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SEER Inquiry System - Report
Produced: 05/28/2023 9:35 PM
Question 20120019
Inquiry Details
References:
2011 SEER Manual
Question:
Surgery of Primary Site/Scope Regional LN Surgery--Breast: How are these fields coded for breast cases diagnosed 2011 and later when the patient has a simple mastectomy with removal of seven sentinel lymph nodes? See Discussion.
Discussion:
Per SINQ 20091076, the correct codes would be 41 [simple mastectomy] and 2 [sentinel lymph node biopsy only] when the patient has any number of sentinel nodes removed, as long as they are designated as sentinel nodes. Under the mastectomy codes in the 2011 SEER Manual, Appendix C, Breast Surgery Codes, the SEER Note states that code 41 [simple mastectomy] includes the removal of one to three axillary lymph nodes. A simple mastectomy with four or more axillary lymph nodes is coded to 51. Does the lymph node count for code 51 include both sentinel and axillary lymph nodes? Or does code 51 refer to strictly the count of axillary lymph nodes, separate from the count of sentinel lymph node(s) biopsied?
Answer:
First, make sure that the seven lymph nodes removed were actually designated to be sentinel nodes and not a combination of sentinel nodes and other regional nodes. Code sentinel nodes only when the nodes are stated to be sentinel nodes or when the surgical procedure includes the injection of dye to identify sentinel nodes.
If all seven nodes removed are sentinel nodes, follow the instructions in SINQ 20091076 and assign codes 41 [simple mastectomy] and 2 [sentinel lymph node biopsy only].
The SEER Note does not pertain to nodes designated as sentinel nodes.
Cancer Site Category:
Breast
Data Item Category:
Surgery of Primary Site, Scope Regional LN Surgery
Other Category:
N/A
Year:
2012
