Skip to main content

Advertisement

Log in

Prognostic value of the AJCC 8th edition staging system for Japanese patients treated with surgery followed by radiotherapy for breast cancer

  • Original Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

American Joint Committee on Cancer (AJCC) 8th Edition Breast Cancer Staging System, biological information in addition to anatomical information was added as a basis for prognosis evaluation, but its prognostic impact in Japanese patients treated with postoperative radiotherapy has not been discussed. To determine the applicability of the updated prognostic staging system, we evaluated the prognostic value and confirmed the effectiveness of this system in patients in whom postoperative radiotherapy was performed.

Materials and methods

Patients who were treated with postoperative radiotherapy for breast cancer in our institution between January 2011 and December 2015 were restaged by the AJCC 8th pathological prognosis staging system, and then overall survival (OS), disease-free survival (DFS) rates and hazard ratios (HR) were analyzed to compare the predictive fit of the two staging systems.

Results

Five hundred and seven patients who in whom postoperative radiotherapy was performed for breast cancer were enrolled in this study. 36.1% patients were downstaged and 5.3% patients were upstaged from the 7th to 8th editions staging system classification. Kaplan–Meier curves and HRs showed differences in OS and DFS rates between the 7th edition and 8th edition staging systems. The AJCC 8th edition prognostic stage system has a better prognostic prediction of OS and DFS than does the 7th edition anatomic stage system.

Conclusions

Compared with the 7th edition in breast cancer, AJCC 8th edition prognostic stage system has more precise stratification and superior prognostic value, providing a more accurate reference for the choice of radiotherapy for patients with breast cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Siegel RL, Miller KD (2017) Jemal A (2017) Cancer Statistics. CA Cancer J Clin 67(1):7–30. https://doi.org/10.3322/caac.21387

    Article  PubMed  Google Scholar 

  2. Duffy MJ, Harbeck N, Nap M et al (2017) Clinical use of biomarkers in breast cancer: Updated guidelines from the European Group on Tumor Markers (EGTM). Eur J Cancer 75:284–298. https://doi.org/10.1016/j.ejca.2017.01.017

    Article  CAS  PubMed  Google Scholar 

  3. Cancer staging manual: updated breast chapter for 8th edition. American Joint Committee on Cancer.https://cancerstaging.org/references-tools/deskreferences/Pages/Breast-Cancer-Staging.aspx. Accessed July 1st, 2017

  4. Kim I, Choi HJ, Ryu JM et al (2018) Prognostic Validation of the American Joint Committee on Cancer 8th Staging System in 24,014 Korean Patients with Breast Cancer. J Breast Cancer 21(2):173–181. https://doi.org/10.4048/jbc.2018.21.2.173

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kantor O, Bao J, Jaskowiak N et al (2019) The prognostic value of the AJCC 8th edition staging system for patients undergoing neoadjuvant chemotherapy for breast cancer. Ann Surg Oncol. https://doi.org/10.1245/s10434-019-07636-w

    Article  PubMed  Google Scholar 

  6. Xu L, Li JH, Ye JM et al (2017) A retrospective survival analysis of anatomic and prognostic stage group based on the American joint committee on cancer 8th edition cancer staging manual in luminal human epidermal growth factor receptor - negative breast cancer. Chin Med J 130(16):1945–1952. 10.4103/0366-6999.211896

  7. Kurundkar A, Gao X, Zhang K et al (2018) Comparison of AJCC Anatomic and Clinical Prognostic Stage Groups in Breast Cancer: Analysis of 3322 Cases From a Single Institution. Clin Breast Cancer 18(6):e1347–e1352. https://doi.org/10.1016/j.clbc.2018.07.013

    Article  PubMed  Google Scholar 

  8. Clarke M, Collins R, Darby S et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366(9503):2087–2106. https://doi.org/10.1016/S0140-6736(05)67887-7

    Article  CAS  PubMed  Google Scholar 

  9. Early Breast Cancer Trialists' Collaborative G, Darby S, McGale P, Correa C et al (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378 (9804):1707–1716. 10.1016/S0140-6736(11)61629-2

  10. Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347(16):1233–1241. https://doi.org/10.1056/NEJMoa022152

    Article  PubMed  Google Scholar 

  11. Weiss A, Chavez-MacGregor M, Lichtensztajn DY et al (2018) Validation Study of the American Joint Committee on Cancer Eighth Edition Prognostic Stage Compared With the Anatomic Stage in Breast Cancer. JAMA Oncol 4 (2):203–209. 10.1001/jamaoncol.2017.4298

  12. De Abreu FB, Schwartz GN, Wells WA et al (2014) Personalized therapy for breast cancer. Clin Genet 86(1):62–67. https://doi.org/10.1111/cge.12381

    Article  CAS  PubMed  Google Scholar 

  13. Harris LN, Ismaila N, McShane LM et al (2016) Use of biomarkers to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer: American Society of clinical oncology clinical practice guideline summary. J Oncol Pract 12(4):384–389. https://doi.org/10.1200/JOP.2016.010868

    Article  PubMed  Google Scholar 

  14. Park S, Koo JS, Kim MS et al (2012) Characteristics and outcomes according to molecular subtypes of breast cancer as classified by a panel of four biomarkers using immunohistochemistry. Breast 21:50–57. https://doi.org/10.1016/j.breast.2011.07.008

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Keiichi Jingu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tang, L., Ishikawa, Y., Matsushita, H. et al. Prognostic value of the AJCC 8th edition staging system for Japanese patients treated with surgery followed by radiotherapy for breast cancer. Int J Clin Oncol 25, 1499–1505 (2020). https://doi.org/10.1007/s10147-020-01686-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-020-01686-x

Keywords

Navigation