Stages and grades of breast cancer
The stage of a cancer tells you how big it is and whether it has spread. It helps your doctor decide which treatment you need.
Stage 4 breast cancer has spread to another part of the body. It is also called advanced cancer or secondary breast cancer. The aim of treatment is to control the cancer and any symptoms. Treatment depends on a number of factors.
The stage of a cancer tells you how big it is and whether it has spread. It helps your doctor decide which treatment you need.
Stage 4 breast cancer has spread to another part of the body. It is also called advanced cancer or secondary breast cancer. The aim of treatment is to control the cancer and any symptoms. Treatment depends on a number of factors.
There are different systems used in the UK to stage breast cancer. Stage 4 is part of the number staging system. Doctors may also use the TNM staging system.
Staging for breast cancer is very complex. Many different factors are considered before doctors can confirm your final stage. Speak to your doctor or breast cancer nurse specialist if you have any questions about your staging. Below is a simplified description of stage 4 breast cancer.
In stage 4 breast cancer:
the cancer can be any size
the may or may not contain cancer cells
the cancer has spread (metastasised) to other parts of the body such as the bones, lungs, liver or brain
TNM stands for Tumour (T), Node (N) and Metastasis (M). The staging is different depending on the type of cancer you have.
The information below is an overview of the TNM staging for all types of cancer.
T describes the size of the tumour (cancer)
N describes whether there are any cancer cells in the nearby lymph nodes
M describes whether the cancer has spread to parts of the body further away from where the cancer started
The doctor gives each factor (T, N and M) a number. The number depends on how far the cancer has grown or spread.
So, a very small cancer which hasn't spread to the lymph nodes or elsewhere in the body may be T1 N0 M0.
A larger cancer that has spread into the nearby lymph nodes and to another part of the body may be T3 N1 M1.
Your doctor will take many different factors into account when deciding which treatment is best for you. These include:
the type of cells the cancer started in
which part of your body the cancer has spread to
the treatment you have already had
your general health
whether you have had the
whether the cancer is growing slowly or more quickly
whether the cancer cells have receptors for particular cancer drugs
Secondary breast cancer may respond to several types of treatment. Doctors usually start with treatment that has as few side effects as possible.
Hormone therapy is a common treatment for secondary breast cancer. It can often shrink and control the cancer wherever it is in the body. It works well if the cancer cells have particular proteins called hormone receptors.
If one hormone therapy stops working so well, your doctor might suggest you try a different one.
Your doctor might suggest chemotherapy if your cancer doesn't have hormone receptors or has spread to the liver or lungs.
There are different types of targeted and immunotherapy drugs for secondary breast cancer. They include trastuzumab (Herceptin) and palbociclib.
You might have radiotherapy if the cancer has spread to the bones or the skin near the breast.
You may have other treatments too. These include:
drugs that strengthen the bones called bisphosphonates
medicines to control symptoms that the cancer causes
surgery to help to relieve symptoms
Last reviewed: 06 Jun 2023
Next review due: 06 Jun 2026
Find out more about Treatment for secondary breast cancer
You have a number of tests to check for breast cancer. This includes a breast examination, a mammogram, a biopsy and scans.
Secondary breast cancer is different from locally advanced breast cancer. You have tests such as a biopsy and a CT scan to help diagnose secondary breast cancer.
The TNM system is a way of staging breast cancer. TNM stands for Tumour, Node, Metastasis.
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