Stage IIIA, IIIB, & IIIC Treatment Options

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Stage III is divided into subcategories known as IIIA, IIIB, and IIIC.

In general, stage IIIA describes invasive breast cancer in which either:

• no tumor is found in the breast or the tumor may be any size; cancer is found in 4 to 9 axillary lymph nodes or in the lymph nodes near the breastbone (found during imaging tests or a physical exam) or
• the tumor is larger than 5 centimeters (cm); small groups of breast cancer cells (larger than 0.2 millimeter [mm] but not larger than 2 mm) are found in the lymph nodes or
• the tumor is larger than 5 cm; cancer has spread to 1 to 3 axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy)

Still, if the cancer tumor measures more than 5 cm across and:

• is grade 2
• cancer is found in 4 to 9 axillary lymph nodes
• is estrogen-receptor-positive
• is progesterone-receptor-positive
• is HER2-positive

it will likely be classified as stage IB.

In general, stage IIIB describes invasive breast cancer in which:

• the tumor may be any size and has spread to the chest wall and/or skin of the breast and caused swelling or an ulcer

and

• may have spread to up to 9 axillary lymph nodes or
• may have spread to lymph nodes near the breastbone

Still, if the cancer tumor measures more than 5 cm across and:

• is grade 3
• cancer is found in 4 to 9 axillary lymph nodes
• is estrogen-receptor-positive
• is progesterone-receptor-positive
• is HER2-positive

it will likely be classified as stage IIA.

Inflammatory breast cancer is considered at least stage IIIB. Typical features of inflammatory breast cancer include:

• reddening of a large portion of the breast skin
• the breast feels warm and may be swollen
• cancer cells have spread to the lymph nodes and may be found in the skin

In general, stage IIIC describes invasive breast cancer in which:

• there may be no sign of cancer in the breast or, if there is a tumor, it may be any size and may have spread to the chest wall and/or the skin of the breast

and

• the cancer has spread to 10 or more axillary lymph nodes or
• the cancer has spread to lymph nodes above or below the collarbone or
• the cancer has spread to axillary lymph nodes or to lymph nodes near the breastbone

Still, if the cancer tumor measures any size and:

• is grade 2
• is estrogen-receptor-positive
• is progesterone-receptor-positive
• is HER2-positive or negative

it will likely be classified as stage IIIA.

Treatment to the breast

• total mastectomy followed by radiation or
• chemotherapy to shrink the cancer tumor and/or treat cancer in the lymph nodes, followed by lumpectomy and radiation or
• chemotherapy to shrink the cancer tumor and/or treat cancer in the lymph nodes, followed by total mastectomy and radiation

Treatment to the lymph nodes

• axillary lymph node removal and
• possible radiation to supraclavicular and/or internal mammary lymph nodes

Chemotherapy

• chemotherapy is almost always recommended

Hormonal therapy

• hormonal therapy is prescribed for people with hormone-receptor-positive cancer

Targeted therapy

• targeted therapy may be used to treat cancers that have certain characteristics (for example, cancers that are HER2-positive)

Treatment to other parts of the body

• does not apply

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