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Staging of Breast Cancer

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Breast Disease

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Abstract

The TNM staging system for breast cancer as described by the American Joint Committee on Cancer (AJCC) was introduced to act as a standard tool to assess the prognosis of patients with newly diagnosed breast cancer. In 2009, the 7th revised edition of the TNM system was published to reflect updates in technology and clinical evidence. In the new staging system, the presence of isolated tumor cells or micrometastases in the axillary lymph nodes was found to have little impact on survival. Furthermore, breast cancer therapy has evolved with the increasing application of neoadjuvant therapy, and therefore, additional pretreatment and posttreatment staging were incorporated into the new staging system to determine chemotherapy response and treatment efficacy. Rapid advances in both clinical and laboratory sciences along with translational research have raised questions about the feasibility of ongoing TNM staging to determine whether to apply systemic therapy based on anatomic prognosis. Although multigene expression assays, such as the 70-gene prognostic signature or Oncotype DX tests, may provide additional prognostic and predictive information beyond anatomic TNM staging and ER/PR and HER2 status, there might be difficulties in incorporating these biomarkers into the TNM system. With advances in personalized medicine, more molecular gene assays and new prognostic and predictive markers such as tumor-infiltrating lymphocytes might be incorporated into future staging systems.

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Authors and Affiliations

  1. Department of General Surgery, Breast Cancer Department, Istanbul University Istanbul Medical Faculty, Capa, Istanbul, 34390, Turkey

    Neslihan Cabioglu MD, PhD

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  1. Neslihan Cabioglu MD, PhD
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Correspondence to Neslihan Cabioglu MD, PhD .

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  1. Inst of Oncology,Ist Tıp Fak, Istanbul University, Istanbul, Turkey

    Adnan Aydiner

  2. General Surgery, Istanbul Univ Istanbul Fac of Med, Istanbul, Turkey

    Abdullah İgci

  3. Breast Surgery,, Magee-Womens Hospital, Pittsburg, USA

    Atilla Soran

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Cabioglu, N. (2016). Staging of Breast Cancer. In: Aydiner, A., İgci, A., Soran, A. (eds) Breast Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-26012-9_3

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