A 56-year-old woman has a 6 cm hard breast lump that is fixed to the underlying ribs and intercostal muscles on all views. The overlying skin is freely mobile with no ulceration, oedema or satellite nodules. There are no palpable axillary nodes and no distant metastases. What is the correct clinical T category?
- A T4a ✓
- B T3
- C T4b
- D T2
Correct answer: A. T4a
Explanation
Direct extension into chest wall structures beyond pectoral adherence, involving ribs, intercostal muscles or serratus, defines T4a. Skin involvement of any kind, whether oedema, ulceration or satellite nodules, would make it T4b, and combined chest wall plus skin disease is T4c. B tumour larger than 5 cm without chest wall or skin involvement is merely T3. With N0M0 status this patient therefore has stage IIIB disease by virtue of the T4 designation.
Reference: AJCC Cancer Staging Manual, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.