Primary tumor / Pathologic features
AJCC 9 pT criteria (expanded)
AJCC 9 (breast) pT summary:
- 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.
Regional lymph nodes
AJCC 9 pN criteria (expanded)
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.
Distant metastasis
AJCC 9 pM criteria (expanded)
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).
AJCC 9 Stage Group Guidance (expanded)
AJCC 9 Stage Group Guidance (expanded)
Simplified AJCC 9 anatomic stage grouping for breast (verify AJCC tables for prognostic staging which includes biomarkers and grade):
- Stage 0: pTis, pN0, pM0.
- Stage I: pT1, pN0, pM0 (IA/B subdivisions by size).
- Stage II: pT2 or limited nodal involvement (N1), M0.
- Stage III: Larger primary (T3/T4) and/or more extensive regional nodal disease (N2/N3), M0.
- Stage IV: Any M1.
Prognostic stage uses ER/PR/HER2, grade and genomic risk — this tool provides anatomic TNM stage only.
AJCC TNM Entry & Auto-staging (AJCC 9)
This auto-staging tool provides simplified AJCC 9 anatomic TNM guidance with expanded TNM comments. For prognostic staging (breast) incorporate ER/PR/HER2, grade, and additional factors per AJCC 9 and institutional practice before final sign‑out.