دورية أكاديمية
Discordance in clinical versus pathological staging in breast cancer: Are we undermining the significance of accurate preoperative staging in the present era?
| العنوان: | Discordance in clinical versus pathological staging in breast cancer: Are we undermining the significance of accurate preoperative staging in the present era? |
|---|---|
| المؤلفون: | Goyal S; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Jacob LA; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Lokanatha D; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Suresh Babu MC; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Lokesh KN; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Rudresha AH; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Saldanha S; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Amirtham U; Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Thottian AGF; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Rajeev LK; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India. |
| المصدر: | Breast disease [Breast Dis] 2022; Vol. 41 (1), pp. 115-121. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: IOS Press Country of Publication: Netherlands NLM ID: 8801277 Publication Model: Print Cited Medium: Internet ISSN: 1558-1551 (Electronic) Linking ISSN: 08886008 NLM ISO Abbreviation: Breast Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Amsterdam : IOS Press Original Publication: [New York, NY] : Elsevier, [c1987- |
| مواضيع طبية MeSH: | Breast Neoplasms/*classification , Breast Neoplasms/*diagnostic imaging , Neoplasm Staging/*methods , Neoplasm Staging/*standards, Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/secondary ; Disease-Free Survival ; Female ; Humans ; Mammography ; Medical Records ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult |
| مستخلص: | Background: The present era of individualized treatment for breast cancer is influenced by the initial disease status including the anatomical extent, grade, and receptor status. An accurate preoperative staging is the basis of treatment planning and prognostication. Our study aims to determine the discordance between the preoperative clinical and the postoperative pathological stages of breast cancer patients. Methodology: The medical records of all non-metastatic breast cancer patients from January 2017 to December 2018 who underwent upfront surgery were reviewed. They were staged as per the eighth AJCC and the concordance between the clinical (c) and pathological T (tumor), N (nodal), and final AJCC stage was studied. A Chi-square test was used to determine factors that significantly correlate with disease discordance. Results: A total of 307 breast cancer patients were analyzed. Among these, 43.3% were hormone receptor-positive, 30.6% were Her2 positive and 26% were triple-negative. Overall stage discordance was seen in 48.5% (n = 149) patients (upstaging in 22.1%, downstaging in 26.4%). The discordance rate was 48.9% for T stage (cT versus pT) and 57.4% for N stage (cN versus pN). Among patients with clinically node-negative disease, 53.4% were found to have positive nodes on histopathology, while 27.2% had vice versa. Overall, the factors associated with upstaging were ER-positive, Her2 positive and triple-negative status (all p < 0.05), while none of the factors showed significant association with downstaging. Conclusions: About half of breast cancer patients had discordance between clinical and pathological staging with higher discordance in the nodal stage. This changes the disease prognosis, and may also affect the offered surgical treatment and radiotherapy. Thus highlighting the need for a precise pre-operative staging. Also, this information will aid clinicians in discussions with patients, keeping in mind the likelihood of change in disease staging and management. |
| فهرسة مساهمة: | Keywords: Discordance; breast cancer; pathological staging; preoperative staging; upstaging |
| تواريخ الأحداث: | Date Created: 20210823 Date Completed: 20220303 Latest Revision: 20220303 |
| رمز التحديث: | 20240628 |
| DOI: | 10.3233/BD-201029 |
| PMID: | 34420937 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1558-1551 |
|---|---|
| DOI: | 10.3233/BD-201029 |