Stage I vs. Stage IV: A Guide to Understanding Breast Cancer from Diagnosis to Treatment | Health News

Breast cancer is the most common cancer in India, accounting for 28.2% of all female cancers. A pressing concern in India is the significant delay faced by patients in accessing healthcare services, resulting in over 60% of breast cancer diagnoses occurring at advanced stages, usually at stage III or IV (when the cancer might have metastasized). Given the complex nature of the disease, understanding the differences between its stages is essential for early detection, effective treatment, and personalized interventions.

“Each stage of breast cancer comes with its own challenges, but with accurate information, timely intervention and a personalised care plan, patients can face their journey with hope,” explains Dr Rakesh Taran, Medical Oncologist, Taran onco-care, Indore. “In the early stages, our aim is to achieve a cure. However, when it comes to metastatic breast cancer, our focus changes and we focus on prolonging life, managing the disease, alleviating symptoms and improving the quality of life of the patient.

To help address the complexities, below is a breakdown of the differences between early breast cancer and advanced breast cancer, from early signs to possible approaches, as shared by Dr. Rakesh Taran.

1. Symptoms: Subtle changes versus obvious indicators

• Early breast cancer:
Early-stage breast cancer often has subtle symptoms. If present, they may include a small lump, mild changes in the shape of the breast, or minor alterations in the texture of the skin. These changes are often so minimal that they can be easily missed without regular screening. Mammograms, breast ultrasounds, and MRIs are commonly used to identify and evaluate any abnormalities.

• Metastatic breast cancer:
In advanced stages, breast cancer may have metastasized to other parts of the body and symptoms become more pronounced. These may include persistent pain in the chest area, extreme fatigue, noticeable changes in breast size or skin appearance, and symptoms related to the spread of the cancer, such as bone pain or neurological problems. Advanced imaging and biopsies are often needed to assess the progress of the spread of the disease. Detection at stage IV often involves more comprehensive imaging techniques, including PET and CT scans, along with biopsies of suspected metastatic sites.

2. Prognosis: Favorable outlook vs. Quality of life management

• Early breast cancer:
The prognosis for early stages of breast cancer is generally very favorable, with high survival rates. Treatment aims to eliminate the cancer completely. The goal is to cure the disease and prevent recurrence.

• Metastatic breast cancer:
In advanced stages, the prognosis varies, as the goal shifts from curing the disease to controlling it. Treatment aims to prolong life, control the spread, relieve symptoms and improve the patient’s quality of life.

3. Treatment options: approaches for different stages

• Early breast cancer:
Treatment for early-stage breast cancer usually involves surgery, such as a lumpectomy or mastectomy. Surgery is often followed by radiation therapy to destroy any remaining cancer cells. In most cases, chemotherapy is part of the treatment plan, especially if the cancer is considered high risk based on its aggressiveness or molecular profile.

• Metastatic breast cancer:
In the advanced stages of breast cancer, including when the cancer has metastasized, treatment focuses on systemic therapies to control the spread of the cancer and relieve symptoms. Options may go beyond chemotherapy to include advanced therapies such as hormone therapy, targeted therapy, and immunotherapy. The goal of treatment is to prolong life and maintain the best quality of life possible.

4. Support systems: short-term care versus ongoing care

• Early breast cancer:
Support often involves preparation for and recovery from treatment, with a focus on short-term interventions such as surgery and radiation therapy. Support groups, counselling and rehabilitation services are common resources during this period.

• Metastatic breast cancer:
For those in advanced stages, including when breast cancer has metastasized, ongoing support is vital. This can include ongoing medical care, pain management, mental health support, and assistance with daily living. Support systems often extend beyond the medical team and include caregivers: family, friends, and community resources.


Understanding the differences between the various stages of breast cancer, including when cancer has metastasized, is essential to making informed decisions about diagnosis, treatment, and management. Early detection and intervention can lead to a more favorable prognosis, while advanced and metastatic stages require a more personalized, comprehensive, and innovative approach. By staying informed and working closely with healthcare providers, patients can navigate their breast cancer journey with greater confidence, whether seeking curative treatment or managing metastatic breast cancer.