Stage 3 breast cancer is cancer that started in the breast and has spread to nearby lymph nodes. Overall, a person’s chance of surviving for 5 years after this diagnosis is around 86%, but this depends on many factors.

The type and grade of the cancer, the treatment type and response, and various individual factors can all affect someone’s outlook.

Doctors describe breast cancer as stage 3 in any of the following situations:

  • A tumor is present, and cancer has spread to many lymph nodes.
  • A tumor is larger than 5 centimeters (cm), and cancer has spread to any lymph nodes.
  • The cancer is growing into nearby tissues such as the breast wall.

At stage 3, the cancer has not spread to distant organs.

Receiving a stage 3 cancer diagnosis can be distressing, but life expectancy and treatments are improving all the time.

This article examines survival rates for stage 3 breast cancer, as well as treatment options, remission, and how to cope with the diagnosis.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Was this helpful?
Close-Up Portrait Of Young WomanShare on Pinterest
Westend61/Getty Images

An individual’s life expectancy depends on various factors besides breast cancer stage.

Some life expectancy measures assess the size of present tumors and how far the cancer cells have spread. However, advancements in tumor biology have changed life expectancy calculations.

Staging system

The current, eighth edition of the American Joint Committee on Cancer (AJCC) staging system considers hormonal factors when determining cancer severity. Previous editions focused on physical aspects.

The current staging system measures a person’s estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status. Doctors describe a tumor as “triple-negative” if it does not have any of these receptors.

Factors that affect a person’s outlook and life expectancy include:

  • physical cancer stage
  • ER and PR levels in the tumor tissue
  • HER2 levels in the tumor tissue
  • whether the tumor tissue is triple-negative
  • pace of tumor growth
  • likelihood that cancer will recur

ER and PR can bind to hormones in the body and use them to grow. If a person’s cancer cells have these receptors, doctors refer to the cancer as “ER-positive” or “PR-positive.”

The HER2 gene produces HER2 receptors, which control how breast cells grow. High levels of HER2 mean that breast cells will grow and divide in an uncontrolled way.

The results of a 2018 study suggest that using ER, PR, and HER2 levels alongside traditional anatomic markers provides a more accurate assessment of a person’s outlook.

This deeper understanding of cancer severity means medical professionals can diagnose significantly different life expectancies and outlooks among people in the same anatomical cancer stage.

Racial and ethnic disparities

A 2023 cohort study highlights racial and ethnic disparities in survival rates among people in the United States with second primary cancer, which is a new cancer in someone who has previously had cancer.

The study found that Black and Hispanic women with breast cancer had lower survival rates than white women with breast cancer.

Potential reasons for this include a higher likelihood of aggressive forms of cancer and diagnosis at a later stage among Black and Hispanic women.

Read more about Black women and breast cancer.

Understanding life expectancy

According to the American Cancer Society, cancer treatment and outlook are constantly improving.

Survival rates are guideline figures that experts calculate using large sample sizes. These rates cannot accurately predict an individual’s life expectancy but can offer an indication.

Also, a study that tracks survival rates over 5 years will reflect the state of medical knowledge 5 years earlier. This means that cancer survival rates may be better than the statistics indicate.

At the time of this writing, the most current statistics reflect results from 2014 through 2020.

To get a more accurate life expectancy estimate, a person should consult a doctor.

According to the National Cancer Institute (NCI), the relative survival rate for females with stage 3 breast cancer over a 5-year period is about 86%. The rate for males is slightly lower, at 84%.

A 5-year relative survival rate is a measure of a person’s chance of living 5 years after their cancer diagnosis compared with a person who does not have breast cancer.

Medical professionals typically use the Surveillance, Epidemiology, and End Results (SEER) Program stages to assess survival rates. Knowing the cancer stage at diagnosis helps doctors determine the best treatments and can also tell them a lot about the life expectancy.

However, each person’s survival rate will be different, and these stages do not account for many of the factors that affect a person’s breast cancer.

The SEER stages are:

  • Localized: A cancerous tumor is present, but it has not spread beyond the original site.
  • Regional: The cancer has spread beyond the original location to lymph nodes.
  • Distant: The cancer has spread to other parts of the body.

According to the NCI, the 5-year relative survival rates for the different SEER stages are as follows:

SEER stage5-year relative survival rate
localized99.6%
regional86.7%
distant31.9%

The relative survival rate for all stages of breast cancer combined is 91.2%.

Stage 3 breast cancer has spread outside the breast but not to distant sites. The cancer is typically in nearby lymph nodes or skin.

Stage 3 breast cancer typically requires more treatment than earlier stages. However, this ultimately depends on several factors, including:

  • hormone receptivity
  • cancer grade
  • cancer type
  • the person’s overall health and preferences
  • menstruation status

A doctor can help someone better understand the cancer stage and how it will affect their treatment options and outlook.

Healthcare professionals further divide stage 3 breast cancer into the following substages:

Stage 3A

For stage 3A breast cancer, either of the following scenarios applies:

  • There may be no tumor, or there may be a tumor of any size in the breast tissue. In addition, the cancer is in four to nine axillary lymph nodes, which are in the armpits, or in the lymph nodes near the breastbone.
  • The tumor is larger than 5 cm, and cancer is present in up to three nearby lymph nodes under the arm or near the breastbone.

Stage 3B

A doctor will diagnose stage 3B breast cancer when tumors of any size are present and cancer cells are in the breast wall or near the breast skin. A person may experience swelling or ulcers in these areas.

Stage 3B breast cancer may have spread to the lymph nodes near the breastbone or may be present in up to nine axillary lymph nodes.

Stage 3C

Stage 3C breast cancer may have a tumor of any size or no tumor at all, but the cancer will be present in the chest wall or the breast skin.

Cancer will have spread to one of the following areas:

  • 10 or more axillary lymph nodes
  • the lymph nodes reaching up to the collarbone
  • the lymph nodes under the arm and those near the breastbone

These days, people with breast cancer can know more about the tumor than ever before.

In addition to a tumor’s stage, oncologists can determine its grade and subtype. This information helps the doctor describe the tumor and cancer stage in more detail so that other members of the care team can better understand the cancer.

The tumor grade and subtype of breast cancer can vary between people. Doctors will test tumors to find out which genes they express so that they can adapt a person’s treatment options to the results.

Doctors define different types of stage 3 breast cancer by:

  • Tumor grade: This measures how much the cancer cells differ from healthy cells under a microscope and how quickly the cancer cells are likely to grow.
  • ER status: This describes whether the cancer cells have receptors for the hormone estrogen.
  • PR status: This indicates whether the cancer cells have receptors for the hormone progesterone.
  • HER2 status: This describes whether the cancer cells are making the HER2 protein.

TNM staging system

The AJCC oversees a tumor, node, and metastasis (TNM) staging system to help doctors better understand and communicate about individual breast cancers.

The TNM staging system assesses the anatomic structure of a breast cancer and describes the following:

  • T (tumor): This number indicates the size or extent of the tumor and how much breast tissue is involved. A higher “T” grade means a larger tumor or more tissue involvement. The categories are as follows:
    • TX: Doctors cannot assess the tumor.
    • T0: There is no evidence of a primary tumor.
    • Tis: This is carcinoma in situ, which means the cancer is not invasive.
    • T1 to T4: This number describes how large or dense the tumor is and how much nearby tissue it involves.
  • N (nodes): This indicates whether the cancer has spread to lymph nodes. The higher the “N” number, the more lymph nodes the cancer affects. The categories are as follows:
    • NX: Doctors cannot assess lymph node involvement — for example, because lymph nodes were removed.
    • N0: Doctors cannot find evidence that the cancer has spread to lymph nodes.
    • N1 to N3: This number indicates how many lymph nodes the cancer affects or how far the lymph node involvement has spread.
  • M (metastasis): This describes whether the cancer has spread beyond the original site. The categories are as follows:
    • M0: There is no evidence that the cancer has spread to distant parts of the body.
    • M1: There is evidence that the cancer has spread.

Doctors may use this anatomic information alongside biologic assessment of ER, PR, and HER2 levels. These two systems provide more accurate breast cancer assessments than ever before.

Learn how breast cancer spreads.

Treatment of stage 3 breast cancer typically involves a combination of medication and surgery that doctors will base on a person’s particular circumstances.

Drug-based treatments

Doctors may suggest neoadjuvant treatment, which involves reducing the size of the tumor, usually with drug-based therapies, so that surgeons can safely remove it.

Some people may have adjuvant treatment, which involves receiving chemotherapy or another drug-based treatment after surgery to prevent any cancer cells that have shed from the original tumor from spreading.

Drug-based treatments can include:

Chemotherapy involves destroying cancer cells with anticancer drugs. There are many side effects of chemotherapy, but they usually subside once a person has finished treatment. These include:

Learn more about the side effects of chemotherapy.

Surgery

If drug treatments do not shrink a large tumor enough, a doctor may recommend removing the whole breast. This procedure is called a mastectomy. A lumpectomy is when surgeons remove only the tumor.

A person may wish to have reconstructive surgery after a mastectomy or lumpectomy. However, some people may opt out of reconstructive surgery.

For example, a 2021 review of mastectomies from an LGBTQ perspective found that many trans men saw the procedure as advantageous to affirming their personal identity and said that it led to an improved quality of life.

After surgery, a person may receive radiation therapy and possibly more chemotherapy. This helps reduce the likelihood that the cancer will return.

If the tumor is small enough, a doctor may recommend surgery first, followed by chemotherapy and radiation therapy.

Some types of breast cancer respond to hormone therapy, in which case the doctor will often prescribe hormone therapy for 5 or more years after the initial treatment is complete.

Remission is when symptoms of cancer completely or almost completely disappear. Remission can be either partial or complete.

In partial remission, some cancer has disappeared after treatment. Complete remission means doctors can detect no sign of cancer.

Remission does not necessarily mean that there is no cancer in a person’s body, only that the doctor cannot detect any. It is not possible for doctors to be sure that all cancer cells are gone or that the cancer will not grow to detectable levels in the future.

Most cancers that return do so within 5 years. Doctors may refer to someone’s cancer as “cured” if the cancer does not return within 5 years.

Learn more about cancer remission.

Stage 3 breast cancers are either operable or inoperable.

If a doctor says the tumor is inoperable, that does not mean it is not treatable — rather, it means that surgery will not yield the desired results at this time.

For breast cancer surgery to be successful, doctors need to remove enough tissue while leaving behind healthy tissue at all the margins. If a tumor is too large or dense for that, the tumor is inoperable.

However, neoadjuvant chemotherapy may help shrink the breast cancer tumor so that it becomes operable.

Significant physical and psychological changes can occur during breast cancer treatment. For example, the side effects of cancer and chemotherapy can reduce a person’s quality of life.

After a mastectomy, people may find the change in their bodies emotionally challenging. The removal of one or both breasts can affect a person’s sense of identity, sexuality, and sexual relationships. This may be especially true for younger women.

For some people, long-term hormone therapy can have ongoing side effects, including:

  • fatigue
  • changes in memory and mood
  • menopause symptoms

Even after remission, a person may experience a fear of breast cancer recurrence, which can affect their quality of life.

Coping with breast cancer

Despite ongoing improvements in detection and treatment, many people experience fear or trauma after a cancer diagnosis.

People may have a wide range of emotions after a breast cancer diagnosis. Each person’s response is unique.

People may find it helpful to speak with others with similar diagnoses. A doctor may be able to recommend support groups.

People may also wish to avoid overexertion and take time for themselves.

The Bezzy Breast Cancer app provides people with access to an online breast cancer community where they can connect with others and gain advice and support through group discussions.

Other online communities also provide a safe place for discussion, and a person may be able to find local support groups in their community.

A therapist can also help someone manage stress and anxiety during treatment and recovery.

Life expectancy and survival rates for stage 3 breast cancer are improving all the time. The current 5-year relative survival rates for stage 3 breast cancer are 86% for females and 84% for males.

However, many factors can influence a person’s life expectancy after a breast cancer diagnosis. A doctor can provide more detailed, personalized information.

People can also speak with a doctor for more resources to help them cope with breast cancer, including support groups and counseling.

Read the article in Spanish.