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Report Produced: 03/03/2026 07:15 AM

Report Question ID Question Discussion Answer Year
20071073 MP/H Rules/Histology--Breast: How is histology coded for a single tumor with ductal and tubular features in only the invasive component and not in the in situ component? See Discussion.

A breast tumor diagnosed in Feb. 2007 is a single tumor with in situ and invasive components. The invasive component is diagnosed as ductal with tubular features.

The only rule that applies is H9 which says 'code the invasive histology.' Is it ductal (8500) or tubular (8211)? If you continue through the H rules, then H12 does not apply, because tubular is not a type of ductal. So then you end up at H17, which would make this 8523. Which code is correct?

For cases diagnosed 2007 or later, code the histology 8523 [duct mixed with other types of carcinoma].

After determining that the invasive histology is to be coded using rule H9, there is another decision to make in this case -- which invasive histology should be coded? Make a second pass through the histology rules, begining with rule H10. Stop at H17 and code 8523.

This advanced concept of a "second pass" through the rules is discussed in an online web training session called "Beyond the basics." Go to the SEER website to view this session http://www.seer.cancer.gov/tools/mphrules/training_advanced.html

 2007
20071098 Multiplicity Counter/Date of Multiple Tumors/CS Tumor Size--Lung: How are these fields to be coded when work-up of a malignancy spans a couple of months and reveals developing nodules? See Discussion. Example: Chest CT on 4-26-07 reveals 2.2 cm mass in lingula, left lung, consistent with lung malignancy. Biopsy on 5-18-07 shows non-small cell carcinoma. PET scan on 6-6-07 shows left upper lobe mass consistent with known non-small cell lung carcinoma. Second developing mass increasing in prominence since 4-07 in periphery of left upper lobe, approximately 3.6 cm which may represent intrapulmonary mets or second primary neoplasm. At least 3 additional intrapulmonary nodules have developed since 4-07, two in the left upper lobe and one in the right upper lobe, suspicious for mets.

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.Multiplicity Counter/Date of Multiple Tumors

Apply the multiple primary rules first and record the number of tumors determined to be a single primary in Multiplicity Counter. Record the corresponding date in Date of Multiple Tumors. These data items may be updated once if future tumors are determined to be the same primary as the initial diagnosis.

CS Tumor Size

Include information gathered through

  • completion of surgery(ies) in first course of treatment OR

  • all information available within four months of the date of diagnosis in the absence of disease progression

    • WHICHEVER IS LONGER.

    Metastasis known to have developed after the diagnosis was established should be excluded.

    		 2007
    		20071085 CS Tumor Size/CS Extension--Prostate: Because prostatectomy results are excluded from the CS Extension field for prostate, is code 95 [No evidence of primary tumor] accurate to reflect bilateral lobe involvement of prostate cancer when it is incidentally found following a radical cystectomy for a bladder primary? Why must tumor size be 000 when the CS Extension code is 95?

    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 prostate CS Extension to 99 [Extension unknown] and code CS Tumor Size according to the information available from the surgery.

    CS Extension code 95 [No evidence of primary tumor] should be used only in that rare situation when the only evidence of disease is distant mets or lymph node involvement, no primary tumor found. That is why CS tumor Size must be 000 when CS Extension code 95 is used.

    		 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
    		20071087 MP/H Rules/Multiple Primaries--Breast: How many primaries are abstracted when bilateral breasts contain DCIS? Is a physician statement referring to this situation as one primary ignored? See Discussion. Patient has microcalcifications both breasts. Has bilateral mastectomy. Path report states Left breast multifocal DCIS predominantly micropapillary. Right breast two foci of DCIS micropapillary.

    For cases diagnosed 2007 or later:

    There are two primaries in this case.

    Using the 2007 MP/H rules for breast, go to the multiple tumors module and start with Rule M4. Stop at rule M7. Tumors on both sides (right and left) are multple primaries.

    Always use the 2007 Multiple Primary rules to determine the number of primaries. Do not use the physician statement.

    		 2007
    		20071016 MP/H Rules/Multiple Primaries--Bladder: The new multiple primary rule M7 states that tumors diagnosed more than three years apart are multiple primaries. Does this apply to in situ bladder tumors that occur more than three years apart and to an in situ tumor that occurs three years after an invasive tumor?

    For cases diagnosed 2007 or later, use the MP/H rules in order. Rule M6 comes before rule M7.

    M6 states that bladder tumors with certain histologies are a single primary. It is a single primary regardless of timing if there is any combination of:

    • papillary carcinoma [8050]

  • transitional cell carcinoma [8120-8124]

  • papillary transitional cell carcinoma [8130-8131]

    • Rule M7 applies to bladder tumors with histologies other than those listed above. If you have such a case, rule M7 applies to in-situ tumors and to an in situ three years after an invasive.

    		 2007
    		20071060

    Reportability/Ambiguous Terminology--Esophagus: Is a case with a biopsy diagnosis of "... focal areas suspicious for adenocarcinoma in situ change" reportable if the diagnosis on the partial esophagectomy specimen only includes the phrase "... with foci of high grade dysplasia; no invasive carcinoma identified"?

    The case is not reportable.

    The biopsy with a suspicious result (suspicious for adenocarcinoma) was disproven by the esophagectomy.

    		 2007
    		20071037 CS Extension--Breast: Is the term "erosion" the same as "ulceration"?

    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.

    "Erosion" is not synonymous with "ulceration" when coding CS extension for breast.

    		 2007
    		20071115 CS Tumor Size/CS Site Specific Factor--Breast: How do you code the CS Tumor size and SSF6 fields for a breast cancer described as "Paget disease with underlying intraductal carcinoma (4cm x 3.2cm)"?

    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.CS Tumor Size: Assign code 040 for tumor size and code SSF6 as 050 [Invasive and in situ components present, size of entire tumor coded in CS TS]. The size of the invasive component is not stated AND proportions of in situ and invasive are not known.

    		 2007
    		20071070 CS Tumor Size--Melanoma: How is this field coded when a smaller invasive and a larger in situ melanoma are reported as a single primary? See Discussion.

    Patient has a 1.2 cm lesion right upper arm with a diagnosis of melanoma in situ. A second lesion on right wrist, 0.5 cm mole, has a diagnosis malignant melanoma, Breslow's 0.78, Clark's level III.

    According to the 2007 MP/H rules, this is a single primary. Because the larger lesion is completely in situ, do you ignore it altogether and go with the smaller, invasive lesion? SEER Program Manual 2007, page 127, rule 4.l, states that when two lesions are reported as a single primary, code the size of the larger lesion, which in this case would be the in situ.

    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 CS Tumor Size as 005 (0.5 cm). Code CS Tumor Size based on the invasive lesion.

    Use the data items "Multiplicity Counter" and "Type of Multiple Tumors Reported as One Primary" to document that there are two tumors present, in situ and invasive.

    		 2007