Clinical relevance of TNM staging system according to breast cancer subtypes

Y. H. Park, S. J. Lee, E. Y. Cho, Y. La Choi, J. E. Lee, S. J. Nam, J. H. Yang, J. H. Shin, E. Y. Ko, B. K. Han, J. S. Ahn, Y. H. Im

Research output: Contribution to journalArticlepeer-review

85 Scopus citations


Background: There has been reported that the association between nodal spread and tumor size was disrupted in triple-negative breast cancer (TNBC) and it showed characteristically early relapse. The TNM (tumor-node-metastasis) staging system might not be equally effective as a prognostic indicator for all subtypes. The aim of our study was to evaluate the usefulness of the staging according to subtypes. Patients and methods: We conducted a retrospective analysis of invasive breast cancer patients who received curative surgery at Samsung Medical Center from 2000 to 2004. Relapse-free survivals (RFS) by stage were analyzed. Results: Thousand eight hundred and seventy-nine patients who were available clinicopathologic data were included. These patients were divided into three subtypes: hormone receptor (HR)+, human epidermal growth factor receptor 2+, and triple negative groups. As the stage became more advanced, the slope of each stage of the RFS curves of patients with HR+ and HER2+ steadily increased. In contrast, RFS curves intermingled and showed overlap from stage 1 to 3A in TNBC patients. There was only wide separation of RFS curves between stage 1-3A and 3B-3C in TNBC. Conclusions: The current TNM staging system might not be enough for encompassing the tumor biology and for predicting outcomes to make therapeutic decisions for all BCs, especially for TNBC patients.

Original languageEnglish
Pages (from-to)1554-1560
Number of pages7
JournalAnnals of Oncology
Issue number7
StatePublished - Jul 2011


  • AJCC TNM staging
  • Breast cancer subtype
  • Triple-negative breast cancer (TNBC)


Dive into the research topics of 'Clinical relevance of TNM staging system according to breast cancer subtypes'. Together they form a unique fingerprint.

Cite this