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Staging Your Breast Cancer at UPMC in Central Pa.

Once breast cancer has been diagnosed it is staged. This process often takes place both before and after breast cancer surgery. The stage given before surgery is called the clinical stage and it is based upon the information collected from the mammogram and other imaging tests.

Then, once the mass – and lymph nodes if necessary – are removed, the pathologist will examine them to provide a more definitive staging number. This is called the pathological stage.

Your UPMC Breast Care Center team will use this staging number to help guide your treatment plan.


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A tool called the TNM system is used to stage your cancer. This system, which was updated in 2018, is used by the American Joint Committee on Cancer and takes into account the following measures:

  • Tumor size (T)
  • Whether the cancer has spread to the lymph nodes (N)
  • Whether the cancer has spread outside the breast or underarm (M)
  • How much the cancer cells look like normal cells (tumor grade)
  • The presence of a protein called an estrogen receptor (ER)
  • The presence of a protein called a progesterone receptor (PR)
  • Whether the cancer makes too much of a protein called Her2 (Her2)

If you were diagnosed with breast cancer prior to 2018, your tumor stage was classified using only the first three of these measures. The additional measures now provide specific information about the tumor that affects your prognosis.

As in the past, the staging system uses numbers or letters after the T, N and M to provide more details about these measures. Higher numbers mean the cancer is more advanced. Under the new system, the tumor stage also includes information about the tumor’s grade and ER, PR and Her2 status.

Tumor staging is complex, so it is best to speak with your doctor about your specific stage and what it means.

Question to Ask the Doctor About Your Diagnosis

  • What type and stage of breast cancer do I have?
  • What does this mean?
  • Is there enough information to recommend a treatment plan for me? If not, which tests or procedures will be needed?
  • How can I prepare myself for each test or procedures?
  • What is my prognosis?

Question To Ask The Doctor About Your Diagnosis (PDF)