BACKGROUND: In this study, the authors evaluated the clinical presentation of @entity1 with T4b @entity0 , analyzed the impact of noninflammatory skin involvement on long-term survival, and addressed the question whether the T4 @entity5 category still has any justification. METHODS: The clinical course of a study group of 119 @entity1 with skin involvement was compared with the outcome of a control group of 299 consecutive @entity1 who had @entity5 of the same size but without skin involvement. All @entity5 were stratified into 1 of 4 subsets according to greatest @entity5 dimension, as follows: Group A, < or = 3.0 cm; Group B, 3.1-5.0 cm; Group C, 5.1-10.0 cm; and Group D, > 10.0 cm. RESULTS: The study group distribution of @entity1 within the size subsets were as follows: Group A, 26.1%; Group B, 24.3%; Group C, 26.1%; and Group D, 23.5%. Differences in disease-specific survival between the @entity5 size subsets were significant (Groups A and B vs. Groups C and D; P < 0.0001). In contrast to large @entity5 (> 5.0 cm), @entity189 < or = 5.0 cm showed no statistical significant differences in disease-specific survival between study group @entity1 and control group @entity1 (Group A: P = 0.17; Group B: P = 0.31). CONCLUSIONS: There is a broad range of clinicopathologic @entity0 entities within the T4b category. For > 50% of @entity1 with T4b @entity0 , the feature noninflammatory skin involvement had no significant prognostic impact. Approximately 25% of @entity1 had an extent of disease similar to that observed in @entity1 with @entity34 and, thus, falsely were considered to have more @entity1442 . Heterogeneity and a lack of prognostic significance suggest that a revision of the T4 category, a relic of historic @entity5 classifications, is necessary.

XXXX with noninflammatory skin involvement (T4b): time to abandon an historic relic from the TNM classification.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast carcinoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinomas'] @entity1442 :: ('MESH:D020178', 'Disease') :: ['advanced disease'] @entity34 :: ('MESH:D016609', 'Disease') :: ['Stage I-II disease']
@entity0 :: (MESH:D001943,Disease) :: ['Breast carcinoma']
