biomarkers include:
- Estrogen receptor, or ER
- Progesterone receptor, or PR
- Human epidermal growth factor receptor 2, or HER2
- A proliferation marker such as Ki-67, when it is reported
Genomic assays
In selected cases, a genomic assay may be used to provide additional information about the likely benefit of certain systemic treatments.
These tests are not appropriate for every patient. Whether one is useful depends on the tumor type, stage and the treatment question being asked.
Why this affects the timing of surgery
For some patients, systemic treatment such as chemotherapy or HER2-directed treatment may be recommended before surgery. Stage and biomarkers are part of how that decision is made, which is why they are reviewed before a surgical plan is finalized.
What staging and biomarkers cannot do
Questions for your clinical team
- What is the stage, and what does it mean for my options?
- What are my ER, PR and HER2 results?
- Could systemic treatment be recommended before surgery?
- Is a genomic assay relevant in my case?