AJCC Eighth Edition Update to Breast Chapter
The decision to delay implementation of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, Eighth Edition to January 1, 2018 has provided the AJCC with an opportunity to take a careful look at the way it has traditionally communicated cancer staging. Since the manual was published last fall, the AJCC has worked with the surveillance community, the pathology community, and clinical decision support software developers to take a more critical look at the content and make improvements and clarifications that will help everyone who uses this information including the registrar, clinician, and the software developer.
As part of this effort, the AJCC decided to validate and update the Eighth Edition breast cancer staging system using an additional year's worth of data from the National Cancer Database (NCDB). The AJCC Breast Expert Panel has recommended providing two breast cancer Prognostic Stage tables based on further analysis of the NCDB data.
The Clinical Prognostic Stage Group will be used to assign stage for all patients based on history, physical examination, imaging studies, and relevant biopsies. The Pathological Prognostic Stage Group will be used to assign stage for patients who have surgical resection as the initial treatment of their cancer before any systemic or radiation therapy. The Breast Expert Panel also recommended clinical, pathological, and post-therapy data elements that cancer registries should record.
As science continues to evolve, the AJCC is committed to validating and incorporating important updates and communicating them transparently. We understand the burden that these changes place on those who purchased the first printing of the manual. To this end, the entire breast cancer chapter of the manual will be publically available on November 10 through the AJCC website, and replacement pages for all updates and corrections made to the entire manual will be available in December 2017. Future printings of the Staging Manual will include the updated breast chapter as well as other minor updates and corrections issued to date.
Please visit cancerstaging.org for education and regular updates to the Eighth Edition.
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