According to the 8th edition AJCC staging for breast cancer, a patient with T2N0M0 disease but a Oncotype DX Recurrence Score of 10 (low) and ER+/HER2- status would be classified as:
- A Pathological Stage IIA
- B Pathological Stage IB due to favorable biomarkers
- C Prognostic Stage IA due to favorable biomarkers ✓
- D Prognostic Stage IIA unchanged by biomarkers
Correct answer: C. Prognostic Stage IA due to favorable biomarkers
Explanation
The 8th edition AJCC classification introduced Prognostic Staging that incorporates tumor grade, ER/PR/HER2 status, and Oncotype DX score alongside anatomical TNM. A T2N0M0 tumor that is ER+/HER2- with a low Oncotype DX score can be downstaged to Prognostic Stage IA. This differs from the older Pathological Stage IIA based on anatomy alone. This distinction has direct therapeutic implications for chemotherapy decisions.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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