Always use maximum dimension

If US staging, include echogenic halo

Do not include satellite nodules < 2 cm from the primary tumor; separately measure those > 2 cm from tumor.

LABC = Inoperable breast CA w/o distant mets.

Includes:

• T3 (>5cm), T4 w/ any N (skin,chest wall invasion)

• Any T stage w/ N2 or N3 

Usually requires NAT

Tumor pathology that effects staging & tx

• ER/PR receptor +/-

• Her2 expression +/-

• Mitotic grade (low, intermediate, high)

• Oncogene testing

Oncotype dx

• Tests for the expression of 21 genes in the tumor samples and combines into a single score.

• Predicts recurrence rate to decide on chemotherapy for LOW-RISK patients.

  • Low if <11

• Performed on ER/PR+, Her2-, <5cm tumors

• Not performed on locally advanced, triple neg, metastatic tumors bc they are high risk and will have chemotherapy regardless on oncotype

Size doesn't matter as long as morphology is normal

MRI kinetics dont matter; most are T2 bright w/ washout

Report the number of abnormal nodes.