Lee Sandy C, Jain Payal A, Jethwa Samir C, Tripathy Debu, Yamashita Mary W
From the Departments of Radiology (S.C.L., P.A.J., S.C.J., M.W.Y.) and Medicine (D.T.), Keck School of Medicine, University of Southern California, Norris Comprehensive Cancer Center, 1441 Eastlake Ave, 2nd Floor #2315, Los Angeles, CA 90089. Recipient of a Certificate of Merit award for an education exhibit at the 2012 RSNA Annual Meeting.
Radiographics. 2014 Mar-Apr;34(2):330-42. doi: 10.1148/rg.342135071.
Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer, and the 5-year survival rate is largely dependent on disease stage. The American Joint Committee on Cancer (AJCC) staging system for breast cancer (7th edition) provides a tumor-node-metastasis (TNM) classification scheme for breast cancer that is important for determining prognosis and treatment. Ascertaining the correct stage of breast cancer can be challenging, and the importance of the radiologist's role has increased over the years. The radiologist should understand how breast cancer stage is assigned and should be familiar with the AJCC's TNM classification scheme. The authors review the AJCC's TNM staging system for breast cancer with emphasis on clinical and preoperative staging, the different imaging modalities used in staging, and the key information that should be conveyed to clinicians. Radiologic information that may alter stage, prognosis, or treatment includes tumor size; number of tumor lesions; total span of disease; regional nodal status (axillary levels I-III, internal mammary, supraclavicular); locoregional invasion (involvement of the pectoralis muscle, skin, nipple, or chest wall); and distant metastases to bone, lung, brain, and liver, among other anatomic structures.
乳腺癌是女性癌症死亡的第二大主要原因，仅次于肺癌，其5年生存率在很大程度上取决于疾病分期。美国癌症联合委员会（AJCC）乳腺癌分期系统（第7版）为乳腺癌提供了一种肿瘤-淋巴结-转移（TNM）分类方案，这对于确定预后和治疗非常重要。确定乳腺癌的正确分期可能具有挑战性，并且多年来放射科医生的作用越来越重要。放射科医生应了解乳腺癌分期是如何确定的，并且应熟悉AJCC的TNM分类方案。作者回顾了AJCC的乳腺癌TNM分期系统，重点介绍了临床和术前分期、分期中使用的不同成像方式以及应传达给临床医生的关键信息。可能改变分期、预后或治疗的放射学信息包括肿瘤大小；肿瘤病灶数量；疾病的总范围；区域淋巴结状态（腋窝I-III级、内乳、锁骨上）；局部区域侵犯（胸肌、皮肤、乳头或胸壁受累）；以及骨、肺、脑和肝等其他解剖结构的远处转移。
