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The new TNM-based staging of breast cancer

  • Review and Perspectives
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Abstract

This review describes the changes that have been implemented in the Tumor–Node–Metastasis (TNM)-based staging of breast cancers by the new, 8th editions of the relevant Union for International Cancer Control (UICC) and American Joint Committee on Cancer (AJCC) publications. After giving a background for TNM being the common language of cancer staging and related activities like cancer treatment and registration, it summarizes not only the changes but reviews some highlights important for pathologists, and lists and comments on the differences between the publications and diagnostic practices based on them. A section is dedicated to the prognostic stages of breast carcinomas introduced in the AJCC Cancer Staging Manual, but not mentioned in the UICC TNM classification of malignant tumors. A few issues that are not appropriately covered by TNM according to the authors’ view (e.g., multifocal tumors, larger lymph node metastases identified by molecular methods, the heterogeneous prognosis of M1-defined stage IV disease) close the review with the final thoughts raising the vision of a potential loss of the common staging language.

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Acknowledgments

This study was partially funded by the National Research, Development and Innovation Office grant GINOP-2.3.2-15-2016-00020.

Author’s contribution.

All authors of the manuscript made substantial contributions to.

– the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work (if applicable);

AND

– drafting the work and/or revising it critically for important intellectual content;

AND

– final approval of the version submitted for publication;

AND

– agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Other contribution is acknowledged in the Acknowledgements section of the manuscript.

Funding

This work was partially funded by the National Research, Development and Innovation Office grant GINOP-2.3.2-15-2016-00020.

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Authors and Affiliations

  1. Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyíri út 38, Kecskemét, H-6000, Hungary

    Gábor Cserni

  2. Department of Pathology, University of Szeged, Állomás u. 1, Szeged, H-6725, Hungary

    Gábor Cserni

  3. Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101, Gliwice, Poland

    Ewa Chmielik

  4. Department of Software Engineering, University of Szeged, Dugonics tér 13, Szeged, H-6720, Hungary

    Bálint Cserni

  5. Pathology and Cytology Dalarna, Falun County Hospital, 79182, Falun, Sweden

    Tibor Tot

Authors
  1. Gábor Cserni
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  2. Ewa Chmielik
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  3. Bálint Cserni
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  4. Tibor Tot
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Correspondence to Gábor Cserni.

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The authors have consulted the journal policy regarding compliance with ethical standards and state that accepted principles of ethical and professional conduct have been followed. The authors include information regarding sources of funding (previous section) and potential conflicts of interest (financial or non-financial) (next section). As no patients or patients’ data are involved, ethical approval and informed consent are not applicable, similarly to animal welfare-related issues.

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Cserni, G., Chmielik, E., Cserni, B. et al. The new TNM-based staging of breast cancer. Virchows Arch 472, 697–703 (2018). https://doi.org/10.1007/s00428-018-2301-9

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  • DOI: https://doi.org/10.1007/s00428-018-2301-9

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