Carcinoma breast stage 4b involves all except
Staging of carcinoma breast TX-Primary tumor cannot be assessed T0-No evidence of primary tumor Tis-Carcinoma in situ Tis(DCIS) - Ductal carcinoma in situ Tis(LCIS) - Lobular carcinoma in situ Tis(Pagets) - Paget's disease of the nipple NOT associated with invasive carcinoma and/or carcinoma in situ (DCIS and/ or LCIS) in the underlying breast parenchyma. Carcinomas in the breast parenchyma associated with Paget's disease are categorized based on the size and characteristics of the parenchymal disease, although the presence of Paget's disease should still be noted T1-Tumor <=20 mm in greatest dimension T1mi-Tumor <=1 mm in greatest dimension T1a-Tumor >1 mm but <=5 mm in greatest dimension T1b-Tumor >5 mm but <=10 mm in greatest dimension T1c-Tumor >10 mm but <=20 mm in greatest dimension T2-Tumor >20 mm but <=5 cm in greatest dimension T3-Tumor >50 mm in greatest dimension T4-Tumor of any size with direct extension to the chest wall and/or to the skin (ulceration or skin nodules)* T4a-Extension to chest wall, not including only pectoralis muscle adherence/invasion T4b-Ulceration and/or ipsilateral satellite nodules and/or edema (including peaud'orange) of the skin, which do not meet the criteria for inflammatory carcinoma Both T4a and T4b T4d-Inflammatory carcinoma** *Note: Invasion of the dermis alone does not qualify as T4 **Note: Inflammatory carcinoma is restricted to cases with typical skin changes involving a third or more of the skin of the breast. While the histologic presence of invasive carcinoma invading dermal lymphatics is suppoive of the diagnosis, it is not required, nor is dermal lymphatic invasion without typical clinical findings sufficient for a diagnosis of inflammatory breast cancer. Ref: Schwaz's principles of surgery 10th edition Pgno: 631
Nipple retraction
Skin ulcer over the swelling
Dermal edema
Satellite nodule
Endocrinology and breast