Diagnosis of gestational diabetes is typically made on the basis of an oral glucose tolerance test. A lack of consensus exists regarding the optimal testing protocol and threshold to identify women and infants with increased risk of complications. The majority of women with pregnancy complicated by diabetes have gestational diabetes (GDM). The American Diabetes Association defines GDM as any degree of glucose intolerance with onset or first recognition during pregnancy. Long-term risks of gestational diabetes include increased risk of recurrent GDM in subsequent pregnancies, risk of diabetes in the mother, and increased risk of childhood obesity, glucose intolerance and diabetes in the offspring.Read More

Tx Primary tumor cannot be assessed T0 No evidence of primary tumor Tis Carcinoma in situ Tis (DCIS) Ductal carcinoma in situ Tis (LCIS) Lobular carcinoma in situ Tis Paget’s disease Paget’s disease of the nipple with no tumor T1 Tumors 1 cm and not more than 2 cm in greatest dimension T2 Tumor > 2 cm and not more than 5 cm in greatest dimension T3 Tumor > 5 cm in greatest dimension T4 Tumor of any size with direct extension to (a) chest wall or (b) only as described below T4a Extension to chest wall, not including pectoralis muscle T4b Edema (including peau d’orange) or ulceration of the skin of the breast or satellite skin nodules confined to the same breast T4c Both TT4a and TT4ba T4d Inflammatory carcinoma REGIONAL LYMPH NODES (N) Nx Regional lymph nodes cannot be assessed (e.g., previously removed) N0 No regional lymph node metastasis N1 Metastasis to movable axillary lymph node(s) N2 Metastasis in ipsilateral axillary lymph nodes fixed or matted, or clinically apparent ipsilateral internal mammary nodes in the absence of clinically evident axillary lymph node metastasis N2a Metastasis to ipsilateral axillary lymph nodes fixed to one another (matted) or to other structures N2b Metastasis only in clinically apparent ipsilateral internal mammary nodes and in the absence of clinically evident axillary lymph node metastasis N3 Metastasis in ipsilateral infraclavicular lymph node(s) or clinically apparent ipsilateral internal mammary node(s) and in the presence of clinically evident axillary lymph node metastasis; or metastasis in ipsilateral supraclavicular lymph node(s) with or without axillary or internal mammary lymph node involvement N3a Metastasis in ipsilateral infraclavicular lymph node(s) and axillary lymph node(s) N3b Metastasis in ipsilateral internal mammary node(s) and axillary lymph nodes(s) N3c Metastasis in ipsilateral supraclavicular lymph node(s) PATHOLOGICAL CLASSIFICATION (PN) pNx Regional lymph nodes cannot be assessed (e.g., previously removed or not removed for pathologic studies) pN0 No regional lymph node metastasis histologically, no additional examination for isolated tumor cells (ITC) Note: ITC are defined as single tumor cells or small cell clusters not greater than 0.2mm, usually detected with immunohistochemistry (IHC) or molecular methods but that may be verified with H&E stains. ITCs do not usually show evidence of metastatic activity (e.g., proliferation or stromal reaction). pN0(i-) No regional lymph node metastasis histologically, negative IHC pN0(i+) No regional lymph node metastasis histologically, positive IHC, no IHC cluster > 0.2 mm pN0(mol-) No regional lymph node metastasis histologically, negative molecular findings (RT-PCR) pN0(mol+) No regional lymph node metastasis histologically, positive molecular findings (RT-PCR) pN1mil Micrometastasis (>0.2 mm, none > 2 mm) pN1 Metastasis in 1-3 axillary lymph nodes and/or internal mammary nodes with microscopic disease detected by sentinel lymph node dissection but not clinically apparent pN1a Metastasis in 1-3 axillary lymph nodes pN1b Metastasis in internal mammary lymph nodes with microscopic disease detected with sentinel lymph node dissection but not clinically apparent pN1c Metastasis in 1-3 axillary lymph nodes and in internal mammary lymph nodes with microscopic disease detected with sentinel lymph node dissection but not clinically apparent (if associated with >3 positive axillary lymph nodes, the internal mammary nodes are classified as pN3b to reflect increased tumor burden) pN2 Metastasis pN2a Metastasis in 4-9 axillary lymph nodes in clinically apparent internal mammary lymph nodes in the absence of axillary lymph node metastasis pN2b Metastasis in clinically apparent internal mammary lymph nodes in the absence of axillary lymph node metastasis pN3 Metastasis to > 10 axillary lymph nodes, in infraclavicular lymph nodes, or in clinically apparent ipsilateral internal mammary lymph nodes in the presence of > 1 positive axillary lymph nodes; or in > 3 axillary lymph nodes with clinically negative microscopic metastasis in internal mammary lymph nodes; or in ipsilateral supraclavicular lymph nodes pN3a Metastasis in > 10 axillary lymph odes (at least 1 tumor deposit > 2.0 mm) or metastasis to the infraclavicular lymph nodes pN3b Metastasis in clinically apparent ipsilateral internal mammary lymph nodes in the presence of > 1 positive axillary lymph nodes; or in > 3 axillary lymph nodes and in internal mammary lymph nodes with microscopic disease detected with sentinel lymph node dissection but not clinically apparent pN3c Metastasis in ipsilateral supraclavicular lymph nodes DISTANT METASTASIS (M) Mx Distant metastasis cannot be assessed M0 No distant metastasis M1 Distant metastasisRead More