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Patients with breast cancer should be assigned a clinical stage based on examination. The stage may be altered once the final pathology report is available. Staging of breast cancer is based on the TNM staging system.
Preoperative staging in stage I and II breast cancer. Preoperative workup should include a CBC, SMA18, and chest x-ray. If elevated alkaline phosphatase or hypercalcemia is present, a bone scan should be completed. Abnormal liver function tests should be investigated with a CT scan of the liver.
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American Joint Committee on Cancer TNM staging |
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Stage |
Description |
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Tumor TX Primary tumor not assessable T0 No evidence of primary tumor chemotherapy, mastectomy, radiotherapy Tis Carcinoma in situ T1 Tumor =2 cm in greatest dimension T1a Tumor =0.5 cm in greatest dimension T1b Tumor >0.5 cm but not > 1 cm T1c Tumor >1 cm but not >2 cm T2 Tumor >2 cm but <5 cm in greatest dimension T3 Tumor >5 cm in greatest dimension T4 Tumor of any size with direct extension into the chest wall or skin T4a Extension to chest wall (ribs, intercostal muscles, or serratus anterior) T4b Peau d'orange, ulceration, or satellite skin nodules T4c T4a plus b T4d Inflammatory Regional lymph nodes NX Regional lymph nodes not assessable N0 No regional lymph node involvement N1 Metastasis to movable ipsilateral axillary lymph nodes N2 Metastases to ipsilateral axillary lymph nodes fixed N3 Metastases |
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