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SEER Inquiry System - Report
Produced: 07/06/2025 9:47 AM
Question 20150066
Inquiry Details
References:
2014+ Grade Instructions
Question:
Grade--Breast: Do you take grade from the most representative specimen along with the histology? What is the correct histology/grade combination? See discussion.
Discussion:
Breast biopsy (from hospital A): DCIS, solid, cribriform, comedo type, high nuclear grade
Breast Lumpectomy (from hospital B): DCIS, cribriform type, nuclear grade 1, tumor 2.5cm
Answer:
Assign 8201/2 for this case.
MP/H rules are to code histology based on the specimen with the most tumor tissue. That would be the lumpectomy in this case. The histology is DCIS, cribriform type.
Reference: http://seer.cancer.gov/tools/mphrules/mphrules_instructions.pdf
The general rule for grade is to code the highest grade specified within the applicable grading system. For the case information provided, follow instruction #5, nuclear grade: use Coding for Solid Tumors #7: 2-, 3-, or 4- grade system. High nuclear grade (grade code 3 for breast) is higher than nuclear grade 1 (grade code 1).
Reference: http://seer.cancer.gov/tools/grade/
