Breast cancer staging

• Determining Tumor Size
  • Only the invasive component
  • Identified specific imaging  modalities including MMG, US and MRI
• Tx
• T0
• Tis
  • Carcinoma in situ, with no evidence of an invasive component.
  • Tis(DCIS)
  • Tis(LCIS)
  • Tis(Paget’s) : Paget’s dz of the nipple NOT associated with underlying breast cancer
• T1
  • Tumor ≤ 20mm in greatest dimension
    • T1mi : microinvasion ≤ 1mm
    • T1a : 1< tumor ≤5mm
    • T1b : 5< tumor ≤10mm
    • T1c : 10< tumor ≤ 20mm
• T2 : 20 < tumor ≤ 50mm
• T3 : > 50mm
• T4 : Any size with direct extension to the chest wall and/or to the skin (ulceration or skin nodules)
  * Note that pectoralis muscle invasion is not categorized as T4
• T4a : Extension to chest wall
• T4b : Edema (including peau d’orange) or ulceration of the skin of the breast, or satellite skin nodules confirmed to the same breast
• T4c : Both T4a and T4b
• T4d : Inflammatory breast cancer

• Inflammatory Carcinoma(T4d)
  • Clinocipathologic entity characterized by diffuse erythema and edema(peau d’orange) of the breast
  • Classically, the skin changes arise quickly in the affected breast
  • Due to tumor emboli within dermal lymphatics
  • Typical skin changes involving ≥ 1/3 of the skin of breast –  T4d

N staging

• NX : Regional lymph nodes cannot be assessed
• N0 : No regional lymph node metastasis
• N1 (Early breast cancer)
  • Metastases to movable ipsilateral level I, II axillary lymph nodes
• N2 (Advanced breast cancer)
  • N2a : Metastases in ipsilateral level I, II axillary lymph nodes fixed to one another (matted) or to other structures
  • N2b : Metastases only in clinically detected ipsilateral internal mammary nodes and in the absence of clinically evident level I,II axillary lymph node metastases
• N3 (Advanced breast cancer)
  • ipsilateral infraclavicular LN with or without axillary involvement
  • ipsiltareal internal mammary LN and in the presence of clinically evident axillary LN metastasis
  • ipsilateral supraclavicular LN with or without axillary or internal mammary LN involvement
    • N3a : Metastasis in ipsilateral infraclavicular lymph node(s)
    • N3b : Metastasis in ipsilateral internal mammary lymph node(s) and axillary lymph node(s)
    • N3c : Metastasis in ipsilateral supraclavicular lymph node(s)

Related posts:

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