A large number of breast cancer patients with non-inflammatory skin involvement are only histologically proven and show, compared with cases exhibiting the classical clinical signs, significant differences in clinical course and prognosis. In general, both subsets were aggregated in one T category/stage (T 4 b/IIIB). This results in a considerable distortion of the reported statistical data.

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This article describes a systematic miniplant‐based approach to rapid development of simulated moving bed (SMB) chromatography applications. The methodology involves analysis of single‐column pulse tests to screen adsorbents and operating conditions and to determine initial values of profile advancement factors used to specify flow rates for an initial SMB miniplant experiment. A lumped‐parameter linear driving force rate‐based model is developed by fitting process data from a single miniplant run. The data are fit in a two‐step procedure involving initial determination of effective adsorption isotherm constants as best‐fit parameters with subsequent adjustment of calculated mass transfer coefficients to refine the data fit. The resulting simulation is used to guide further miniplant work and minimize experimental effort. The methodology is illustrated with miniplant data for a binary protein separation showing excellent agreement between model results and process data generated over a wide range of operating conditions. © 2009 American Institute of Chemical Engineers AIChE J, 2009

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BACKGROUNDBecause of the considerable heterogeneity in breast carcinoma with noninflammatory skin involvement (T4b/Stage IIIB), a revision was proposed of the TNM staging system that would classify these tumors exclusively based on their tumor size and lymph node status. In the current study, the authors evaluated how implementation of this proposal will affect Stage III noninflammatory breast cancer.METHODSTwo hundred seven patients who were classified with noninflammatory Stage III breast cancer were treated consecutively between 1990 and 1999 at the University Hospital Basel, Switzerland. To assess the extent of T4b/Stage IIIB tumors independent of the clinicopathologic feature of skin involvement, the reclassification was undertaken.RESULTSOf 68 patients who had nonmetastatic T4b breast cancer, 37 patients (54.4%) had a tumor extent in accordance with Stage I/II and had improved disease‐specific survival (DSS) compared with patients who had Stage III breast cancer (P = .008). Excluding those patients from Stage III led to a 17.9% reduction of the number of patients in this group (n = 170 patients). The 10‐year DSS declined from 48.5% to 42.9%.CONCLUSIONSConsiderable numbers of patients who are classified with noninflammatory Stage IIIB breast cancer show only a limited disease extent. Through a revision of the T4 category, these low‐risk patients were excluded from the highest nonmetastatic TNM stage, and overstaging could be avoided. This procedure decreased the degree of heterogeneity of the entire Stage III group and may result in a more precise assessment of this disease entity. Cancer 2006. © 2006 American Cancer Society.