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Can you tell me about the staging of breast cancer? |
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Breast cancer pathology
Lymph node status
10 year survival
no nodes = 75%
nodes involved = 25% ( More nodes the worst the prognosis)
sentinel node biopsy
Tumour size
Time dependent
Tumours > 15mm have a 40% risk of LN +ve
Tumours <15mm have a 0-15% risk of LN +ve
Differentiation
Nottingham method
Grade 1 tumour = 85% 10 year survival
Grade 3 tumour = 45% 10 year survival
E2 / Progesterone
30 % patients will respond to endocrine therapy
60% patients with ER +ve tumours respond
78% patients with ER /PR +ve tumours respond
BRCA1 and BRCA2
BRCA1 are usually medullary carcinomas, less likely yo be ERE/PR +ve and are of high grade, higher p53
HER-2
HER-2 overexpression in LN+ve cancers carries a bad prognosis
HER-2 and LN-ve cancers….no consensus
Stage
1 T1 <2cm N0 90%
2 T2 2-5cm N1 mobile nodes 70%
3 T3 >5cm N2 Fixed nodes 50%
4 Fixed any size N3 supraclav nodes < 20% |
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