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Stage 0 Breast Cancer: Treatment and Prognosis

Posted on March 09, 2022
Medically reviewed by
Mark Levin, M.D.
Article written by
Aminah Wali, Ph.D.

At the time of breast cancer diagnosis, a doctor will determine the stage of the disease to help determine treatment and prognosis (outlook). Cancer is classified into different stages based on whether and where it has spread throughout the body. Breast cancer identified during early stages will have a different treatment strategy and outlook than more advanced-stage disease.

To stage breast cancer, doctors typically use the TNM staging system. TNM stands for tumor, node, and metastasis. The staging system takes into account the size of the original tumor (T), whether cancer cells can be found in nearby lymph nodes (N), and whether there are cancer cells in more distant tissues (M). Each letter is assigned a number — a lower number means the cancer is in the early stages, whereas a higher number indicates the disease is progressing.

In 2018, the TNM staging system was updated to include more information to better define breast cancer stages. These new cancer characteristics include:

  • Hormone receptor status — Whether the cancer contains estrogen receptors or progesterone receptors
  • Tumor grade — A measure of how abnormal the cancer cells look compared to normal cells
  • HER2 status — Whether the cancer has high levels of a protein called HER2
  • Oncotype DX score — Results of a genetic test used to predict if a stage 1 cancer might progress to a more serious form of cancer

What Is Stage 0 Breast Cancer?

Stage 0 breast cancer is the earliest stage of detected disease. At this stage, the disease is usually called ductal carcinoma in situ (DCIS), which means cancer cells have formed in the lining of the milk ducts. DCIS is noninvasive, so there is no evidence of abnormal cells breaking through to the breast tissue surrounding the milk ducts. While noninvasive disease is considered highly treatable, there is a chance that DCIS can eventually become invasive.

Stage 0 disease may also be lobular carcinoma in situ (LCIS), which occurs when abnormal cells form in the lobules (glands that make milk). LCIS is not truly cancer, as the cells are precancerous. However, LCIS may put a person at a higher risk of developing breast cancer.

Treatments for Stage 0 Breast Cancer

Treatment options for stage 0 breast cancer typically include surgery to remove the breast tumor and possibly the surrounding tissue.

Lumpectomy

In a lumpectomy, a surgeon removes the breast tumor and some of the surrounding tissue. This procedure is also called breast-conserving surgery (BCS). If the breast tumor is small enough, BCS is often recommended because it avoids removal of the entire breast.

If there are signs that stage 0 breast cancer may be progressing to a more advanced stage, a doctor may recommend a sentinel lymph node biopsy to remove the surrounding lymph nodes.

Following this type of surgery, radiation therapy is commonly used to kill off any remaining cancer cells that may have been missed by treatment.

Mastectomy

Another surgical procedure called a mastectomy may be recommended in some cases. In contrast to a lumpectomy, a mastectomy involves removal of the entire breast. A person with stage 0 breast cancer is likely to be treated with a simple mastectomy, which removes the breast tissue but not the lymph nodes in the armpit.

A mastectomy is more likely to be recommended over a lumpectomy for people who have large breast tumors. It can be followed by reconstructive surgery.

Hormone Therapy

Some cases of breast cancer are hormone receptor-positive, meaning that the cancer cells contain either the estrogen receptor or progesterone receptor. These hormone receptors are proteins that play a role in breast cancer progression.

People with stage 0 tumors that are hormone receptor-positive are treated with hormone therapy drugs such as tamoxifen or Aromasin (exemestane). These drugs aim to prevent the possibility of cancer after surgery. Because hormone therapy is not effective against hormone receptor-negative tumors, a doctor will first need to confirm the hormone receptor status of the cancer before starting hormone therapy.

Prognosis for Stage 0 Breast Cancer

Survival rates for breast cancer are determined based on whether the cancer is localized (only in the breast), regional (spread to nearby tissues), or distant (spread farther throughout the body). Localized disease has a very favorable prognosis, with a five-year survival rate of at least 99 percent. Due to a risk of cancer developing, it is important that people treated for stage 0 breast cancer maintain regular follow-up appointments with their health care provider.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you or a loved one been diagnosed with stage 0 breast cancer? Share your experiences in the comments below, or start a conversation by posting on MyBCTeam.

All updates must be accompanied by text or a picture.
Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Aminah Wali, Ph.D. received her doctorate in genetics and molecular biology from the University of North Carolina at Chapel Hill. Learn more about her here.

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