| Report | Question ID | Question | Discussion | Answer | Year |
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20041078 | Ambiguous Terminology: Is the expression "has the markings of a malignancy" a clinically reportable term? See Discussion. |
12/02 Baseline mammogram: spiculated mass with associated marked retraction located in UOQ lt breast. This has the markings of malignancy. Several microcalcifications in outer aspect of rt breast. BI-RADS 5 higly suggestive of malignancy. |
Do not accession cases using only the term "has the markings of malignancy." This term is not on the list of ambiguous terms that are reportable. If the term does not appear on either the reportable or not reportable list, the term is not diagnostic of cancer. Do not accession the case. Please see SINQ 20010094 in reference to BI-RADS terminology. |
2004 |
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20041058 | Primary Site/Sarcoma--Breast: Is the primary site coded to C504 [upper-outer quadrant of breast] or C493 [ Connective, subcutaneous and other soft tissue of thorax ] for a tumor described as a "high grade soft tissue sarcoma present in the upper outer quadrant of breast"? | If the sarcoma is primary in the breast, code the primary site to C504 [upper-outer quadrant of breast]. C500 - C509 includes soft tissue of breast. | 2004 | |
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20041012 | Multiple Primaries (Pre-2007)--Colon: What is the number of primaries for a case of familial polyposis with at least three separate tumors having invasive adenocarcinoma, one in the rectum? See Discussion. | A patient had a total proctocolectomy and was found to have familial polyposis. At least 3 separate tumors were identified with invasive adenocarcinoma, one of which was in the rectum. Is this 2 primaries: C18.9 with 8220/3 and C20.9 with 8140/3 or is this all one primary cancer? | For tumors diagnosed prior to 2007:
Familial polyposis is always a single primary. Code the primary site for the case example above to C199 [colon and rectum].
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. |
2004 |
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20041065 | Date Therapy Initiated/First-Course of Cancer-Directed Therapy Fields/Summary Stage 2000--Prostate: How do you code these fields for a case that received preventative chemo before a definitive cancer diagnosis? | A patient has a "suspicious but not diagnostic" biopsy of the prostate in 09/2002. Doctor said it was not cancer and put the patient on a preventative chemo drug study (GTX-211). The patient returned for a repeat biopsy on 04/2003. Biopsy returned positive for adenocarcinoma. The patient had not been diagnosed when chemo was administered. Can the case be staged using the post-chemo information? | Stage this case the same as all other cases. Use only the information subsequent to the date of diagnosis to code stage and treatment.
The diagnosis date in the example is 04/2003. Do not use information prior to 04/2003 to code stage or treatment. Do not code the preventative chemo as treatment. |
2004 |
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20041049 | Histology (Pre-2007): What code is best used to represent a diagnosis of "metaplastic carcinoma, matrix producing type." The tumor shows poorly differentiated infiltrating duct carcinoma and myxoid, cartilaginous stroma. | For tumors diagnosed prior to 2007:
Code the histology to 8575 [metaplastic carcinoma, NOS]. According to the WHO Classification of Tumors of the Breast and Female Genital Organs, metaplastic carcinoma is a type of epithelial breast tumor. Matrix producing carcinoma is a synonym of metaplastic carcinoma. ICD-O-3 does not have a code for matrix producing carcinoma.
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. |
2004 | |
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20041099 | First Course Treatment: If a patient makes a blanket refusal of all recommended therapy or refuses all treatment before any therapy was recommended, are only immunotherapy and hematologic/endocrine therapies to be coded as refused (code 87)? Or should all treatment modalities be coded as refused if a patient makes a blanket refusal? Or should none of the treatment modalities be coded as refused because we do not know what would have been recommended? See Discussion. | Coding instructions for immunotherapy and for hematologic/endocrine procedures state that Code 87 is to be assigned if either of the following circumstances apply: 1) If the patient made a blanket refusal of all recommended treatment. 2) If the patient refused all treatment before any was recommended. These instructions are not included for other treatment modalities. | When the patient refuses treatment, the first course of therapy is no treatment. Code all treatments as refused. | 2004 |
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20041047 | Multiple primaries (Pre-2007)/EOD-Extension--Fallopian Tube: How many primaries are coded when endometrioid adenocarcinoma involves bilateral fallopian tubes? See Discussion. | The pathologist states "because of the intimate association with the luminal line of the fallopian tube it is felt that this represents synchronous primaries rather than mets." The SEER Code Manual only lists ovary, retinoblastomas, and Wilms Tumors under the bilateral code stated to be a single primary. | For tumors diagnosed prior to 2007:
Complete two abstracts, one for left fallopian tube and one for right fallopian tube. This case has been determined to be two primaries by the pathologist. Bilateral involvement of paired sites (other than ovary, retinoblastoma and Wilms tumor) with the same histology within two months requires a determination of whether there are one or two primaries. The pathologist in the case above has made this determination.
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. |
2004 |
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20041092 | CS Extension--Bladder: How would the following statements be coded for bladder extension -- Code 03 [inferred description of non-invasion] vs code 15 [invasive confined to subepithelial connective tissue]. See Discussion. | 1) no smooth muscle invasion 2) no muscle invasion 3) without muscle invasion 4) no invasion of muscularis propria |
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 in 2004 and later code CS extension: 1) no smooth muscle invasion -- 15 2) no muscle invasion -- 15 3) without muscle invasion -- 15 4) no invasion of muscularis propria -- 03 |
2004 |
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20041079 | CS Mets at Dx/CS Mets Eval--Colon: Would the metastasis field be coded to 00 [No; none] and the evaluation field be coded to 1 [No path exam of metastatic tissue performed.] when the source of information is from the operative findings for the following 6 different cases? 1) Liver normal; 2) No evidence of metastatic disease; mesentery normal, 3) Small ascites; no liver metastasis, mass adherent to duodenum without obvious invasion, 4) No mets or local invasion, 5) No evidence of carcinomatosis, peritoneal studding or malignant effusion and 6) Tumor adherent to lateral sidewall (path negative); no evidence of metastatic implants. | 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. The CS Mets Eval code refers to the method used to evaluate the site farthest from the primary site. The correct code may not be the highest eval code. For example 1 above, if the liver is the site farthest from the colon primary that was evaluated for distant mets, code the CS Mets Eval code to the method used to evaluate liver. Code surgical evaluation as 1. Assuming this is all of the information about possible distant metastatic sites for the examples above, code CS Mets at DX as 00, and CS Mets Eval as 1 for each. Please note: imaging of farther sites should also be included when CS Mets at DX is coded. For example, if there was also a negative chest X-ray, the CS Mets at DX field would be 00 but the CS Mets Eval field would be 0 because the CXR documents that there are no mets beyond the immediate area of the tumor. |
2004 | |
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20041001 | Histology (Pre-2007)--Pancreas: Should pancreatic neoplasia III (PanIN III) be coded to 8010/2 [carcinoma in situ, NOS] or 8500/2 [Ductal carcinoma in situ]? See Description. |
There is no specific morphology code for PanIN-III in the ICD-O-3. In the chapter for exocrine pancreas found in the sixth edition of AJCC cancer staging manual, pg 160, reference is made to PanIN-III and its inclusion with carcinoma in situ. |
For tumors diagnosed prior to 2007:
Code PanIN-III (pancreatic intraepithelial neoplasia III) as 8500/2 [Ductal carcinoma in situ, includes DIN 3: Ductal intraepithelial neoplasia 3]. PanIN-III is a synonym for carcinoma in situ according to the WHO classification of Tumors and the College of American Pathologists' Protocol for exocrine pancreas. Do not code PanIN-I or PanIN-II as cancer.
For tumors diagnosed 2007 or later, see SINQ 20110081 and 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. |
2004 |
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