Stage IIIA, IIIB, & IIIC Treatment Options
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 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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