[Proposals for revisions of UICC TNM system (1997)--breast cancer]

The TNM system for classification and staging approved by Union Internationale contro le Cancer (UICC)/TNM Committee is designed primarily for patient care and, in this context, is equally applicable to patients in clinical research, community hospitals, and developing countries. It is clearly evident to all who have been involved that international agreement on the classification of cancer at all anatomical sites is exhilarating, since data from around the world can finally be compared with validity. The UICC believes that the TNM system can fulfil the following five objectives: (1) aid in the planning of treatment; (2) give an indication of prognosis; (3) assist in evaluation of the results of treatment; (4) facilitate the exchange of information between centres; and (5) contribute to the continuing investigation of human cancer. The important questions for planning of treatment (1), however, can not be answered by the information of the clinical TNM stage as the concept in the Japanese Joint Committee. The knowledge of the TNM stage does not yield information of prognostic importance (2). More accurate indices of prognosis can be calculated from multivariate analysis to examine many clinicopathological variables, and biological markers along with patient age and nodal status. The analysis makes the difficulties for the results of treatment due to the large number of combinations with T and N subgroups (3) (4). According to the fifth objective (5) of TNM classification, we would like to propose a more simple and pragmatic classification by classifying patients into those requiring surgical approach and adjuvant therapy.