What is Stage 3 Breast Cancer

All types of invasive breast cancer can be classified as stage 3 of this malignancy. These may include the following: 

Stage 3 metaplastic breast cancer is a type of triple-negative breast cancer that accounts for about 1-2% of all breast cancers. 

Staging System for Stage 3 Breast Cancer 

Stage 3 breast cancer is further classified into three subcategories based on the size of the tumour, lymph node involvement, and the extent of cancer spread to nearby tissues. These include the following: 

1. Stage 3A: The cancer may involve either: 

1. No cancerous tumour in the breast, but malignant cells present in 4 to 9 lymph nodes under the arm or near the breastbone

2. A tumour larger than 5 cm with cancer in 1 to 3 lymph nodes near the breastbone or under the arm 

2. Stage 3B: The cancer spreads to the skin of the breast or chest wall (ribs, muscles, or connective tissue), causing ulceration or swelling. It may involve up to 9 lymph nodes in the armpit or near the breastbone. 

3. Stage 3C: The cancer may have grown in the breast skin or chest wall and spread to one of the following: 

1. Ten or more lymph nodes in the armpit

2. Lymph nodes above or below the collarbone 

3. Lymph nodes near the breastbone and under the arm  

Stage 3 breast cancer symptoms can vary based on the location of the tumour and the extent of spread to nearby lymph nodes. These may include: 

1. Dimpling, redness, swelling, scaling, or open sores

2. Visible changes in the shape or size of the breast 

3. Clear, red, yellow, or green discharge from the nipple or an inverted nipple

4. Lump in the underarm or breast 

5. Pain or itchiness in the breast or surrounding area 

Stage 3 breast cancer develops when cancer cells in the breast continue to grow uncontrollably and create tumours. The exact cause or trigger for this change is not known. However, some factors increase the risk of this condition, including: 

Non-modifiable risk factors cannot be changed or influenced and include: 

1. Age above 55 years 

2. Gender (women have a higher risk because of their exposure to female hormones, which promote cell growth) 

3. Having parents, siblings, or children with breast cancer 

4. Inherited genetic mutations involving the BRCA1 and BRCA2 genes

5. Radiation exposure, especially to the head, neck, or chest 

There are also some modifiable risk factors which can be addressed to lower the risk. These are as follows: 

1. Using hormone replacement therapy 

2. Smoking and alcohol consumption 

3. Obesity

Diagnosing stage 3 breast cancer involves various tests and evaluations to determine the extent of the disease and decide an appropriate treatment approach. It includes the following: 

1. Physical Examination: The doctor will assess the breast and lymph nodes for lumps, swelling, or other abnormalities. However, a lump may not always be cancerous. Different tests are required to confirm the presence of cancer. 

2. Imaging Tests: A mammogram, ultrasound, or MRI is performed to get detailed images of the breast and surrounding tissue. 

3. Biopsy: If an imaging test shows any abnormality, a tumour or lymph node sample will be removed and examined under a microscope.  

Starting at age 40, a person with an average risk of the condition should get breast cancer screenings each year. It helps detect cancer early when it is easier to treat. People with a higher risk may need these screenings more often. You should consult a doctor to understand your risk. 

Timeline for Stage 3 Breast Cancer Treatment

Stage 3 breast cancer treatment timeline varies depending on the patient. Generally, active treatment for this condition, including neoadjuvant treatment, lasts for about a year. Furthermore, patients may receive targeted treatments for 1-2 years, depending on the type of therapy. 

Though locally advanced, stage 3 breast cancer can be cured depending on the type of cancer, the extent of spread, tumour growth rate, and the patient’s overall health. Treatment options for this condition are mentioned below: 

1. Chemotherapy: Neoadjuvant (before surgery) chemotherapy for breast cancer stage 3 is the use of drugs to shrink the tumour and destroy cancer cells in the body. These medications are given through a vein or orally. 

2. Surgery: Some patients with locally advanced cancer may need breast surgery for treatment. It can be of two types, including: 

1. Mastectomy: The surgeon removes the entire breast of the patient. 

2. Breast-conserving Surgery (Lumpectomy): If the patient responds well to chemotherapy, the doctor may remove the cancer and only some parts of the breast during surgery. 

3. Radiation Therapy: For this stage of cancer, radiation (high energy rays or particles) is performed after surgery to destroy any remaining cancer cells. There are two types of radiation therapy: 

1. External Beam Radiation Therapy: A machine sends radiation to target and kill cancer cells. 

2. Brachytherapy: Also called internal radiation, it involves inserting radioactive pellets or seeds inside the breast tissue. 

4. Hormone Therapies: These are used to treat hormone receptor-positive tumours. Drugs like anastrozole and tamoxifen stop the effect of hormones on cancerous cells. These can be used alone or with other treatments. 

5. Targeted Therapy: It uses drugs for special proteins in cancer cells and treats only specific types of breast cancer. Examples of targeted therapies include: 

1. Trastuzumab

2. Pertuzumab  

3. Neratinib 

4. Abemaciclib 

5. Olaparib 

6. Immunotherapy: Drugs like pembrolizumab stimulate the immune system to help it fight cancer cells. They are used for people with stage 3 triple-negative breast cancer. 

Disclaimer: Please consult your doctor before taking any drugs for breast cancer treatment. They will adjust the dosage according to your condition. 

Treatment Effectiveness

Monitoring progress after stage 3 breast cancer treatment is important. Your care team will schedule follow-up appointments to manage symptoms and monitor signs of recurrence. If physical exam findings suggest the cancer has returned, your doctor may recommend blood tests or imaging like PET or CT scans. 

If the cancer returns, your doctor may explore alternative treatment options. Additionally, if you experience side effects, consult your care team, as they can prescribe medications to help manage them.

Stage 3 breast cancers can be operable or inoperable. An inoperable tumour does not mean that cancer is untreatable. It means that surgery for this type of malignancy may not achieve the desired results. 

Successful breast cancer surgery involves removing enough cancerous tissue while ensuring healthy tissue remains at all margins. A tumour is considered inoperable if it is too large or dense to meet this criteria. In such cases, neoadjuvant chemotherapy may be performed to shrink the tumour and make it operable. 

Remission From Stage 3 Breast Cancer

Remission is referred to as the phase where stage 3 breast cancer symptoms decrease or disappear after treatment. It can be either partial (some cancer disappears after treatment) or complete (no signs of cancer detected). 

However, remission does not necessarily mean that cancer cells are absent from the body or that they will not grow in the future. Rather, it means that the doctor cannot detect any malignant cells. If a patient remains in remission for at least five years, doctors may declare the condition to be cured. 

Stage 3 breast cancer life expectancy depends on several factors, including the size of the tumour, the patient’s age, overall health, and response to treatment. According to the American Cancer Society, the 5-year relative survival rate for stage 3 breast cancer is 86%. This means that 86% of individuals diagnosed with this stage of cancer will survive at the end of 5 years. 

A study conducted by Saghir et al., 2023, found the stage 3 breast cancer 10-year survival rate to be 40%. This drop in survival rate underscores the importance of early detection, personalised treatment, and ongoing advancements in cancer care. 

Stage 3 breast cancer is a serious but treatable condition. With advancements in medical treatments, many patients can achieve positive results. It is advised that you consult a doctor to discuss your needs, treatment, and supportive care options. 

At HexaHealth, we are dedicated to offering accurate information and expert assistance to help you manage health challenges. From understanding stage 3 breast cancer symptoms to exploring treatment options, our platform connects you with leading doctors for timely care. Count on HexaHealth to provide the support and resources you need.