Fouad Tamer M, Barrera Angelica M Gutierrez, Reuben James M, Lucci Anthony, Woodward Wendy A, Stauder Michael C, Lim Bora, DeSnyder Sarah M, Arun Banu, Gildy Babiera, Valero Vicente, Hortobagyi Gabriel N, Ueno Naoto T
Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Medical Oncology, The National Cancer Institute, Cairo University, Cairo, Egypt.
Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Lancet Oncol. 2017 Apr;18(4):e228-e232. doi: 10.1016/S1470-2045(17)30192-4.
In the absence of histological criteria that distinguish between inflammatory and non-inflammatory breast cancer, diagnosis of inflammatory breast cancer relies entirely on the existence of clinical criteria as outlined by the TNM classification. This classification restricts patients presenting with clinical criteria characteristic of inflammatory breast cancer to subcategory T4d, which immediately relegates all patients with non-metastatic inflammatory breast cancer to stage 3, regardless of tumour size or nodal spread. Patients who present with metastatic disease are consigned to stage 4, and the TNM classification does not distinguish patients on the basis of the presence of inflammatory criteria. Evidence by our group and others suggests that patients with inflammatory breast cancer have significantly reduced overall survival among those who present with distant metastasis at diagnosis (stage 4). In light of these results, this Personal View addresses whether the current TNM staging classification accurately represents a distinction between patients with inflammatory and those with non-inflammatory breast cancer.
在缺乏区分炎性乳腺癌和非炎性乳腺癌的组织学标准的情况下，炎性乳腺癌的诊断完全依赖于TNM分类所概述的临床标准。该分类将具有炎性乳腺癌临床标准的患者归为T4d亚类，这就立即将所有非转移性炎性乳腺癌患者归为3期，而不考虑肿瘤大小或淋巴结转移情况。出现转移性疾病的患者被归为4期，并且TNM分类并未根据炎性标准的存在来区分患者。我们团队和其他团队的证据表明，在诊断时出现远处转移（4期）的患者中，炎性乳腺癌患者的总生存率显著降低。鉴于这些结果，这篇个人观点文章探讨了当前的TNM分期分类是否准确地体现了炎性乳腺癌患者与非炎性乳腺癌患者之间的区别。
