November 10th, 2017
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 10th 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.
To request permission to photocopy, duplicate, republish, or otherwise reuse AJCC material in journals, presentations or course material please e-mail ajcc@facs.org.
Breast Webinar
Please join the American Joint Committee on Cancer (AJCC) Physician to Physician Webinar Series for the 8th Edition Cancer Staging Manual. This webinar covered the Breast Staging System and occured on Wednesday, November 8, 2017. The presenter was Dr. Gabriel Hortobagyi.