What Are the Stages of Breast Cancer?
Medically reviewed by: Dr. Jay R. Anam
Topics covered in this Article:
Overview
In this video, Dr. Jay R. Anam (Breast cancer surgeon, SSO Hospital, Mumbai) will inform us about 5 pages of breast cancer and how they are diagnosed. The stage of breast cancer is determined by cancer’s characteristics, such as how large it is and whether or not it has hormone receptors.
TNM Staging
The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer (AJCC). The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.
TNM means T – Tumor Size, N- Nodal status and M- Metastasis. TNM staging is a universal language for understanding for classifying the extent of the spread of cancer.
Breast cancer staging
The breast cancer stage is usually expressed as a number on a scale of 0 through IV
Breast cancer Stage 0
Breast cancer stage 0- describes non-invasive non-cancerous lumps which may later be cancerous such as Ductal carcinoma in situ , Lobular carcinoma in situ and Paget’s disease of the nipple.
Breast cancer Stage I
- The tumour measures up to 2 cm.
- Cancer has not spread outside the breast; no lymph nodes are involved
- In some chances there is no tumour in the breast; instead, small groups of cancer cells larger than 0.2 mm but not larger than 2 mm are found in the lymph nodes or there is a tumor in the breast that is no larger than 2 cm, and there are small groups of cancer cells — larger than 0.2 mm but not larger than 2 mm — in the lymph nodes.
This does not impact much on treatment or prognosis. Therefore this is included in stage 1.
Breast Cancer Stage II
- No tumor can be found in the breast, but cancer (larger than 2 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
- The tumor measures 2 cm or smaller and has spread to the axillary lymph nodes
- The tumor is larger than 2 cm but not larger than 5 cm and has not spread to the axillary lymph nodes
Stage 1 and Stage 2 breast cancer are called early stage of breast cancer.
Breast cancer Stage III
- 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
- The tumor is 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
- The tumor is larger than 5 cm; cancer has spread to more than 3 axillary lymph nodes or to the lymph nodes near the breastbone.
Stage III breast cancer is also called as locally advanced breast cancer.
Breast cancer Stage IV
Stage IV describes invasive breast cancer that has spread beyond the breast and nearby lymph nodes to other organs of the body, such as the lungs, distant lymph nodes, skin, bones, liver, or brain.
Breast cancer is detected in the early stages can be cured completely. If you believe you feel a lump in your breast, talk with your doctor to determine the next best steps. They will help guide you through the diagnosis and treatment process.
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Facing breast cancer surgery is a brave step, and we know the recovery process may feel overwhelming at times. One aspect of recovery many patients encounter is managing surgical drains.
While these medical devices play a crucial role in your healing, they can be intimidating at first. But don’t worry. With the right knowledge and tools, you can manage them confidently and focus on feeling better.
This guide is here to walk patients and caregivers through every step of drain care—from the basics to troubleshooting to emotional support. By the end, you'll feel prepared to tackle this part of your recovery with ease.
Author
Dr. Jay Anam
Breast Cancer Surgeon and Oncoplasty specialist in Mumbai
Introduction
Why are surgical drains important after breast cancer surgery? These small, plastic tubes help remove excess fluids that can build up in your body as you heal. Getting rid of this fluid reduces swelling, prevents complications like infections, and helps your body recover faster.
We’ll cover everything you need to know, including how to empty and clean your drains, spot signs of infection, manage discomfort, and return to daily life with confidence.
Understanding Surgical Drains
To start, it’s helpful to understand what surgical drains are and why they’re used.
What Are Surgical Drains and Why Are They Necessary?
After surgery, your body produces fluid as part of its natural healing process. Sometimes, this fluid needs help draining so it won’t pool under the skin. That's where surgical drains come in.
Types of Drains
There are a few kinds of surgical drains commonly used:
- Jackson-Pratt (JP) drain – Often shaped like a small bulb, this popular option collects fluid that you can measure and empty.
- Hemovac drain – A slightly larger round container, often used for higher drainage needs.
Your surgeon will determine the best type for you based on your surgery.
How Long Will They Stay in Place?
The timeline varies. Most patients have their drains for 7 to 14 days, but it depends on how much fluid they produce. Don’t worry; your doctor will remove them once output slows down.
Step-by-Step Drain Care Guide
Drain care is manageable if broken down into steps. Let's cover the essentials.
How to Empty the Drain Properly
- Wash your hands thoroughly with soap before touching the drain.
- Unplug the bulb or container, holding it upright.
- Carefully pour the fluid into a measuring cup.
- Record the amount and time in a log to share with your doctor.
- Squeeze the bulb to reset the suction before plugging it back in.
💡 Tip: Empty the drains 2-3 times a day, or whenever they’re about half full.
Cleaning & Infection Prevention
- Gently clean around the drain site with soap and water or antibacterial wipes. Avoid tugging or rubbing the area.
- Watch for signs of infection, such as:
- Redness or swelling around the site
- Fever above 100.4°F
- Foul odor or colored drainage
If you notice these, call your doctor.
Best Sleeping Positions
Finding a comfortable position can be tricky. Try:
- Sleeping on your back with pillows under your arms for support.
- If you’re a side sleeper, place a small cushion around the drains for padding and avoid putting pressure on them.
💡 Tip: A drain-friendly post-surgery pillow with built-in pockets can make rest easier.
Showering & Hygiene Tips
Ask your surgeon if showers are allowed. If so:
- Cover your drains with a waterproof dressing or use a surgical drain belt.
- Limit water exposure to avoid infections.
If showering isn’t an option, stick to sponge baths until your doctor gives the green light.
Recognizing and Managing Complications
Sometimes, issues arise. Here’s what to keep an eye on:
When to Call Your Doctor
- Drainage suddenly increases or stops altogether
- Severe pain or swelling
- Fever or signs of infection
Dealing with a Clogged Drain
A frequent issue is a clogged drain. If you notice reduced suction:
- Milk the tube by gently squeezing it to dislodge the blockage.
- If this doesn’t help, notify your healthcare provider promptly.
Signs of Seroma (Fluid Buildup)
Once drains are removed, some patients develop a seroma. Symptoms include swelling, tenderness, or a feeling of liquid under the skin. While many seromas go away on their own, consult your doctor for advice.
Pain & Discomfort Management
-
Pain is part of recovery, but you don’t have to suffer unnecessarily.
Medication vs. Non-Drug Relief
- Use prescribed painkillers as directed.
- Non-medical options, like a cold compress or heating pad (with your doctor’s approval), can help with aches and stiffness.
Gentle Exercises
Simple arm stretches or shoulder rolls can prevent tightness, but avoid anything strenuous. A physical therapist can provide guidance.
Relaxation Techniques
Practice deep breathing or try mindfulness exercises to cope with discomfort.
Diet & Nutrition for Faster Healing
Fueling your body helps tissues heal faster. Focus on:
- Protein-rich foods, like lean meats, tofu, beans, and eggs.
- Anti-inflammatory options, like berries, leafy greens, and nuts.
- Drink plenty of water every day.
- Consider supplements, like zinc or vitamin C, but check with your doctor first.
Physical Activity & Movement Guidelines
Movement helps, but balance is key:
- Begin with light stretches or short walks to prevent stiffness.
- Avoid lifting anything heavier than a few pounds in the first week.
- Your doctor will guide you on when you can resume driving or house chores.
💡 Tip: Use a supportive bra to minimize any strain during recovery.
Emotional & Psychological Support
Caring for drains can feel isolating. It’s okay to have mixed emotions.
Coping with Anxiety
Deep breathing, journaling, or talking to a friend can help manage stress.
Find Support Groups
Connect with others who’ve been in your shoes. Online breast cancer recovery forums or local groups can make you feel less alone.
Mental Health Resources
Don’t hesitate to reach out to a counselor or therapist to process emotions during your recovery.
Emotional & Psychological Support
Caring for drains can feel isolating. It’s okay to have mixed emotions.
Coping with Anxiety
Deep breathing, journaling, or talking to a friend can help manage stress.
Find Support Groups
Connect with others who’ve been in your shoes. Online breast cancer recovery forums or local groups can make you feel less alone.
Mental Health Resources
Don’t hesitate to reach out to a counselor or therapist to process emotions during your recovery.