Comparison of Pathological Prognostic Stage and Anatomic Stage Groups According to the Updated Version of the American Joint Committee on Cancer (AJCC) Breast Cancer Staging 8th Edition

Abstract

BackgroundWe compared pathological prognostic stage (PPS) with anatomic stage (AS) groups according to the updated version of breast cancer staging of the American Joint Committee on Cancer (AJCC) 8th Edition.Material/MethodsWe evaluated 353 breast cancer patients initially treated with surgery. AS and PPS were performed by evaluating the pathological data of the patients according to the AJCC 8th Edition breast cancer updated version. Stages and survival rates between the 2 staging systems were evaluated and compared. Disease-free survival (DFS) and disease-specific survival (DSS) were calculated according to both staging systems using Kaplan-Meier test. After the PPS change was made in each AS group, 10-year DFS and 10-year DSS of the changed groups were compared using the chi-square test.ResultsThe median follow-up was 114 months and the median age was 48 years. In 192 (54.4%) patients the stage change. The most significant change was 1-level downstaging in 70 (22.4%) patients, and 2-levels downstaging in 78 (22.1%) patients. Five-year DFS, 10-year DFS, 5-year DSS rate, and 10-year DSS were 86.3%, 80.3%, 93.8%, and 84.1%, respectively. The PPS system was found to provide better prognostic information when the patients with AS IIB and IIIA groups were compared according to the PPS.ConclusionsAccording to the updated version of the AJCC 8th Edition, half of our patients had stage change when they were evaluated according to AS and PPS system. PPS gives better information about prognosis than does AS.

Integration of Ki-67 index into AJCC 2018 staging provides additional prognostic information in breast tumours candidate for genomic profiling

“…The results obtained confirm that integration of tumour load (size and presence of node involvement) with tumour type (grade and prognostic factors) leads to an increased number of patients classified as stage I, as previously reported. 16,17 Furthermore, in line with other studies, 18,19 we found that stage I according to PS clearly identifies a group of patients with a more favourable outcome, distinguishing them from other patients with lesions classified as stage II or III and providing more accurate prognostic information compared with AS.…”

The prognostic value of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system in triple-negative breast cancer

“…PS IIIB and IIIC from AS IIB had significant differences in DFS (χ 2 =5.628, p=0.014) and OS (χ 2 =6.037, p=0.018). Ibis et al [22] also found patients with AS IIB breast cancer restaged to different PS groups in a cohort of 353 Turkish patients, with a significant difference in 10-year DFS among restaged PS groups. Thus, we confirmed that PS system provided more accurate information on prognosis than AS system in patients with TNBC, especially in AS IIB group.…”

Evaluation of the 8th edition of the American joint committee on cancer’s pathological staging system in prognosis assessment and treatment decision making for stage T1-2N1 breast cancer after mastectomy

“…Studies have indicated that the inclusion of these biological factors in the traditional anatomic staging system would be beneficial [ [3] , [4] , [5] , [6] , [7] , [8] ], and accordingly, some changes were made in the 8th AJCC breast cancer staging system [ 1 , 2 , 7 , 8 ], which is the first staging system to incorporate biological factors into the TNM staging system. The new prognostic staging system is considered to be a significantly superior tool for predicting survival outcome as compared to the previous one, and its prognostic benefits have been validated in several studies [ [9] , [10] , [11] , [12] , [13] , [14] , [15] ].…”