Revised Staging System for Breast Cancer
The American Joint Committee on Cancer (AJCC) has recently revised the breast cancer chapter in the sixth edition of the Cancer Staging Manual, based on advice by a Breast Task Force comprised of internationally renowned experts. The need for substantive changes in the staging system for breast cancer stems from the continuing developments in the field of breast cancer diagnosis and management.
Due to the widespread use of screening mammography, most breast tumours are detected when still small. However, there is a remarkable difference in outcomes among these small tumours. To assist with the differentiation of these tumours, additional descriptors of histological observations or measurement of serum of tumour markers have been suggested to complement the anatomic factors represented in the tumour/node/metastasis (TNM) staging system.
Changes to the American
Joint Committee on
Cancer Staging System
- Size-based discrimination between micrometastases and isolated tumour cells
- Identifiers to indicate usage of innovative technical approaches
- Classification of lymph node status by number of involved lymph nodes
- New classifications for metastasis to the infraclavicular, internal mammary, and supraclavicular lymph node
|
The use of histological grading is an important prognostic factor in breast cancer. While the available data do not support the addition of histological grade to the TNM staging system for breast cancer, it is likely that emerging data will support this addition in the future. Genetic markers have shown great promise as prognostic indicators for breast cancer, although lack of standardised measurement techniques for many of them limit their current usefulness. However, it is likely that some of these markers will provide powerful supplemental information to the existing staging system for breast cancer as these technical problems are solved.
|
This article was summarised from Singletary
SE, Allred C, Ashley P, et al. Revision of the
American Joint Committee on Cancer Staging
System for Breast Cancer. J Clin Oncol
2002;20:3628-3636.
|
|
