A 48-year-old woman is found to have a 2.2 cm invasive ductal carcinoma of the right breast with one axillary lymph node positive on sentinel node biopsy (micrometastasis, 0.3 mm deposit). Pathology shows ER+/PR+, HER2-. According to current AJCC 8th edition staging incorporating biomarkers, the T and N staging is T2 N1mi. What is the pathological prognostic stage group?

• A Stage IIA
• B Stage IIB
• C Stage IIIA
• D Stage IA ✓

Explanation

Under AJCC 8th edition, biomarker-based prognostic staging downgrades anatomic stage for hormone receptor-positive, HER2-negative tumours. A T2 N1mi ER+/PR+ HER2- tumour with low-grade genomic profile is reclassified to pathological prognostic Stage IA. This is a critical distinction from anatomic staging alone, which would place T2N1mi at Stage IIA.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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