The 2018 Staging Guidelines for Breast Cancer in the 8th Edition of AJCC (American Joint Commission on Cancer) incorporates a clinical prognosis stage and pathological prognostic stage in addition to anatomic stage.
Clinical prognostic stage will be done for all patients prior to treatment including neoadjuvant treatment based on history, physical exam, imaging, biopsies, grade, and estrogen receptor, progesterone receptor, and Her 2 status.
Clinical Pathological Prognosis will be done for all patients who have surgery initially . this does not include neoadjuvant therapy patients. This prognostic profile will take into consideration the sam as clinical prognostic staging but also multigene panels such as OncotypeDX, and Mammaprint.
Staging patients helps physicians make decisions on how to treat a patient.