Breast cancer with non-inflammatory skin involvement: Current data on an underreported entity and its problematic classification

被引:9
作者
Gueth, Uwe [1 ]
Huang, Dorothy Jane [1 ]
Schoetzau, Andreas [2 ]
Dirnhofer, Stephan [3 ]
Wight, Edward [1 ]
Singer, Gad [3 ,4 ]
机构
[1] Univ Basel Hosp, Dept Gynecol & Obstet, CH-4031 Basel, Switzerland
[2] Schotzau & Simmen Inst Biomath, CH-4052 Basel, Switzerland
[3] UHB, Inst Pathol, CH-4031 Basel, Switzerland
[4] Cantonal Hosp Baden, Inst Pathol, CH-5404 Baden, Switzerland
关键词
Breast cancer; Skin involvement; Staging; Prognosis; TNM classification; TNM CLASSIFICATION; SYSTEM; CARCINOMA; REVISION; CATEGORY; T4B;
D O I
10.1016/j.breast.2009.11.008
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We evaluated 166 breast cancer cases with non-inflammatory skin involvement (NISI), which were classified in the TNM classification as T4b. The distribution of tumour sizes and stages was: <= 3 cm:24.1%, 3.1-5 cm:21.7%, 5.1-10 cm:33.1%, >10 cm:21.1%; stages: I/II:21.0%, III:43.4%, IV:35.6%. To assess the impact of NISI on axillary lymph node involvement (ALNI), we analyzed a sub-group of 50 patients with tumours <= 5 cm and compared them with a matched control group. NISI was found to be associated with increased ALNI (HR, 2.66: 95%CI, 1.59-4.63; p < 0.0001). According to the inherent rules of tumour classification, only tumours with similar morphologic extent and prognostic significance should be combined. Since there is a high grade of heterogeneity, this basic tenet is clearly violated regarding breast cancer with NISI Our proposal is to eliminate these tumours from the T4 category and to classify them simply by size (T1-3). Due to its prognostic significance, NISI should be indicated by an optional descriptor (e.g. SI). (C) 2009 Elsevier Ltd. All rights reserved.
引用
收藏
页码:59 / 64
页数:6
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