Inflammatory breast cancer: a proposed conceptual shift in the UICC–AJCC TNM staging system

Abstract

In the absence of histologic criteria that distinguish inflammatory breast cancer (IBC) from non-inflammatory breast cancer (non-IBC), the diagnosis of IBC relies entirely on the existence of clinical criteria as outlined by the Tumor-Node-Metastasis (TNM) classification of breast cancer. The current TNM classification of breast cancer restricts patients presenting with clinical IBC criteria to subcategory T4d. This has the immediate effect of relegating all patients with non-metastatic IBC to stage III regardless of tumor size or nodal spread. For patients presenting with metastatic disease, the TNM classification consigns them to stage IV and does not distinguish patients based on the presence of inflammatory criteria. Recent evidence by our group, as well as others, suggests that patients with IBC criteria have a significantly reduced overall survival among patients who present with distant metastasis at diagnosis (stage IV breast cancer). In light of these results, this manuscript addresses whether the current TNM staging classification accurately represents the distinction between IBC and non-IBC.

Development and verification of a nomogram for prediction of recurrence‐free survival in clear cell renal cell carcinoma

“…28 Researchers found that T cells with chimeric antigen receptors (CAR T cells) which targets human CD19 (hCD19) have shown great efficacy against B cell malignancies. 30,31 Importantly, when patients presented with the same stage or grade, these traditional factors are unable to predict an individual's risk. .…”

BRCA mutations in women with inflammatory breast cancer

“…All patients in the current study were cared for by a multidisciplinary team comprised of a breast medical oncologist, a surgeon, and a radiation oncologist. A clinical diagnosis of IBC was defined according to the criteria outlined in the seventh edition of the American Joint Committee on Cancer staging manual and the recommendations of an expert panel on IBC . All pathologic specimens were reviewed by a dedicated breast pathologist at MDACC, and all patients underwent routine staging workup.…”

“…All pathologic specimens were reviewed by a dedicated breast pathologist at MDACC, and all patients underwent routine staging workup. HER2, ER, and PR status were determined according to the American Society of Clinical Oncology/College of American Pathologists recommendations . Family history was obtained from patient reports provided during a genetic counseling session and the collection of a 3‐generation pedigree or from the IBC registry questionnaire.…”

“…A clinical diagnosis of IBC was defined according to the criteria outlined in the seventh edition of the American Joint Committee on Cancer staging manual and the recommendations of an expert panel on IBC. 12,13 All pathologic specimens were reviewed by a dedicated breast pathologist at MDACC, and all patients underwent routine staging workup. HER2, ER, and PR status were determined according to the American Society of Clinical Oncology/ College of American Pathologists recommendations.…”

Identification of a 4‐mRNA metastasis‐related prognostic signature for patients with breast cancer

“…However, the current TNM Classification method cannot perfectly provide accurate information to predict patients’ prognosis . Then some patients with BC received unnecessary or excessive medication, while others may be faced with recurrence or metastasis due to lack of appropriate treatment . These limitations have prompted a search for new biomarkers for discrimination of cancer patients to improve precision cancer treatment.…”