Stage IIA & IIB Treatment Options
Stage II is divided into subcategories known as IIA and IIB.
In general, stage IIA describes invasive breast cancer in which:
- no tumor can be found in the breast, but cancer (larger than 2 millimeters [mm]) is found in 1 to 3 axillary lymph nodes (the lymph nodes under the arm) or in the lymph nodes near the breast bone (found during a sentinel node biopsy) or
- the tumor measures 2 centimeters (cm) or smaller and has spread to the axillary lymph nodes or
- the tumor is larger than 2 cm but not larger than 5 cm and has not spread to the axillary lymph nodes
Still, if the cancer tumor measures between 2 and 5 cm and:
- has not spread to the lymph nodes or parts of the body away from the breast
- is HER2-negative
- is hormone-receptor-positive
it will likely be classified as stage IB.
Similarly, if the cancer tumor measures between 2 and 5 cm and:
- has not spread to the lymph nodes
- is HER2-negative
- is estrogen-receptor-positive
- is progesterone-receptor-negative
- has an Oncotype DX Recurrence Score of 9
it will likely be classified as stage IA.
In general, stage IIB describes invasive breast cancer in which:
- the tumor is larger than 2 cm but no larger than 5 cm; small groups of breast cancer cells — larger than 0.2 mm but not larger than 2 mm — are found in the lymph nodes or
- the tumor is larger than 2 cm but no larger than 5 cm; cancer has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy) or
- the tumor is larger than 5 cm but has not spread to the axillary lymph nodes
Still, if the cancer tumor measures between 2 and 5 cm and:
- cancer is found in 1 to 3 axillary lymph nodes
- is HER2-positive
- is estrogen-receptor-positive
- is progesterone-receptor-positive
it will likely be classified as stage IB.
Treatment to the breast
- total mastectomy; radiation after mastectomy may be needed or
- lumpectomy plus radiation, in some cases following chemotherapy to shrink a large single cancer
Treatment to the lymph nodes
- sentinel lymph node biopsy, also known as sentinel lymph node dissection (preferred approach) or
- axillary lymph node biopsy
and
- possible radiation to supraclavicular and/or internal mammary lymph nodes
Chemotherapy
- chemotherapy is commonly recommended
Hormonal therapy
- hormonal therapy is prescribed for people with hormone-receptor-positive cancer
Targeted therapy
- targeted therapy medicines may be used to treat cancers that have certain characteristics (for example, cancers that are HER2-positive)
Immunotherapy
- immunotherapy may be recommended before and after surgery if the cancer is triple-negative
Treatment to other parts of the body
- does not apply
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