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Scope and significance of non-uniform classification practices in breast cancer with non-inflammatory skin involvement: a clinicopathologic study and an international survey.

作者信息

Güth U, Singer G, Schötzau A, Langer I, Dieterich H, Rochlitz C, Herberich L, Holzgreve W, Wight E

机构信息

Department of Gynecology and Obstetrics, University Hospital Basel, Switzerland.

出版信息

Ann Oncol. 2005 Oct;16(10):1618-23. doi: 10.1093/annonc/mdi319. Epub 2005 Jul 20.

Abstract

BACKGROUND

The study evaluates the scope of non-uniform classification practices concerning breast carcinomas with non-inflammatory skin involvement.

PATIENTS AND METHODS

We compared the clinical course of patients with histologically proven non-inflammatory skin involvement: 119 (65.4%) with clinically obvious 'classical' skin changes (Group A) and 63 (34.6%) with no or only discreet changes (Group B). A questionnaire was circulated to pathology departments in 24 countries to assess the practice concerning the placement of skin- involved breast carcinomas in the TNM classification.

RESULTS

Patients in Group B showed a significantly better disease specific survival (P=0.0002). Eighty-six respondents (70.5%) of the survey preferred the 'histological view' and classified tumors with only histological proven skin involvement as T 4 b/stage IIIB. The opposing classification principle ('clinical view'), which dictates that T 4 b breast cancer is a clinical diagnosis and the classical signs must be present, was supported by 31 respondents (25.4%).

CONCLUSIONS

A large number of breast cancer patients with non-inflammatory skin involvement are only histologically proven and show, compared with cases exhibiting the classical clinical signs, significant differences in clinical course and prognosis. In general, both subsets were aggregated in one T category/stage (T 4 b/IIIB). This results in a considerable distortion of the reported statistical data.

摘要

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