A recently published study from researchers at Fox Chase Cancer Center (PA, USA) suggests that women whose breast cancer has spread to the chest wall or skin, but not beyond, may have a better chance of survival than current staging guidelines suggest. However, this only applies to a subset of breast cancers. The researchers suggest that another staging category for tumors with skin involvement should be added to the current criteria.
Richard Bleicher, Associate Professor in the Department of Surgical Oncology and Director of the Breast Fellowship Training Program at Fox Chase Cancer Center, explained: “Many women with tumors that happen to have spread to the skin may unfortunately be given an inaccurately dire prognosis – along with, perhaps, some unnecessary treatment. We need to update our staging criteria to more accurately reflect a woman’s true chances of surviving her cancer because the size of her tumor and the involvement, or lack of involvement, of lymph nodes tells us more about her prognosis than whether skin is involved.”
Using data from the SEER-Medicare Linked Database, the researchers compared individuals with significant skin involvement (n = 924) to individuals whose tumors had not spread to skin (n = 66,185). The former group had all originally been classified as having stage III tumors. By regrouping the tumors based strictly on the size and/or extent of the primary tumor, and whether the cancer had spread to nearby lymph nodes, 43% of individuals were reclassified to earlier stages. The restaged individuals did as well as the women classified to those other stages because they didn’t have skin involvement. The study suggests that, based on tumor size and nodal status, some women may have a 96% chance of surviving 5 years.
Discussing the results, Bleicher explained: “Classifying all tumors with skin involvement as stage III belies the purpose of staging, which is to group tumors with a similar prognosis. Some small, invasive tumors will spread to the skin simply because they happen to arise close to it. That doesn’t necessarily mean they will have a worse prognosis than a similar tumor that is located far enough away from the skin that it hasn’t reached it yet.”