Re: Influence of the New AJCC Breast Cancer Staging System on Sentinel Lymph Node Positivity and False-Negative Rates

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Abstract
The new American Joint Committee on Cancer (AJCC) staging system for breast cancer correctly recognizes that small clusters of malignant cells do not confer the same adverse prognostic impact as larger metastatic deposits ( 1 ). The AJCC’s decision to place patients with small clusters of malignant cells in the N0 category rather than the N1 category is rational. Also rational is their use of special substages based on findings from immunohistochemical or molecular techniques to distinguish patients that have otherwise undetectable metastatic deposits from patients with no evidence of disease in regional lymph nodes.