The assessment of local advanced-stage breast cancer patients according to prognostic staging

In our study, we aimed to re-stage patients with locally advanced breast cancer according to the prognostic staging added to the 8th edition of AJCC (American Joint Committee on Cancer) and to evaluate the results of the new staging system. In addition, overall, disease-free, and distant metastasis-free survival rates of the patients were analyzed. A retrospective evaluation was conducted on 557 patients with locally advanced breast cancer who received radiotherapy at Akdeniz University School of Medicine, Department of Radiation Oncology between 2000 and 2019. The survival analysis was conducted using the Kaplan-Meier method. A log-rank test was performed to analyze the correlation between the two staging systems, and a p-value less than 0.05 was considered statistically significant. The median follow-up period was 83 months (range 10-292 months). According to the prognostic staging, 30.3% of the patients were classified in the same stage, whereas 9.5% were in higher stages, and 44.7% were in lower stages. In terms of overall survival rates, patients in stage IIA had better outcomes compared to those in stages IIIA, IIIB, and IIIC (p = 0.01, p <0.01, and p <0.01, respectively). In terms of disease-free survival, patients with prognostic stage IIA had better outcomes than stage III A-C patients (p = 0.03, 0.01, and 0.05, respectively). In addition, both anatomical and prognostic staging were found to make a difference in overall survival in luminal A tumors (p= 0.008 and p= 0.001, respectively). In this group of tumors, disease-free survival showed a statistically significant difference with prognostic staging (p=0.028), but not with anatomical staging (p=0.093). The survival rates of our patients with locally advanced breast cancer were found to be higher than what is reported in medical literature. It was suspected that this could be due to the fact that these patients were at a lower stage than what was initially predicted by using prognostic staging. Molecular biomarkers were also evaluated alongside prognostic staging, which allowed for more individualized treatment plans.