Inflammatory breast cancer: a proposed conceptual shift in the UICC-AJCC TNM staging system.
Inflammatory breast cancer: a proposed conceptual shift in the UICC-AJCC TNM staging system.
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DOI：
10.1016/s1470-2045(17)30192-4
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发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Ueno NT
中科院分区：
文献类型：
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作者：
Fouad TM;Barrera AMG;Reuben JM;Lucci A;Woodward WA;Stauder MC;Lim B;DeSnyder SM;Arun B;Gildy B;Valero V;Hortobagyi GN;Ueno NT
在缺乏区分炎性乳腺癌 (IBC) 和非炎性乳腺癌 (non-IBC) 的组织学标准的情况下，IBC 的诊断完全依赖于乳腺癌肿瘤-淋巴结-转移 (TNM) 分类所概述的临床标准。目前乳腺癌的 TNM 分类将临床 IBC 标准的患者限制为 T4d 亚类。这具有将所有非转移性 IBC 患者降级至 III 期的立竿见影的效果，无论肿瘤大小或淋巴结扩散如何。对于出现转移性疾病的患者，TNM 分类将其归为 IV 期，并且不会根据是否存在炎症标准来区分患者。我们小组以及其他人的最新证据表明，在诊断时出现远处转移（IV 期乳腺癌）的患者中，符合 IBC 标准的患者的总生存期显着降低。鉴于这些结果，本手稿讨论了当前的 TNM 分期分类是否准确地代表了 IBC 和非 IBC 之间的区别。
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.