Erschienen in:
08.09.2017 | Breast Oncology
Evolution of the Staging System in Breast Cancer
verfasst von:
Cory A. Donovan, MD, Armando E. Giuliano, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 12/2017
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Excerpt
Tumor biology strongly influences the prognosis and treatment of breast cancer. Hormone receptor status and HER2/Neu (HER2) receptor overexpression guide treatment and are related to disease recurrence and survival. Anatomic staging based solely on tumor size, nodal status and the presence or absence of metastatic disease (TNM staging) fails to accurately capture the behavior of some tumors, patient prognosis, and tumor response to targeted therapy. This limitation of anatomic staging has been acknowledged by the American Joint Committee on Cancer (AJCC) Expert Panels in past editions of the staging system, and has resulted in the incorporation of estrogen receptor (ER) status, HER2 status, grade, and molecular tumor characteristics into the 8th Edition Revision published in November 2016 and set for adoption in 2018.
1 Unfortunately, since there are no robust data to support the prognostic value of a more complex staging system, the Expert Panel writing the 8th edition extensively debated the incorporation of biologic factors into the AJCC staging system. …