Pathologists staging in breast cancer

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Breast cancer stage ranges from Stage 0 (pre-invasive disease) to Stage IV (metastatic disease). Stage is a prognostic factor, and in broad generalization, "low stage" cancers (Stages 0-II) tend to have better long term outcome than "high stage" cancers (Stages III-IV).

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The new prognostic stage group incorporates biomarkers (ER, PR, HER2) and tumor grade in addition to traditional anatomic pTNM stage factors to more accurately group patients into prognostic groups based on their specific tumor biology. This staging system results in 41% of cases being classified into a better or worse prognostic group.


A pathologist is a doctor who does this examination and writes the pathology report. Pathology reports play an important role in cancer diagnosis and staging (describing the extent of cancer within the body, especially whether it has spread), which helps determine treatment options. Pathologic staging (the standard way to stage breast cancer) is based on a pathologist’s study of the tumor tissue and any lymph nodes removed during surgery. Sometimes, results from a health care provider’s physical exam and/or tests such as mammography may help with staging.
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Collins LC. Premalignant lesions: ductal carcinoma in situ, lobular carcinoma in situ, and other lesions that increase the risk of invasive breast cancer. Program and abstracts of the Breast Cancer Symposium; Gown AM. Current issues in ER and HER2 testing by IHC in breast cancer. Mod Pathol. May; 21 Suppl 2:S8-S

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This article deals with breast cancer staging.. An introduction to cancer staging is in the cancer staging article. An introduction to breast pathology is in the breast pathology article. Common Breast Cancer Pathology Terms The following terms were developed by pathologists to describe the types and kinds of breast cancers. These descriptions help the breast surgical oncologist, medical oncologist and radiation oncologist design an individualized treatment plan for each patient.

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If the stage is based on removal of the cancer with surgery and review by the pathologist, the letter p (for pathologic) may appear before the T and N letters. The T category (T0, Tis, T1, T2, T3, or T4) is based on the size of the tumor and whether or not it has spread to the skin over the breast or to the chest wall under the breast. The most recent AJCC system, effective January , has both clinical and pathologic staging systems for breast cancer. The pathologic stage (also called the surgical stage) is determined by examining tissue removed during an operation.

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Jump to a specific breast cancer stage to learn more: Stage 0; Stage I; Stage II; Stage III; Stage IV; The updated AJCC breast cancer staging guidelines have made determining the stage of a cancer a more complicated but accurate process. So, the characteristics of each stage below are somewhat generalized. The size of the cancer tumor is one of the factors that determines the stage of the breast cancer. Pathologic Staging and TNM Status Breast cancer staging ranges from Stage 0 (pre-invasive) to Stage IV (cancer has spread to distant organs).
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