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Question

What is the pathological staging using the seventh and eighth edition of the AJCC? How would the stages change if the hormonal status were triple negative in the following case?

Fifty-seven-year-old female presents with palpable mass in the upper outer quadrant of the left breast. Physical examination revealed a 3-cm mobile breast mass. There were no skin changes or palpable LNs. Bilateral diagnostic mammogram was read as negative. Ultrasound demonstrated a 3.2-cm hypoechoic density with irregular margins with one enlarged LN. Ultrasound-guided core biopsy was consistent with invasive ductal carcinoma, nuclear grade 3. ER+/PR+/HER2/neu was not amplified. She underwent left partial mastectomy and axillary sentinel lymph biopsy and axillary LN dissection. Pathology demonstrated a 3.5-cm tumor consistent with invasive ductal carcinoma nuclear grade 3 with negative margins. Three of three sentinel LNs contained tumor and 0/6 axillary LNs contained tumor.

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