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Chapter 086. Breast Cancer (Part 5)

Staging Correct staging of breast cancer patients is of extraordinary importance. Not only does it permit an accurate prognosis, but in many cases therapeutic decisionmaking is based largely on the TNM (primary tumor, regional nodes, metastasis) classification (Table 86-1). Comparison with historic series should be undertaken with caution, as the staging has changed several times in the past 20 years. The current staging is complex and results in significant changes in outcome by stage as compared with prior staging systems. Table 86-1 Staging of Breast Cancer Primary Tumor (T) T0 No evidence of primary tumor TIS Carcinoma in situ T1 Tumor ≤2 cm T1a Tumor 0.1 cm but ≤0.5. | Chapter 086. Breast Cancer Part 5 Staging Correct staging of breast cancer patients is of extraordinary importance. Not only does it permit an accurate prognosis but in many cases therapeutic decisionmaking is based largely on the TNM primary tumor regional nodes metastasis classification Table 86-1 . Comparison with historic series should be undertaken with caution as the staging has changed several times in the past 20 years. The current staging is complex and results in significant changes in outcome by stage as compared with prior staging systems. Table 86-1 Staging of Breast Cancer Primary Tumor T TO No evidence of primary tumor TIS Carcinoma in situ T1 Tumor 2 cm T1a Tumor 0.1 cm but 0.5 cm T1b Tumor 0.5 but 1 cm T1c Tumor 1 cm but 2 cm T2 Tumor 2 cm but 5 cm T3 Tumor 5 cm T4 Extension to chest wall inflammation satellite lesions ulcerations Regional Lymph Nodes N PN0 i- No regional lymph node metastasis histologically negative IHC PN0 i No regional lymph node metastasis histologically positive IHC no IHC cluster greater than 0.2 mm PN0 mol- No regional lymph node metastasis histologically negative molecular findings RT-PCR PN0 mol No regional lymph node metastasis histologically positive molecular findings RT-PCR PN1 Metastasis in one to three axillary lymph nodes or in internal mammary nodes with microscopic disease detected by sentinal lymph node dissection but not clinically .