SEER Inquiry System - Search

Per the SEER*Rx Database, Lupron is coded as Other Therapy for breast cancer until such time that it receives FDA approval. However, SINQ 20021042 states Lupron should be coded as Hormone Therapy when given as cancer-directed therapy. These two sources contradict each other.

Information regarding hormone therapy for breast cancer in both the SEER*Rx Database and the National Cancer Institute's Cancer Topics website (http://www.cancer.gov/types/breast/breast-hormone-therapy-fact-sheet) seem to indicate that the SINQ answer is the correct choice. The NCI Cancer Topics website states that Lupron acts to block ovarian function and is an example of an ovarian suppression drug that has been approved by the FDA. The SEER*Rx Database Remarks section states that a combination of letrozole and leuprolide (Lupron) "is considered standard treatment for metastatic breast cancer and is sometimes used for treatment of early stage breast cancer." But the Remarks go on to state that Lupron should be coded as Other Therapy until it receives FDA approval.

It is unclear how to code Lupron for breast cancers when the NCI website indicates that it is standard treatment while the SEER*Rx Database states both that it is and that it is not standard treatment.

Breast biopsy (from hospital A): DCIS, solid, cribriform, comedo type, high nuclear grade

Breast Lumpectomy (from hospital B): DCIS, cribriform type, nuclear grade 1, tumor 2.5cm

How many primaries should be reported when a 12/19/14 RUL lung wedge resection shows: 2.0 cm invasive adenocarcinoma (8140/3) and an additional RUL wedge resection during the same procedure shows: multifocal adenocarcinoma in situ (bronchioloalveolar carcinoma), non-mucinous type (8252/2) size: 1 mm – 2 mm; followed by a 2/12/15 left upper lobectomy also showing Adenocarcinoma, invasive at several foci, with a prominent bronchioloalveolar (in situ) component….tumor focality: multifocal (10 cm mass, 6 cm mass and numerous smaller foci)?

Please confirm correct coding for grade for papillary urothelial carcinoma of the bladder/renal pelvis and urothelial carcinoma of the bladder/renal pelvis. SEER Manual 2014 and 2015 state: "Do not use these tables to code grade for any other groups including WHO (CNS tumors), WHO/ISUP (bladder, renal pelvis), or FIGO (female gynecologic sites) grades." They also state "In transitional cell carcinoma for bladder, the terminology high grade TCC and low grade TCC are coded in the two-grade system" in the Grade section. These statements are not included in SEER Manuals prior to 2014.

This patient underwent a "partial decortication" per the operative report. While the operative report does not specifically note that this was performed with a partial pleurectomy, it appears the patient had a partial pleurectomy because the largest specimen removed was a "pleural peel" specimen, which included the parietal and visceral pleural surfaces with a small amount of underlying lung tissue. The operative report notes the patient had involvement of both the lung and chest wall. A total resection was not possible due to the extent of the tumor. However, this patient does appear to have undergone at least a partial resection of the pleura/tumor burden. The patient did not simply undergo a pleurodesis to free adhesions. Per the NCI's PDQ, pleurectomy and decortication are performed together. Because the operative report and pathology report only called this procedure a "partial decortication" without specifically mentioning a pleurectomy, would this be coded as a tumor excision (surgery code 20)? Or should we assume the procedure is best coded as a partial pleurectomy and decortication and use code 30 (simple/partial resection)?