Stage 2 breast cancer means the cancer hasn’t spread beyond your breast tissue or nearby lymph nodes. The outlook for people with this diagnosis is good. The 5-year relative survival rate is 99%.
Cancer isn’t a single disease. It’s a group of diseases, and breast cancer is no different. Because there are various types of breast cancer, not all stage 2 breast cancers are the same or involve the same treatment.
This article explores how doctors define stage 2 breast cancer, along with treatment options and survival rates.
When you first receive a diagnosis of breast cancer, your doctor will assign a stage to your cancer. This is called clinical staging. It’s based on:
- a physical exam
- imaging tests
- biopsy results
If surgery is done to examine the breast tissue, laboratory test results on the tissue and lymph nodes can provide more information.
Based on these results, your doctor can determine the cancer’s pathologic or surgical stage, which is more accurate than the clinical stage.
Breast cancer staging involves the TNM system, which provides specific details about:
- T: the size of the tumor
- N: lymph node involvement
- M: whether the cancer has spread (metastasized)
The size of the primary tumor (T)
A T followed by a number indicates the size of the primary tumor. A higher number means a larger tumor.
- TX: the tumor can’t be measured
- T0: primary tumor can’t be located
- T1, T2, T3, T4: size of the tumor from smallest to largest
Lymph node involvement (N)
The letter N followed by a number tells you whether the cancer has spread to lymph nodes. If so, the number indicates how many lymph nodes the cancer cells have spread to.
- NX: cancer cells in nearby nodes can’t be measured
- N0: cancer has not spread to nearby nodes
- N1, N2, N3: number of nodes that contain cancer
Metastasis (M)
The letter M indicates whether the cancer cells have spread to other organs in the body.
- M0: there’s no sign that cancer has spread to other parts of the body (stage 2 breast cancer is always M0)
- MX: spread can’t be measured
- M1: cancer has spread to other parts of the body, like the lungs, liver, or bones
These factors are combined to determine the cancer stage. Breast cancer is staged from 1 to 4.
Stage 2 breast cancer has two subcategories.
Stage 2ABreast cancer is stage 2A if one of these is true:
- There’s no tumor in the breast, but breast cancer cells are found in nearby lymph nodes.
- The primary tumor is 2 centimeters (cm) or smaller and cancer cells are found in fewer than four of the axillary lymph nodes.
- The breast tumor is between 2 and 5 cm, but there’s no lymph node involvement.
Stage 2BBreast cancer is stage 2B if one of these is true:
- The breast tumor is between 2 and 5 cm and the cancer has reached four or fewer lymph nodes.
- The tumor is over 5 cm but there’s no lymph node involvement.
Additional considerations
Breast cancer staging is complicated. A number of factors can affect the overall staging diagnosis, including a tumor grading system and the presence of certain receptors in breast cancer cells.
A tumor grading system indicates how fast cancer cells are likely to grow and spread. Higher grades indicate more aggressive cancer.
Tumor grading
- G1: well differentiated or low grade
- G2: moderately differentiated or intermediate grade
- G3: poorly differentiated or high grade
In addition, the tumor will be tested for receptors that can affect your treatment options and provide a better idea of what to expect.
Receptor status
- Estrogen receptor (ER) status: ER-positive or ER-negative
- Progesterone receptor (PR) status: PR-positive or PR-negative
- HER2 status (a growth-promoting protein found on the outside of breast cells): HER2-positive or HER2-negative
ER and PR status are sometimes referred to as hormone receptor (HR) status.
These factors can also be used in staging because these cancers behave differently. For example:
- HR-positive/HER2-negative breast cancer is generally slow-growing and less aggressive than other types.
- HR-negative/HER2-negative, also known as triple-negative, tends to be more aggressive.
- HR-positive or HER2-positive is another type that can be aggressive.
The tumor’s HR and HER2 status determines some of your treatment options. Your doctor will also consider:
- any other health conditions you may have
- your age
- your menopausal status
Typically, treatment involves a combination of therapies. Here’s a look at some of the most common types of treatment for stage 2 breast cancer.
Surgery
Depending on the size and location of the tumor, surgical options may include:
- lumpectomy, a breast-conserving surgery
- modified radical mastectomy with or without reconstruction
During both of these procedures, the surgeon also performs a sentinel lymph node biopsy to see whether the cancer has spread.
Radiation therapy
Radiation therapy typically follows surgery, especially if you have a lumpectomy.
If you have a mastectomy, certain factors will help determine whether you need radiation treatment. These factors include:
- the size of the tumor
- the number of lymph nodes to which the cancer has spread
Radiation is used to lower the chances of recurrence. Radiation therapy works by damaging the DNA of cancer cells. This helps destroy them.
Radiation therapy is typically a localized type of treatment. This means it’s only targeted at the specific area that is radiated. It doesn’t target your whole body like chemotherapy or some types of medication.
There are various forms of radiation. Some regimens are 5 days, some are 3 to 4 weeks, and some are 5 to 6 weeks long.
The most common side effects include fatigue and redness, skin peeling, and swelling around the area that’s being treated.
Chemotherapy
Chemotherapy can be used to shrink tumors before surgery or to lower the chance of recurrence after surgery.
Immunotherapy is also now offered before surgery along with chemotherapy for some stages of triple-negative breast cancer.
There are fewer treatment options for triple-negative breast cancer since it doesn’t have HR or HER2 receptors. But it tends to respond well to chemotherapy. In 2021, the
For breast cancer, chemotherapy drugs are usually given through a vein intravenously (IV). This may be as an injection that lasts several minutes or as an infusion that lasts for hours or longer.
Chemotherapy for breast cancer is typically given in cycles of about 1 or 2 to 3 weeks. You’re given chemotherapy through an IV on one day of the week or for a few days in a row. You’re then given time to recover from the drugs before starting your next cycle.
One of the disadvantages of chemotherapy is that these drugs can’t tell cancerous cells from healthy cells. As a result, some healthy cells can get temporarily damaged in addition to cancerous ones. This can result in side effects such as:
Some types of chemotherapy may also cause early menopause.
Targeted therapy
Targeted or biologic therapies involve the use of drugs that can tell the difference between cancer cells and normal cells a little better than chemotherapy. These drugs have the ability to affect cancer cells, sometimes with less harm to other cells.
Targeted therapies are a newer treatment approach. New drugs are being developed as scientists learn more about how cancer cells grow and multiply and what differentiates them from typical, noncancerous cells.
For stage 2 breast cancer, targeted hormone therapy can be effective for ER-positive or PR-positive cancers. Therapies may include:
- tamoxifen
- anastrozole
- exemestane
- letrozole
Side effects of hormone therapy can include:
- hot flashes
- vaginal dryness
- bone mineral density loss
Other types of targeted therapy have the ability to detect certain proteins or enzymes associated with cancer cells. For instance, with HER2-positive breast cancer, targeted therapy can disrupt the high levels of growth-promoting protein on the surface of the cancer cells.
Some therapies for stage 2 HER2-positive breast cancer include:
Clinical trials
You may be able to take advantage of innovative targeted therapies or chemotherapy drugs by participating in a clinical trial. Ask your doctor if there’s a trial that’s a good fit for you.
Side effects and complications
All treatments have some side effects. These can range from mild to severe. Most clear up when treatment ends, but some lasting complications can occur.
It’s important to tell your care team about all symptoms, even if they seem minor. Your doctors will work with you to ease side effects and deal with complications.
Follow-up care
Once primary treatment ends, hormone therapy can continue anywhere from 5 to 15 years. Breast reconstruction, if you choose to have it, is a multistep process that may take many months.
Your first post-treatment visit will probably be within a few months. Your doctor will want to see how you’re doing and if you need help with the side effects of treatment.
Eventually, you’ll transition to visits every 6 months, then yearly visits. Yearly checkups will include breast imaging.
Your doctor will work out a schedule based on the level of care you need.
Emotional care
Coming to the end of your treatment can be a challenging transition. Emotions can range from relief and exhilaration to anxiety and sadness. Fear of recurrence is common. These emotions and fears are normal.
When your focus has been on treatment, side effects, and scheduling appointments, it can take a little time to get used to life on the other side of those details.
Also, loved ones may be so happy for you that they don’t realize you’re still dealing with the physical and emotional effects of your cancer treatment. You don’t have to live up to anyone’s expectations but your own. When or if you get back to your old routine depends on circumstances unique to you.
It’s important to follow your own timetable and to do things at a pace that works for you.
Overall, the outlook for people with stage 2 breast cancer is generally good. According to the
- 99% for localized breast cancer (cancer has not spread outside the breast)
- 86% for regional breast cancer (cancer has spread to nearby lymph nodes)
These figures represent people who received diagnoses between 2013 and 2019. These percentages vary somewhat based on ER/PR and HER2 status.
Certain types of breast cancer have a better outlook than others.
This may be because some, such as HR-positive and HER2-negative, are more responsive to hormonal therapy, and HER2-positive breast cancers are responsive to anti-HER2 targeted therapy. Some, like triple-negative breast cancers, have fewer treatment options and a higher recurrence rate in the first few years.
Your care team can review your complete medical profile to give you a better idea of what to expect.
There are many resources and support groups for people with breast cancer. There’s no obligation to stick with a group. You can try it out and move on whenever you’re ready. You might be surprised to learn that you also have a lot to offer others.
The American Cancer Society has a variety of support services and programs. You can call the 24/7 helpline at 800-227-2345, visit the
If you like having information at your fingertips, download the free Breast Cancer Healthline app. The app lets you connect with others who have a similar diagnosis and understand what you’re going through.
Other support options
- Check out the Community Discussion Boards at Breastcancer.org.
- Get in-person, online, or phone support at Living Beyond Breast Cancer.
- Connect with young breast cancer survivors through the Young Survival Coalition.
- Browse titles of more than 400 episodes of “Breast Cancer Update,” a podcast featuring oncologist Dr. Neil Love.
- Peruse relevant topics from the Breastcancer.org podcast.
- Get important health information and listen to personal stories on the Centers for Disease Control’s breast cancer podcast, “
My Motivated MomentTrusted Source .”
Supporting someone with breast cancer
If you’re reading this because there’s a breast cancer survivor in your life, you’re already being supportive.
Maybe you don’t know what to say or fear saying the wrong thing. Say something anyway. Don’t let breast cancer go unmentioned. The best thing you can do now is to be there and let them lead the way.
People with breast cancer may feel obligated to act with confidence and have a positive attitude. That may mask what’s really going on. Let them know they can be real with you, then listen without judgment.
Offer to help in a concrete way. Can you prepare a meal? Do some chores? Share a movie night? Let them know what you’re willing to do. But take them at their word. If they don’t want help, don’t push it. Just making the offer lets them know you care.
The end of treatment is not the end of the experience. There are many adjustments ahead. Some things may never return to the way they were, but change isn’t always bad.
In stage 2 breast cancer, cancer cells have not spread beyond the breast or nearby lymph nodes. Knowing the HR and HER2 status of your stage 2 breast cancer can help your care team determine which treatments are most likely to be effective.
Stage 2 breast cancer is very treatable, and the overall outlook for someone with this stage is good. As with most types of cancer, the earlier your cancer is diagnosed and treated, the better the outcome.
