| Ch 6 | Example of Cancer Classification | |
| Cancer Classification |
Breast cancer | |
The following links give access to diagrams of the various stages of breast cancer.
| Classification |
Description | ||||||||
| TX |
Primary tumour cannot be assessed | ||||||||
T0 |
No evidence of primary tumour | ||||||||
| Tis |
In situ tumour | ||||||||
T1 |
Tumour <= 2cm | ||||||||
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| Tumour >2.0 cm but <=5.0 cm at
its largest point |
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Tumour >5.0 cm at its largest point |
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T4 |
Tumour of any size with direct extension to (a) chest wall or (b) skin | ||||||||
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This is a very complicated classification which has changed many times.
| Classification |
Description |
NX |
Regional lymph nodes cannot be assessed |
N0 |
No regional lymph node metastasis |
| N1 | Metastasis to movable ipsilateral axillary lymph node(s) |
| N2a | Metastasis in ipsilateral axillary lymph nodes fixed to one another (matted) or to other structures |
| N2b | Metastasis only in clinically apparent ipsilateral internal mammary nodes and in the absence of clinically evident axillary lymph node metastasis |
| N3a | Metastasis in ipsilateral infraclavicular lymph node(s) |
| N3b | Metastasis in ipsilateral internal mammary lymph node(s) and axillary lymph node(s) |
| N3c | Metastasis in ipsilateral supraclavicular
lymph node(s) |
In classical forms (except in inflammatory diseases), the T value is of relatively little consequence for 5 year survival (unless there is thoracic wall invasion) except that, generally speaking, the higher the T value, the greater the risk of having positive nodes.
For this indirect reason, here are the results of our Centre François
Baclesse (from 1989 to 1999 - Work by Thierry Delozier - Hubert Crouet). The
time scale is in months.
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Data from Centre François Baclesse |
However, the T value is very important for surgical treatment (since beyond T2 it becomes very difficult to save the breast due to the size of the tumour).
The N classification is very important for prognosis and justifies the numerous clinical trials (noticeably the intensification in chemotherapy) aimed at increasing survival. Here are the results of disease free survival observed by our team.
('1 to 3 positive nodes' describes stage pN1b; '4 to 9 positive nodes' describes stage pN2a; '10 and above positive nodes' describes stage pN3).
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Data from Centre François Baclesse |
Below is a classical representation of the importance of node status on 5 year survival (according to the number of positive nodes after surgery).
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For French speaking readers, the website of Lorraine cancer network Oncolor describes breast carcinoma, its classification and decision trees according to the various and complex situations observed.
For English speaking readers, the NCI website also gives a lot of information.
Another website (in English) is very interesting for pathology : Webpath from Florida University.
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