Risk stratification according to stage and pathology
1Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
Breast (Edinburgh, Scotland)
|December 17, 2019
Summary
Advances in early breast cancer risk stratification include new staging systems and the prognostic value of pathological complete response (pCR) and stromal tumor infiltrating lymphocytes (sTILs). These findings aid in tailoring adjuvant therapy for high-risk patients.
Area of Science:
- Oncology
- Pathology
- Clinical Research
Background:
- Early breast cancer risk stratification relies on stage and pathology.
- Recent advances have refined these foundational elements.
- The St. Gallen International Breast Cancer Conference highlights key developments.
Purpose of the Study:
- To summarize recent advances in early breast cancer risk stratification.
- To highlight the impact of updated staging and pathological assessments.
- To discuss the implications for treatment decisions.
Main Methods:
- Review of updates from the 8th edition of the AJCC Staging Manual.
- Analysis of clinical trial results regarding neoadjuvant systemic therapy response.
- Evaluation of evidence supporting the prognostic role of stromal tumor infiltrating lymphocytes (sTILs).
Main Results:
- The AJCC Staging Manual introduced Clinical and Pathological Prognostic Stages.
- Achieving pathological complete response (pCR) after neoadjuvant therapy is a significant prognostic indicator.
- Residual disease after neoadjuvant therapy identifies a high-risk group.
- Stromal tumor infiltrating lymphocytes (sTILs) show a robust prognostic role, especially in triple-negative breast cancer.
Conclusions:
- Stage and pathology remain critical for early breast cancer risk stratification.
- Pathological complete response (pCR) and sTILs are valuable tools for refining prognosis and guiding therapy.
- These advancements support personalized treatment strategies for breast cancer patients.
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