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Fox Chase researchers recommend updating the staging criteria for breast cancer diagnoses
Date:7/9/2014

s age 65 or older who had been diagnosed with invasive breast cancer, and had surgery to completely remove or reduce the size of their tumors.

The researchers then created two additional subgroups: those who had extensive skin involvement and those without. From there, they regrouped the cancers using the TNM Staging System, a commonly used tool for doctors to stage different types of cancer based on certain standardized criteria.

"We used this system to regroup both types of cancer by tumor size and nodal involvement," said Dr. Bleicher. "We also looked at factors like age, race, sex, histology, grade, estrogen and progesterone receptor status, surgery, chemotherapy and radiotherapy."

After excluding some patients who lacked pertinent data and other factors, the researchers compared 924 with significant skin involvement to 66,185 others whose tumors had not spread to skin. All of the patients with significant skin involvement were originally classified as stage III. However, after restaging these tumors based strictly on the size and/or extent of the primary tumor, and whether the cancer had spread to nearby lymph nodes, nearly half (43%) were staged to earlier stages. The women restaged in this fashion did as just well as the women classified to those other stages because they didn't have skin involvement.

Overall, stage III cancers have a 5-year survival that ranges from 41% to 67%; these results suggest that some women diagnosed with tumors that spread to the skin actually have a 96% chance of surviving 5 years, based on their tumor's size and nodal status similar to other early-stage tumors that have not spread to the skin. "Classifying all tumors with skin involvement as stage III belies the purpose of staging, which is to group tumors with a similar prognosis," says Bleicher.

It makes sense that not all tumors with skin involvement behave the same, adds Bleicher. "Some small, invasive tumors will spread t
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Contact: Diana Quattrone
Diana.Quattrone@fccc.edu
215-728-7784
Fox Chase Cancer Center
Source:Eurekalert

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