BREAST CANCER
"last update: 21 August 2024"
- Glossary
Non-Metastatic Breast Cancer:
Includes patients who have Early Breast Cancer (EBC) and Locally advanced Breast Cancer (LABC).
➡️ EBC: This includes ductal carcinoma in situ and stage I, stage IIA, stage IIB, and stage IIIA breast cancers.
➡️ LABC: this includes inoperable breast adenocarcinoma without distant metastases stage IIIB, and C.
Menopausal status (Defined by NCCN)
Postmenopausal status:
▪️ Permanent cessation of menses includes a profound and permanent decrease in ovarian estrogen synthesis.
Premenopausal status:
▪️ It is the ongoing process of menses and normal ovarian estrogen synthesis.
Perimenopausal status:
▪️ It is the transition status between the pre- and post-menopausal status with irregularities in menses and estrogen levels.
Definitions of molecular subtypes of breast cancer according to: (The ESMO Clinical Practice Guidelines, 2023):
➡️ Luminal A : (ER-positive, HER2-negative, Ki67 low, PgR high)
➡️ Luminal B :
▪️ (HER2-negative subtype): (ER-positive, HER2-negative, and either, Ki67 high or PgR low)
▪️ (HER2-positive subtype): (ER-positive, HER2-positive, any Ki67, any PgR)
➡️ HER2 overexpression (nonluminal): (HER2-positive, ER and PgR absent)
➡️ Triple-negative: (ER and PgR absent, HER2-negative)
Cancers with 1%–100% ER IHC staining are considered ER-positive.
Cancers with 1%–10% ER IHC staining are considered ER-low-positive.
HER2 positive patients (IHC+++ or ISH positive for gene amplification (HER2/CEP17 ratio ≥2.0 AND average HER2 copy number ≥ 4.0 signals/cell))
Ki67 index of 5% or less, or 30% or more, can be used to estimate prognosis for T1-2, N0-1 patients as per the International Ki67 in Breast Cancer Working Group (IKWG)
Definition of High-risk patients:
-HER2-positive disease
-TNBC
- ≥ cT2 or ≥ cN1
-Large primary tumor relative to breast size
