Diagnosis and Treatment
Once a patient has been diagnosed with cancer, the physician will determine the degree of spread and aggressiveness of the tumor: the “stage” and “grade” of disease. The “stage” is the degree of spread of the tumor: Doctors often use the “TNM” system for staging. TNM stands for 'tumor, node, metastasis'. Important aspects of the staging of cancer are:
- The size of the tumor (The “T” in the TNM system, T1 being a very small tumor, and e.g. T4 a locally advanced tumor)
- Whether it has spread to lymph nodes around the site of the tumor (The “N” in the TNM system, N0 means no lymph nodes involved, and e.g. N3 will mean 3 lymph nodes with cancer identified)
- Whether it has spread (metastasized) to other (distant) tissues and organs (the “M” in the TNM system, M0 means no metastases, and e.g. M2 meaning two metastases detected)
The “grade” of a cancer relates to its appearance under the microscope. Low-grade malignancy often has a better prognosis than a high-grade malignancy. High grade is characterized by a highly abnormal appearance of the cancer cells.
There is no standard treatment for cancer; it will depend on the unique situation. If a cancer is confined to a single site, surgical removal is often (but not always) the first step. After this, the additional therapy depends on the estimated aggressiveness of the cancer. Doctors judge the aggressiveness of a cancer by a number of patient - and tumor characteristics, including the “grade” of the cancer as determined by microscopic evaluation. The estimated aggressiveness of the cancer determines the subsequent course of treatment. If the risk of metastasis is judged to be low, the doctor may decide not to give additional (chemo)therapy (adjuvant therapy); if the tumor is considered to be highly malignant, adjuvant (chemo)therapy may be required to kill remaining tumor cells that may already have disseminated from the primary tumor site. This additional (chemo)therapy has been shown to improve survival for many forms of cancer, but also has undesired side effects. The choice to give additional therapy to a patient is therefore a difficult but important decision to make and varies from patient to patient. This is where our test called MammaPrint® can help doctors. MammaPrint® is a tool to help doctors determine how aggressive a breast cancer is and hence assist in determining the optimal therapy for each breast cancer tested.