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Report Produced: 01/06/2026 17:53 PM

Report Question ID Question Discussion Answer Year
20071107

MP/H Rules/Recurrence--Breast: If the pathologist and oncologist call a 2007 lobular carcinoma that appears in a skin nodule of a mastectomy scar a recurrence of a patient's 1975 primary breast duct carcinoma, should we abstract this as a new primary? See Discussion.

According to the pathologist and oncologist, the change in histology is attributed to the present availability of E-cadherin, which was not available in 1975.

For cases diagnosed 2007 or later, abstract the 2007 diagnosis as a separate primary using rule M5.

Rule M5 applies to this case because it comes before rule M12. Furthermore, based on your statement, the answer presumes that the original tumor was duct carcinoma only, there was no lobular carcinoma present. This must be a new primary because there are two different histologies.

The 2007 MP/H rules were developed with input from clinicians. They advised that a subsequent breast tumor more than five years later is a new primary. It is important to apply the rules so that these cases are handled in a consistant manner across all registries.

 2007
20071093 Reportability--Brain and CNS: In addition to Schwannoma, are there additional types of benign tumors that arise in peripheral nerves along the spinal cord that are not reportable? See Discussion.

Are neuroepitheliomatous neoplasms such as ganglioneuroma, gangliocytoma, ganglioglioma occurring along the spinal cord reportable? Are nerve sheath tumors such as neuroma occurring along the spinal cord reportable? Angioma?

Reference: SINQ 20051071; Primary Central Nervous System Tumors, NPCR Training Materials 2004

Reportability depends on the location of the tumor. Tumors in the following sites are reportable:

  • C700 - C709

  • C710 - C719

  • C720 - C729

  • C751 - C753

    • Benign and borderline tumors of the peripheral nerves (C47_), including peripheral nerves along the spinal cord, are not reportable.

    Please note: spinal schwannomas arising in the nerve root or spinal dura are reportable.

    		 2007
    		20071079 MP/H Rules/Recurrence--Breast: Do we use a pathologists comment of "recurrent ductal carcinoma" found in the pathology report for a new specimen to determine whether the new specimen actually represents a new primary or recurrent disease? See Discussion.

    The patient had a left breast cancer LIQ, ductal with DCIS. Nodes (-) diagnosed in 1998

    Treatment: Lumpectomy-clear margins

    Refused radiation

    Hormone therapy: Tamoxifen

    Present: June 2007

    Left breast-invasive ductal ca, UOQ

    Pathology report comments: Recurrent ductal ca.

    Left axillary nodes (+)

    For cases diagnosed 2007 or later, apply the 2007 MP/H breast rules. Go to the multiple tumors module and begin with rule M4. Stop at rule M5: tumors diagnosed more than 5 years apart are multiple primaries.

    The only time you can accept a pathologist's statement of recurrence is when the statement is made based on a review of the slides from the previous diagnosis compared to the slides from the current diagnosis.

    		 2007
    		20071012 Reportability--Melanoma: Is a skin excision final diagnosis of "melanocytic tumor with uncertain malignant potential" reportable if the path COMMENT states the initial shave biopsy diagnosis was "melanocytic tumor with uncertain malignant potential [minimal deviation melanoma]"? See Discussion.

    SKIN, RIGHT FOOT, EXCISION: CHRONIC SCARIFICATION WITH RESIDUAL ATYPICAL MELANOCYTES IN THE DERMIS IDENTIFIED, BUT COMPLETELY EXCISED.

    Comment: The prior outside biopsy report indicates that the lesion was a melanocytic tumor of uncertain malignant potential (minimal deviation melanoma) measuring at least 2.5 mm in depth. There was apparently no in situ component. Special stains performed here are similar, with positive reactivity for Melan A and S-100. The cells are atypical, but there are reactive changes, making it impossible to accurately assess the true nature of the lesion in this biopsy. If this is a minimal deviation melanoma, it would be classified as a T3 (T3a since there is no description in the outside report of ulceration) lesion. The atypical melanocytes extend to a depth of 1.1 mm in this 2 mm deep biopsy, but are completely excised, both at the deep margin and at all of the peripheral margins (closest margin is superior, with clearance of 7 mm).

    PATH FROM INITIAL BIOPSY: Diagnosis: Rt dorsal foot, shave biopsy: Melanocytic tumor of uncertain malignant potential (see comment). Tumor depth at least 2.5mm Deep margin involved. Comment: As a primary lesion, I would favor that this represents a melanocytic tumor with indeterminate biologic potential also known as minimal deviation melanoma. The lesion does extend to the deep margin and wider excision is recommended.

    		 This case is not reportable. Based on the information provided, there is no definitive diagnosis of malignancy. 2007
    		20071048 MP/H Rules/Histology--Breast: If the abstractor only has the CAP protocol information from a pathology report and it does not include a "final diagnosis" label, which fields of the protocol are used to determine the histology and whether there is carcinoma in situ present in the specimen? For cases diagnosed 2007 or later, if the CAP protocol is used in lieu of a final diagnosis, use all of the information in the CAP protocol. 2007
    		20071011 Multiple Primaries (Pre-2007)--Breast: How many primaries are to be abstracted when each of multiple breast "re-excisions" performed more than two months apart in 2006 demonstrate intraductal carcinoma and there is no mention of "recurrence"? See Discussion.

    Right Breast

    06/27/2002 exc bx, DCIS. Margins involved.

    09/24/2002 re-exc, several foci of intraductal ca. Margins involved.

    10/15/2002 re-exc, microfocus of DCIS

    Radiation treatment started 11/18/2002.

    Is this 1, possibly 2, or maybe 3 breast primaries because of the 2 month rule and no statement of "recurrence"? Based on SINQ #20000478, this would be at least 2, but possible 3 primaries. Based on SINQ #20021143, this would be 1 primary if the case were diagnosed from 1998-2003. The excisions appear to represent wider excisions of the same tumor.

    For cases diagnosed prior to 2013:

    For tumors diagnosed prior to 2007, this is one primary, assuming these are wider excisions of the same tumor.

    For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

    		 2007
    		20071058

    CS Tumor Size: Is a measured "area" equivalent to a tumor, mass or lesion size? See Discussion.

    Collaborative Stage manual, page 26

    Rule 4a: "always code size of the primary tumor, not size of the polyp, ulcer, cyst or distant metastasis."

    Rule 4e: Additional rule for breast primaries: Example: Duct carcinoma in situ covering a 1.9 cm area with focal areas of invasive ductal carcinoma. Record the tumor size as 1.9 cm.

    This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.In general, a measured area is not equivalent to a tumor size.

    Do not apply the rule related to the breast example to other primary sites. This example in the CS manual pertains to coding tumor size for breast primaries when the size of the invasive component is not stated. In the example, the area involved with duct carcinoma in situ is the only measurement available. The size of the invasive component was not given.

    		 2007
    		20071105 Multiple Primaries/Histology--Lymphoma/Leukemia: How many primaries and what histologies are coded when a path diagnosis for a cervical/neck mass demonstrates classical Hodgkin's lymphoma on a background of chronic lymphocytic leukemia?

    For cases diagnosed prior to 1/1/2010:Hodgkin disease and chronic lymphocytic leukemia are separate primaries according to our current instructions. Abstract and code them separately.

    For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

    		 2007
    		20071084 MP/H Rules/Histology--Prostate: How is an "acinar adenocarcinoma with focal large duct adenocarcinoma" coded?

    For cases diagnosed 2007 or later:

    As long as this is NOT urothelial carcinoma extending to the prostatic ducts, code histology to 8140/3 [adenocarcinoma] using rule H10.

    Do not code histologies designated as "focal."

    		 2007
    		20071057 Primary Site/CS Extension--Lymphoma: How are these fields coded for a lymphoma found in the spleen and retroperitoneal lymph nodes? See Discussion. A patient presents with a 6-month history of night sweats, low grade fever and significant weight loss. Physical exam reveals no palpable lymph nodes, tender abdomen and splenomegaly. Patient undergoes an exploratory laparotomy with splenectomy and dissection of two retroperitoneal lymph nodes. Spleen and both lymph nodes were positive for small cleaved-cell lymphoma, high grade.

    Code the primary site to spleen.

    Code CS extension as 22 [involvement of spleen plus lymph nodes below the diaphragm]. This gives it a stage IIS.

    Spleen is an extranodal (not extralymphatic) site.

    The retroperitoneal lymph nodes are located below the diaphragm.

    		 2007