Uehiro Natsue, Horii Rie, Iwase Takuji, Tanabe Masahiko, Sakai Takehiko, Morizono Hidetomo, Kimura Kiyomi, Iijima Kotaro, Miyagi Yumi, Nishimura Seiichiro, Makita Masujiro, Ito Yoshinori, Akiyama Futoshi
Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Breast Cancer. 2014 Nov;21(6):748-53. doi: 10.1007/s12282-013-0453-7. Epub 2013 Feb 23.
The TNM classification of the Unio Internationalis Contra Cancrum was revised for the seventh edition. The major change concerning breast cancer is a change in the stages for patients with T0 or T1N1miM0. In the present study, the seventh edition of the TNM classification was validated in breast cancer.
The stages of 416 breast cancer patients, treated at our hospital in 1996, were classified according to the TNM classification, sixth and seventh editions, and their prognoses were compared.
Case distribution using the sixth edition was stage 0, 56 cases (13.5 %); stage I, 158 cases (38.0 %); stage II, 130 [A, 102; B, 28] cases (31.2 [A, 24.5; B, 6.7] %); and stage III, 72 [A, 31; B, 8; C, 33] cases (17.3 [A, 7.5; B, 1.9; C, 7.9] %). According to the seventh edition, the stages for 20 patients, accounting for 19.6 % of IIA cases according to the sixth edition, decreased from IIA to IB. The 10-year overall survivals were stage 0, 91.1 %; stage I, 88.6 %; stage II, 80.8 %; and stage III, 63.9 % according to the sixth edition; and stage 0, 91.1 %; stage I, 88.8 %; stage II, 79.1 %; and stage III, 63.9 % according to the seventh edition. Although no significant differences were seen among the survival rates for stages 0 to II according to the sixth edition, there was a significant difference between stage I and II according to the seventh edition (p = 0.026).
The latest revision of the TNM classification is appropriate for breast cancer from the perspective of prognosis.
国际抗癌联盟（Union for International Cancer Control，UICC）的TNM分类法已修订至第七版。乳腺癌方面的主要变化是T0或T1N1miM0患者的分期有所改变。在本研究中，对TNM分类法第七版在乳腺癌中的应用进行了验证。
对1996年在我院接受治疗的416例乳腺癌患者，按照TNM分类法第六版和第七版进行分期，并比较其预后情况。
按照第六版分类，病例分布为：0期56例（13.5%）；I期158例（38.0%）；II期130例[A，102例；B，28例]（31.2%[A，24.5%；B，6.7%]）；III期72例[A，31例；B，8例；C，33例]（17.3%[A，7.5%；B，1.9%；C，7.9%]）。按照第七版分类，20例患者（占第六版IIA期病例的19.6%）的分期从IIA期降至IB期。按照第六版，0期、I期、II期和III期的10年总生存率分别为91.1%、88.6%、80.8%和63.9%；按照第七版，分别为91.1%、88.8%、79.1%和63.9%。虽然第六版中0至II期的生存率之间无显著差异，但第七版中I期和II期之间存在显著差异（p = 0.02）。
从预后角度来看，TNM分类法的最新修订适用于乳腺癌。
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