title: The Will Rogers phenomenon in the staging of breast cancer - does it matter?
abstract: BACKGROUND
  Changes in the American Joint Commission on Cancer staging for breast cancer occurred when the 5th Edition was updated to the 6th Edition.
  
  
  OBJECTIVE
  To investigate how these changes affected stage and survival.
  
  
  METHODS
  3127 cases of breast cancer were restaged.
  
  
  RESULTS
  Late stages increased from 27.7% to 38.1%. The five-year survival improved in Stage 2 (82.9-86.1%) and Stage 3 (50.6-59%).
  
  
  CONCLUSIONS
  Stage shift leads to an erroneous impression that women are presenting with later stages and stage-specific survival is improving.
  
  
  CONCLUSIONS
  Standardizing cancer staging is important when reporting stage and survival in different time periods.
authors.affiliation: Department of Surgery, University Malaya Medical Center, 50603 Kuala Lumpur, Malaysia. Electronic address: giehooi@gmail.com.
authors.forename: G H
authors.initials: GH
authors.lastname: Tan
authors.affiliation: Department of Social and Preventive Medicine, University Malaya Medical Center, 50603 Kuala Lumpur, Malaysia; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508GA Utrecht, Netherlands. Electronic address: ovenjjay@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Bhoo-Pathy
authors.affiliation: Department of Surgery, University Malaya Medical Center, 50603 Kuala Lumpur, Malaysia. Electronic address: nuraish@gmail.com.
authors.forename: N A
authors.initials: NA
authors.lastname: Taib
authors.affiliation: Department of Surgery, University Malaya Medical Center, 50603 Kuala Lumpur, Malaysia. Electronic address: smhoong76@gmail.com.
authors.forename: M H
authors.initials: MH
authors.lastname: See
authors.affiliation: Department of Surgery, University Malaya Medical Center, 50603 Kuala Lumpur, Malaysia. Electronic address: ahshun82@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Jamaris
authors.affiliation: Department of Surgery, University Malaya Medical Center, 50603 Kuala Lumpur, Malaysia. Electronic address: chenghar.yip@gmail.com.
authors.forename: C H
authors.initials: CH
authors.lastname: Yip
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D015996:Survival Rate
keywords: American Joint Commission on Cancer; Breast cancer; Stage shift; Stage-specific survival; Staging; Will Rogers phenomenon