TNM分期系统.pdf
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TNM Staging System
台中榮民總醫院
外科部 一般外科
葉大成 醫師? gendy@episerv.cph.ntu.edPhilosophy of classification
A clinical useful classification scheme for cancer must
encompass the attributes of the tumor that define its
behavior.General rules for staging of cancer
Objectives:
? Selection of primary and adjuvant therapy.
? Estimation of prognosis.
? Assistance in evaluation of the results of treatment.
? Facilitation of the exchange of information of the
exchange if information among treatment centers.
? Contribution to the continuing investigation of
human cancers.TNM staging of the Breast
? Introduction
? Anatomy
? Primary site
? Chest wall
? Regional lymph nodes
? Metastatic sites
? Rules for classification
? Clinical staging
? Pathologic staging
? TNM classification
? Primary tumor (T)
? Regional lymph nodes (N)
? Distant metastasis (M)
? Definition of TNM
? Primary tumor (T)
? Regional lymph nodes (N)
? Distant metastasis (M)
? Stage grouping
? Histopathologic type
? Histologic grade (G)乳房的解剖與編碼
? Nipple (C50.0)
? Central potion (C50.1)
? Upper-inner quadrant (C50.2)
? Lower-inner quadrant (C50.3)
? Upper-outer quadrant (C50.4)
? Lower-outer quadrant (C50.5)
? Axillary tail (C50.6)
? Overlapping lesion of breast (C50.8)
? Breast, NOS (C50.9)Introduction
? This staging system for carcinoma of the breast
applies to
? Infiltrating carcinoma
(including microinvasive)
? In situ carcinoma
?Microscopic confirmation of the diagnosis in
mandatory, and the histologic type and grade of
carcinoma should be recorded.All cases should be confirmed microscopically.
Any cases not so proved must be reported separately.
? Microscopic confirmation of choriocarcinoma is not
required if the hCG is abnorally elevated.
? Microscopic unconfirmed cases can be staged, but
should be analyzed separately.
The General Rules of the TNM systemMicroscopic confirmation? Introduction
? Anatomy
? Primary site
? Chest wall
? Regional lymph nodes
? Metastatic sites
? Rules for classification
? Clinical staging
? Pathologic staging
? TNM classification
? Primary tumor (T)
? Regional lymph nodes (N)
? Distant metastasis (M)
? Definition of TNM
? Primary tumor (T)
? Regional lymph nodes (N)
? Distant metastasis (M)
? Stage grouping
? Histopathologic type
? Histologic grade (G)
TNM staging of the Breast? Terminal duct-lobular unit
? Terminal duct
z Extralobular, intralobular
? Lobules
? Alveoli
? Major duct
? Collecting ducts
? Lactiferous sinuses
? Segmental ducts
? Subsegmental ducts
? The mammary gland is
? segmentally
divided into 15 to
20 distinct
glandular units or
lobes,? each has a ductal
orifice at the apex
of nipple.
Microscopic anatomy of the breastBreast profile:
A ducts
B lobules
C dilated section of duct to hold
milk
D nipple
E fat
F pectoralis major muscle
G chest wall/rib cage
Enlargement:
A normal duct cells
B basement membrane
C lumen (center of duct)
Microscopic anatomy
of the breastBreast CancerApproximate distribution of breast tissue on ......
台中榮民總醫院
外科部 一般外科
葉大成 醫師? gendy@episerv.cph.ntu.edPhilosophy of classification
A clinical useful classification scheme for cancer must
encompass the attributes of the tumor that define its
behavior.General rules for staging of cancer
Objectives:
? Selection of primary and adjuvant therapy.
? Estimation of prognosis.
? Assistance in evaluation of the results of treatment.
? Facilitation of the exchange of information of the
exchange if information among treatment centers.
? Contribution to the continuing investigation of
human cancers.TNM staging of the Breast
? Introduction
? Anatomy
? Primary site
? Chest wall
? Regional lymph nodes
? Metastatic sites
? Rules for classification
? Clinical staging
? Pathologic staging
? TNM classification
? Primary tumor (T)
? Regional lymph nodes (N)
? Distant metastasis (M)
? Definition of TNM
? Primary tumor (T)
? Regional lymph nodes (N)
? Distant metastasis (M)
? Stage grouping
? Histopathologic type
? Histologic grade (G)乳房的解剖與編碼
? Nipple (C50.0)
? Central potion (C50.1)
? Upper-inner quadrant (C50.2)
? Lower-inner quadrant (C50.3)
? Upper-outer quadrant (C50.4)
? Lower-outer quadrant (C50.5)
? Axillary tail (C50.6)
? Overlapping lesion of breast (C50.8)
? Breast, NOS (C50.9)Introduction
? This staging system for carcinoma of the breast
applies to
? Infiltrating carcinoma
(including microinvasive)
? In situ carcinoma
?Microscopic confirmation of the diagnosis in
mandatory, and the histologic type and grade of
carcinoma should be recorded.All cases should be confirmed microscopically.
Any cases not so proved must be reported separately.
? Microscopic confirmation of choriocarcinoma is not
required if the hCG is abnorally elevated.
? Microscopic unconfirmed cases can be staged, but
should be analyzed separately.
The General Rules of the TNM systemMicroscopic confirmation? Introduction
? Anatomy
? Primary site
? Chest wall
? Regional lymph nodes
? Metastatic sites
? Rules for classification
? Clinical staging
? Pathologic staging
? TNM classification
? Primary tumor (T)
? Regional lymph nodes (N)
? Distant metastasis (M)
? Definition of TNM
? Primary tumor (T)
? Regional lymph nodes (N)
? Distant metastasis (M)
? Stage grouping
? Histopathologic type
? Histologic grade (G)
TNM staging of the Breast? Terminal duct-lobular unit
? Terminal duct
z Extralobular, intralobular
? Lobules
? Alveoli
? Major duct
? Collecting ducts
? Lactiferous sinuses
? Segmental ducts
? Subsegmental ducts
? The mammary gland is
? segmentally
divided into 15 to
20 distinct
glandular units or
lobes,? each has a ductal
orifice at the apex
of nipple.
Microscopic anatomy of the breastBreast profile:
A ducts
B lobules
C dilated section of duct to hold
milk
D nipple
E fat
F pectoralis major muscle
G chest wall/rib cage
Enlargement:
A normal duct cells
B basement membrane
C lumen (center of duct)
Microscopic anatomy
of the breastBreast CancerApproximate distribution of breast tissue on ......
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