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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.

For cases diagnosed prior to January 1, 2007, according to the CS Steering Committee, record the pathologist's interpretation of the assay value for the most representative tumor specimen. This may require conversation with the pathologist when specimen size is not specified.

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.Code SSF6 888 [Clinical tumor size coded]. When the size recorded in CS Tumor Size is not determined pathologically, 888 must be coded in SSF6. Note: The code in SSF 6 pertains to pathologic tumor size. It describes the relationship of invasive and in situ tumor in the tumor size coded.

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.Code SSF6 050 [invasive and insitu components present, entire size coded in CS TS, size of invasive not stated, proportion invasive and insitu not known] when the size of the invasive portion is not provided and clarification is not available.

If possible, obtain clarification from the pathologist for phrases like these and document in a text field. For example, a pathologist may confirm that when he/she states "invasive ductal carcinoma 2.0 cm, DCIS present" the size of the invasive portion is 2 cm. If so, code CS tumor size 020 and SSF6 020 and explain in a text field.

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.

Yes. Based on the information provided above, the in situ component is "mininmal" for the purpose of coding Breast CS Site Specific Factor 6. The phrase "no extensive intraductal component" suggests that there is some intraductal carcinoma present.

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.For tumors diagnosed 2004 only:

Code the CS Site Specific Factor 4 to 999 [Unknown or no information; Not documented in patient record]. If there is no report of a lab test in the health record, code as 999.

Code this field to 000 [Test not done] when there is a statement in the record that a test was not performed.

Tumors diagnosed 1/1/2005 forward no longer have PAP coded in the Site Specific Factor 4 field.

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.

Assign the second digit of CS SSF 4 based on prostatectomy only, do not include biopsy or other histologic information in the second digit.

According to the CS Steering Committee, the clinical or biopsy of the prostate is included in the first number of the code and should not be combined with the prostatectomy code which is the second number. These were separated purposely.

Example 1: Code the second digit of SSF 4 based on the prostatectomy, 1 [no involvement of prostatic apex].

Example 2: Code the second digit of SSF 4 based on the prostatectomy, 5 [apex extension unknown].

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.

Assign code 052 [Levator muscle, Skeletal muscle, NOS, Ureter]. The description for this case states periprostatic "striated" muscle tissue. According to our pathologist consultant, "striated muscle in this context is skeletal muscle and the term is being used to differentiate the muscle from smooth (non-striated) muscle." Smooth muscle involvement would be most likely be coded 050 [Extension to bladder neck...] because smooth muscle in a prostatectomy or TURP specimen is usually from the urinary bladder neck.

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.Accept your registrars' codes at your discretion. It is encouraged, but not required, to enter text for CS data elements. These cases do not automatically default to code 999.

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.Record lymph nodes that are pathologically confirmed as positive in Regional Nodes Positive. Evidence of previous involvement by cancer is not recorded in this data item.

In the above scenario, the lymph nodes are negative according to pathology.

Clinically positive lymph nodes are coded in CS Lymph Nodes.

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.Code regional lymph nodes positive 01 [one positive lymph node] and regional lymph nodes examined 01 [one lymph node examined] (assuming the positive node was the only node examined).

If the only lymph node involvement is the positive axillary lymph node, it is reasonable to conclude that this is a regional lymph node. When only one chain of lymph nodes is involved with metastatic melanoma, the metastatic cells had to come from skin with direct drainage to those lymph nodes.