Risk stratification according to stage and pathology

Stage and pathology are the essential foundation of early breast cancer risk stratification upon which we build, with advances since the last St. Gallen International Breast Cancer Conference. The 8th edition of the American Joint Committee on Cancer (AJCC) Staging Manual made a notable update for breast cancer staging, introducing Clinical and Pathological Prognostic Stages. Two of the most meaningful research advances concerning risk stratification were stage- and pathology-based. The clinical utility of achieving pathological complete response (pCR) after preoperative neoadjuvant systemic therapy versus residual disease, with residual disease defining a high-risk population that can benefit from escalation of adjuvant therapy, was borne out by recent trial results. The strength of evidence of the prognostic role of the morphological assessment of stromal tumor infiltrating lymphocytes (sTILs) increased, robustly demonstrated in triple-negative breast cancer. Presented at the St. Gallen International Breast Cancer Conference.