TNM classification (Tumor, Nodal and Metastasis classification)

of The American Joint Committee on Cancer (AJCC)


Source - National Breast Cancer Centre

Primary tumor (T)

The definitions for classifying the primary tumor (T) are the same for clinical and for pathological classification. The telescoping method of classification can be applied. If the measurement is made by physical examination, the examiner will use the major headings (T1, T2, or T3). If other measurements, such as mammographic or pathologic are used, the telescoped subsets of T1 can be used.

TX - primary tumor cannot be assessed

T0 - no evidence of primary tumor

Tis - carcinoma in situ, intraductal carcinoma, lobular carcinoma in situ, or Paget's disease of the nipple with no tumor.

T1 - Tumor is 2cm or less in the greatest dimension.
T2 - Tumor is more than 2cm but not more than 5cm in the greatest dimension.

T3 - Tumor is more than 5cm in the greatest dimension.

T4 - Tumor of any size with direct extension to the chest wall or skin.

Regional Lymph Nodes (N)


NX - Regional lymph nodes cannot be assessed (e.g. previously removed).

N0 - No regional lymph node metastasis.

N1 - Metastasis to movable ipsilateral axillary lymph node(s).

N2 - Metastasis to ipsilateral axillary lymph node(s) fixed to one another or to other structures.

N3 - Metastasis to ipsilateral internal mammary lymph node(s).


Distant Metastasis (M)


MX - Presence of distant metastasis cannot be assessed.

M0 - No distant metastasis.

M1 - Distant metastasis (includes metastasis to ipsilateral supraclavicular lymph node(s)).

     Breast Cancer Stage Grouping


Tumor

Nodes

Metastasis

Stage 0

Tis N0 M0

Stage I

T1* N0 M0

Stage IIA

T0 N1 M0

T1* N1 M0

T2 N0 M0

Stage IIB

T2 N1 M0

T3 N0 M0

Stage IIIA

T0 N2 M0

T1* N2 M0

T2 N2 M0

T3 N2 M0

T3 N1,N2 M0

Stage IIIB

T4 Any N M0

Any T N3 M0

Stage IV

Any T Any N M1
*T1 includes T1mic