Breast Cancer Staging

  • Neslihan Cabioğlu
  • Ekrem Yavuz
  • Adnan Aydiner


The TNM staging system for breast cancer as described by the American Joint Committee on Cancer (AJCC) was introduced as a standard tool to assess the prognosis of patients with newly diagnosed breast cancer. According to the seventh revised edition of the TNM system in 2009, the presence of isolated tumor cells (ITCs) or micrometastases in axillary lymph nodes has little impact on survival. Furthermore, due to the increasing application of neoadjuvant therapy, additional pretreatment and post-treatment stagings were incorporated into the new staging system to determine chemotherapy response and treatment efficacy. Rapid advances in both clinical and laboratory science 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. 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 the estrogen receptor/progesterone receptor (ER/PR) and human epidermal growth factor receptor-2 (HER-2) status. In 2017, the eighth revised edition of the TNM system was published. Clinical and pathological stages (PSs) were incorporated in addition to the traditional anatomic prognostic stage tables. The pathological stage table is based on clinical information, biomarker data including multigene genomic assays, and findings from surgery and resected tissue. It is anticipated that updates will be made on a more frequent basis than the 6- to 8-year cycle of TNM revisions when relevant validated information is available.


Staging TNM staging AJCC Prognostic stage Gene expression assays 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Neslihan Cabioğlu
    • 1
  • Ekrem Yavuz
    • 2
  • Adnan Aydiner
    • 3
  1. 1.Department of General SurgeryIstanbul Faculty of Medicine, University of IstanbulIstanbulTurkey
  2. 2.Department of PathologyIstanbul Faculty of Medicine, University of IstanbulIstanbulTurkey
  3. 3.Oncology Institute, Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey

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