Nodal Staging

Question 1

cN0

Answer 1

No evidence abnormal ln on exam or imaging

Question 2

cN1

Answer 2

Mets to mobile ipsilateral level I/II axillary LN

Level I lateral to pec minor, level 2 deep to pec minor

Question 3

cN1mi

Answer 3

Micrometastasis - larger than 0.2mm none larger than 2mm

Question 4

cN2

Answer 4

Mets to fixed/matted ipsilateral level I/II LN

Or ipsilateral internal mammary artery nodes alone

Question 5

cN2a

Answer 5

Mets to fixed/matted level I/II axillary LN

Question 6

cN2b

Answer 6

Metastases to ipsilateral internal mammary LN alone

Question 7

cN3

Answer 7

Mets to ipsilateral infraclavicular (level 3 axillary LN)
Or ipsilateral internal mammary LN and level I/II axillary LN
or ipsilateral SCF ln

Question 8

cN3a

Answer 8

Mets to ipsilateral infraclavicular (axillary level III) LNs

Question 9

cN3b

Answer 9

Mets to ipsilateral internal mammary LN AND level I/II axillary LN

Question 10

cN3c

Answer 10

Mets to ipsilateral SCF Lymph nodes

Question 11

pNx

Answer 11

Cannot be assessed eg not removed or previously removed

Question 12

pN0

Answer 12

No evidence of mets or isolated tumour cells only

Question 13

pN0(i+)

Answer 13

Isolated tumour cells only malignant tumour cell clusters none larger than 0.2mm

Question 14

pN1

Answer 14

Micrometastases
Or
Mets to 1-3 axillary LN
Or
Clinically negative internal mammary nodes with  metastases by sentinel LN biopsy

Question 15

pN1mi

Answer 15

Micrometastases - larger than 0.2mm but none larger than 2mm

Question 16

pN1a

Answer 16

Mets in 1-3 axillary LN, at least one larger than 2mm

Question 17

pN1b

Answer 17

Mets (excluding isolated tumour cells) in isolated internal mammary sentinel node

Question 18

pN1c

Answer 18

pN1a and pN1b

Question 19

pN2

Answer 19

Mets in 4-9 axillary LN
OR
Clinically positive internal mammary node with absence of axillary LN mets

Question 20

pN2a

Answer 20

Mets in 4-9 axillary LN (at least one greater than 2mm)

Question 21

pN2b

Answer 21

Mets to ipsilateral internal mammary LN by imaging (with or without microscopic confirmation) with pathologic negative axillary LN

Question 22

pN3

Answer 22

Mets to 10 or more axillary LN
OR
Infraclavicular (level 3 axillary) LN
OR
Clinically positive ipsilateral internal mammary nodes PLUS positive level I/II axillary nodes
OR
More than 3 axillary LN AND positive sentinel LN biopsy in clinically negative internal mammary LN
OR
SCF LN

Question 23

pN3a

Answer 23

Mets to 10 or more axillary LN
OR
Level 3 axillary (infraclavicular LN)

Question 24

pN3b

Answer 24

pN1a or pN2a PLUS cN2b (positive internal mammary node by imaging)
OR
pN2a PLUS pN1b

Question 25

pN3c

Answer 25

Mets to ipsilateral SCF LN