Report | Question ID | Question | Discussion | Answer | Year |
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20230005 | SEER Manual/First Course Treatment--Radiation Treatment Modality: How is Peptide Receptor Radionuclide Therapy (PRRT), a form of molecular therapy, coded when used to treat neuroendocrine tumors? See Discussion. |
The 2023 SEER Manual indicates PRRT should be coded in the Other Therapy field per coding instruction 2.d. Likewise, SINQ 20180106 instructs to code PRRT as Other Therapy, while the discussion portion clearly outlines the radioactive nature of this modality. Would PRRT be best coded as a radioisotope in the Radiation Treatment Modality--Phase I, II, III field rather than in the Other Therapy field? |
For cases diagnosed in 2023 and later, Update to the current manual: Assign code 13 (Radioisotopes, NOS) in Radiation Treatment Modality--Phase I, II, III for PRRT. We will make this change in the next version of the SEER Manual. |
2023 |
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20230006 | SEER Manual/First Course Treatment--Hematologic Transplant And Endocrine Procedures: How are Surgery of Primary Site and the Hematologic Transplant And Endocrine Procedures data items coded when patient has total abdominal hysterectomy and bilateral oophorectomy for an endometrial primary during the same procedure? Also, how would these data items be coded for a vaginal primary in a surgical scenario? See Discussion. |
The 2023 SEER Manual instructions contain a new note in Hematologic Transplant And Endocrine Procedure, Coding Instruction 6, regarding bilateral salpingo-oophorectomy (BSO) when performed for hormonal effect for breast, endometrial, vaginal, and other primary cancers. While we have observed BSO being performed for breast primaries, we do not recall ever seeing a statement for endometrial or vaginal primaries regarding a “BSO being done as hormonal manipulation” when scheduled either with or without a hysterectomy being performed simultaneously. As a result, we are not clear exactly when a BSO would be captured in the Hematologic Transplant And Endocrine Procedure field for these gynecologic primary sites. Also, if these types of procedures are Hematologic Transplant And Endocrine Procedures, are they also captured and coded in the Surgery of Primary Site codes that directly relate to those same organs? Does timing have any effect on the coding of either field? |
For a primary endometrial or ovarian cancer, record the oophorectomy/BSO procedure using the appropriate Surgery of Primary Site code that includes oophorectomy/BSO when done as part of first course of treatment (surgical resection). If performed for hormone effect, also record in the Hematologic Transplant and Endocrine Procedures data item. For other primary sites whose Surgery of Primary Site codes do not include oophorectomy/BSO, record it in the Hematologic Transplant and Endocrine Procedures data item when performed for hormone effect. Document information in the appropriate text fields. Candidates for risk-reducing BSO may include those with hereditary syndromes (such as BRCA mutations) or genes that carry a substantially increased lifetime risk of ovarian malignancy or hormone-sensitive cancers including estrogen-dependent cancers, like breast cancer, ovarian cancer and endometrial (uterine) cancer that rely on estrogen to develop and grow. |
2023 |
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20230018 | SEER Manual/First Course Treatment--Chemotherapy: Does the First Course of Treatment end when subcategories change for treatments such as hormone therapy or immunotherapy or is that instruction specific to chemotherapy? See Discussion. |
Treatment for estrogen receptor positive (ER+) breast cancer started with tamoxifen (non-steroidal estrogen subcategory) and switched to letrozole (non-steroidal aromatase inhibitor subcategory). Patient being treated with immunotherapy, Avastin (cytostatic agent-antiangiogenesis agent subcategory), and then changed to Atezolizumab (monoclonal antibody subcategory). Is Atezolizumab a new course of therapy because it is a different subcategory? |
A change in the subcategory for a hormone drug does not indicate the end of First Course of Treatment because different hormone therapies generally achieve the same result. For example, some forms of breast cancer are estrogen-dependent and the various subcategories of hormone drugs used to treat them, such as gonadotropin-releasing factor agonists, aromatase inhibitors and estrogen antagonists, all achieve the same result - to block estradiol effects in these tumors. Similarly, a change in immunotherapy is not a new course of treatment. The instruction in the SEER Manual is specific to chemotherapy. Chemotherapy is the only systemic treatment for which a change in the subcategory of a drug indicates the end of First Course of Treatment, due to the fact that different chemical agents damage cancer cells in different ways and at different phases in the cell cycle. |
2023 |
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20110093 | Residence at dx: After living elsewhere (Florida) and traveling around the country in an RV with his spouse, is a patient a resident of this area for either primary if he was diagnosed with his first primary less than a month after arriving in the area and a second primary more than a year after parking his RV here? |
Use the patient's usual residence to determine residency. If the usual residence is not known or the information is not available, use the residence the patient specifies at the time of diagnosis. The SEER rules for determining "usual residence" match the rules used by the US Census Bureau. |
2011 | |
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20041089 | Reportablility--Breast: Is lobular neoplasia, grade 2 reportable? See Discussion. |
Path report reads: Lobular neoplasia, grade 2.
According to the AFIP nomenclature for DCIS (taken from the WHO terminology), this would be the equivalent of LCIS. But nowhere can I find this specifically applies to lobular in the same way that ductal neoplasia is treated. |
According to the editors of ICD-O-3, lobular neoplasia grade 2 is not equivalent to LCIS. It is not a reportable term. Lobular neoplasia and lobular intraepithelial neoplasia are equivalent terms having a three grade system. Only LN/LIN grade 3 would be reportable since those terms are analogous to ductal intraepithelial neoplasia grade 3. |
2004 |
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20150037 | Reportablility--Breast: Is lobular neoplasia reportable as lobular carcinoma in situ? See Discussion. |
According to College of American Pathologists (CAP), lobular neoplasia is also known as lobular carcinoma in situ. In a previous SEER question 20041089, it was stated that they were not the same and should not be reported unless it was a Grade 3. I assume this has changed and we are to report lobular neoplasia as lobular carcinoma in situ, is this correct? |
For cases diagnosed 2021 or later Lobular neoplasia (LN II and LN III) and lobular intraepithelial neoplasia (LIN II and LIN III) are reportable and coded 8520/2. |
2015 |
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20210075 | Reportability: What American College of Radiology Reporting and Data Systems (RADS) can be used to determine reportability? See Discussion. |
LI-RADS (liver), PI-RADS (prostate), and TI-RADS (thyroid) can be used to determine reportability. BI-RADS (breast) and Lung-RADS cannot be used to determine reportability. Can these systems below to determine reportability? C-RADS (from CT colonography) NI-RADS (head & neck) O-RADS (ovarian-adnexal) |
The following cancer cases are reportable unless there is information to the contrary. –Liver cases with an LI-RADS category LR-4 (reportable since 2021) or LR-5 (reportable since 2016) –Prostate cases with a PI-RADS category 4 or 5 (reportable since 2017) The following are not reportable without additional information. –Breast cases designated BI-RADS 4, 4A, 4B, 4C or BI-RADS 5 –Lung cases designated Lung-RADS 4A," 4B, or 4X –Liver cases based only on an LI-RADS category of LR-3 –Colon cases with only C-RADS information (C-RADS category C4 is not reportable by itself) –Head and Neck cases with only NI-RADS information (NI-RADS category 3 is not reportable by itself) –Ovarian or fallopian tube cases with only O-RADS information (none of the O-RADS categories are reportable without additional information) –Thyroid cases with only TI-RADS information (none of the TI-RADS categories are reportable without additional information) |
2021 |
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20021187 | Reportability: When a hospital pathologist sends the slides from an original biopsy to two or more outside reviewers and the reviewers differ on whether or not the case is reportable, is the case SEER reportable? Does the decision to treat the patient have any bearing on whether the case would be reportable? |
Typically, the final diagnosis of the reviewing pathologist is the one used to determine whether the case is SEER reportable. If two or more reviewing pathologists disagree as to whether the case should be reportable, determine reportability based on the following priority order: 1) If the patient is treated for cancer, the case is reportable. 2) If the patient is not treated for cancer, use the amended diagnosis on the original pathology report if the hospital pathologist used the reviewing pathologists' opinions in establishing his new diagnosis. 3) If there is not an amended diagnosis for the original hospital pathology report, use the clinician's opinion regarding what the diagnosis is to determine whether the case is reportable. |
2002 | |
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20100011 | Reportability: Should a benign gangliocytic paraganglioma [8683/0] be a reportable (malignant) tumor based on the presence of lymph node metastases? See Discussion. |
"Resection, periampullary duodenum: Gangliocytic paraganglioma, with metastasis to one large periduodunal lymph node. Six other small lymph nodes negative. COMMENT: The primary tumor in the duodenum is made up mainly endocrine cell component. This component appears to have metastasized to a periduodenal lymph node." |
This neoplasm is reportable because it is malignant as proven by the lymph node metastases. Code the behavior as malignant (/3) when there are lymph node metastases. |
2010 |
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20150050 | Reportability: Is penile intraepithelial neoplasia, differentiated type, reportable? See discussion. |
Foreskin circumcision shows: Penile intraepithelial neoplasia, differentiated type (differentiated PeIN). If reportable, how would the histology and behavior be coded? Is this behavior /2? |
For cases diagnosed 2018 and later Differentiated penile intraepithelial neoplasia (differentiated PeIN), is reportable (8071/2). Please note: Penile intraepithelial neoplasia, grade 3 (PeIN 3) is also reportable to SEER (C600-C609, 8077/2). |
2015 |