Breast Cancer Synoptic Report — CAP elements with AJCC 9th Edition (auto stage)

AJCC 9 (breast) pT summary (invasive tumor): 
- pTis: DCIS (in situ). 
- pT1: Tumor ≤20 mm. 
    Subdivisions: 
     pT1mi ≤1 mm; 
     pT1a >1–5 mm; 
     pT1b >5–10 mm; 
     pT1c >10–20 mm. 
- pT2: Tumor >20–50 mm. 
- pT3: Tumor >50 mm. 
- pT4: Tumor of any size with direct extension to chest wall and/or skin (ulceration or satellite nodules); 
    Subdivisions: 
     pT4a–pT4d describe chest wall, skin, inflammatory cancer, or combinations. 
     Record presence of skin ulceration, peau d'orange, fixation to chest wall. 

Note: For multifocal disease, use size of largest invasive focus for T; report total extent and DCIS separately.

AJCC 9 (breast) pN summary: 
- pN0: No regional nodal metastasis (pN0(i+) if only ITC present). 
- pN1: Metastasis to movable ipsilateral level I–II axillary lymph node(s); 
    subdivided by number and size; includes micrometastasis (pN1mi). 
- pN2: Metastasis to fixed/matted ipsilateral level I–II or internal mammary nodes with positive axillary nodes. 
- pN3: Metastasis in ipsilateral infraclavicular (level III) nodes, clinically apparent ipsilateral internal mammary nodes with positive axillary nodes, or supraclavicular nodes. 

Record number of positive nodes, size of deposits, presence of ENE, and ITC vs micrometastasis vs macrometastasis.

AJCC 9 (breast) pM summary: 
- pM0: No distant metastasis. 
- pM1: Distant metastasis present (biopsy proven when possible). 
    Subclassification: 
     pM1a (non-regional lymph node), 
     pM1b (bone), pM1c (visceral/other). 

Any pM1 = Stage IV. Document site(s), number of lesions, and method of confirmation (biopsy/imaging).