The comparison of the anatomic stage and pathological prognostic stage according to the AJCC 8th edition for the prognosis in Japanese breast cancer patients: data from a single institution

Abstract

Background The TNM system, which reflects the anatomical extent of disease, was used for stage definition. In the recently published AJCC 8th edition, the new staging system of the clinical and pathological prognostic stage, which incorporates biological factors, is introduced. Patients and methods A total of 2622 patients with primary breast cancer at stage I–III were included in this study. The anatomic stage (aStage) and the pathological prognostic stage (ppStage) for each case were determined according to the definition of the AJCC 8th edition, and the influence of these stages on the prognosis was compared. Results The stage distributions of aStage and ppStage were as follows: aStage, stage IA (54.8%), IB (1.1%), IIA (26.1%), IIB (9.2%), IIIA (5.6%), IIIB (0.1%), and IIIC (3.1%); and ppStage, stage IA (66.6%), IB (13.1%), IIA (11.1%), IIB (3.2%), IIIA (3.3%), IIIB (1.4%), and IIIC (1.2%). Compared with the aStage, the ppStage stayed the same in 1710 patients (65.2%), was downstaged in 778 patients (29.7%), and was upstaged in 134 patients. The pathological tumor size (pT2) and lymph node metastasis (pN1) were associated with downstaging, and histological grade 3 was associated with upstaging. ER positivity, PgR positivity, and HER2-positivity were significantly associated with downstaging, and the TN subtype was associated with upstaging. Both the aStage and ppStage were significantly associated with the prognosis; however, the Kaplan–Meier curves for the relapse-free survival (RFS), distant recurrence-free survival (DRFS), and overall survival were better stratified by the ppStage. Conclusion The ppStage reflects the prognosis of patients with early breast cancer more accurately than the aStage.

Effect of Stereotactic Body Radiation Therapy Combined with Thermoplastic Fixation on Set-Up Errors in Breast Cancer Patients Undergoing Radiotherapy

“…The head mask and baseplate in the thermoplastic fixation can effectively fix the patients to make them feel comfortable and safe during treatment, and the groove and fixing lugs in the baseplate not only facilitate the fixation of headrest but also increase the comfort level [21][22][23]. Besides, Tokunaga et al [24] have pointed out that thermoplastic fixation has remarkably smaller set-up errors compared with the breast bracket and can effectively enhance radiotherapy effect and benefit the patients' prognoses. Tables 3, 4, and 5 in this paper present the analysis results of set-up errors of the breast bracket and thermoplastic fixation.…”

Evaluation of the histological and immunohistochemical subtype of breast cancer patients from a referral hospital in the inland of the state of São Paulo

“…In addition, the prognostic staging assesses the histological grade of the tumor and the presence or absence of hormone receptors (ER and PR) and HER2. Currently, the Oncotype Dx ® genomic test can also be evaluated 32 .…”

“…Prospective studies have shown greater accuracy when evaluating the pathological-prognostic staging to define patient management 32 . Yet, as the objective of this study was only to investigate whether molecular subtypes influenced the disease staging, no adjuvant therapy was analyzed; thus, no further statements on the subject are pertinent.…”

Establishment of A Risk-Predicting Twenty-Two-Gene Signature Based on the Prognosis-Related RNA Binding Proteins of Breast Cancer

“…Clinicopathologicalfeatures, such as age, clinical stage, and tumor classi cation are major predictors of survival outcomes in patients with BC (14). Recent researches have shown that RBP is closely related to the occurrence and development of various cancers and plays a critical role in tumor invasion, migration, and metastasis (15).…”