| Report | Question ID | Question | Discussion | Answer | Year |
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20051007 | CS Tumor Size--Breast: How is this field coded for a 1.5 cm clinically palpable tumor that appeared to be a cyst with a papilloma when the partial mastectomy Path Micro stated the lesion was an "intraductal papilloma with focal noninvasive papillary carcinoma"? See Discussion. | Should the size be coded to 999 [unknown] because the noninvasive papillary carcinoma is described only as "focal" and is not measured and it is not known how much of the tumor is benign and how much is in situ. Or would the size be coded to the size of the palpable mass, 1.5 cm? | 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 999 [unknown]. Size of the focal noninvasive papillary carcinoma is not stated. |
2005 |
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20051056 | Histology (Pre-2007)--Sarcoma: How is "acral myxoinflammatory fibroblastic sarcoma" coded? | For tumors diagnosed prior to 2007:
The ICD-O-3 histology code is 8811/3 [Fibromyxosarcoma] according to the WHO Classification of Tumours of Soft Tissue and Bone. WHO defines myxoinflammatory fibroblastic sarcoma (MIFS) as "a unique low grade sarcoma with myxoid stroma, inflammatory infiltrate and virocyte-like cells that predominantly involves the hands and feet."
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. |
2005 | |
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20051143 | CS Extension--Prostate: Can the EOD Manual clarifications regarding apparent and inapparent tumors be used to determine CS clinical extension for prostate primaries? | 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.Do not use the EOD information to determine apparent and inapparent when coding Collaborative Stage for tumors diagnosed 1/1/2004 or later.
The August 2007 CoC Flash stated that "After consultation with the AJCC curators for genitourinary disease, the CS Steering Committee has determined that the SEER list of terms for apparent and inapparent in the SEER Extent of Disease Manual is NOT to be used for interpreting reports for Collaborative Staging. While it was a convenient tool for registrars, the curators are of the opinion that the use of the list will lead to misinterpretation of reports. Rather, the curators recommend that registrars rely on a direct physician statement of apparent or inapparent disease for Collaborative Staging."
August 2007 CoC Flash: http://www.facs.org/cancer/cocflash/august07.pdf, Coding Prostate Cancer: A Message from the Collaborative Staging Steering Committee. |
2005 | |
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20051133 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How are the number of primaries, histologies and CS extension fields coded for breast tissue that contains separate areas of invasive ductal carcinoma, intraductal carcinoma and Paget disease? See Discussion. | Excisional biopsy of a breast mass: 1.0 cm tumor that was infiltrating ductal carcinoma, high grade, with an associated intraductal component with comedonecrosis. Pathology report for the mastectomy three weeks later: no residual tumor was found near the original biopsy site. In another portion of the same breast was found high-grade intraductal carcinoma involving the nipple ducts, with Paget Disease of the nipple. (No size was given for this.) |
For tumors diagnosed prior to 2007:
This is a single primary. According to Exception 3 of Multiple Primary Rule 6 for multiple tumors, combinations of Paget disease and ductal carcinoma are a single primary. The histology code for this case is 8541 [Paget disease and infiltrating duct carcinoma]. Assign CS extension code 10 [confined to breast tissue] based on the information above.
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. |
2005 |
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20051064 | Cancer-Directed Treatment/Surgery of Primary Site--Anus: Is "infrared coagulation" coded as surgery or "other" treatment for anal canal primaries? | Do not code infrared coagulation -- it is not treatment for cancer. | 2005 | |
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20051140 | CS Reg LN Pos/Exam--Breast: How are nodes positive/examined coded for a positive FNA of a lymph node followed by a subsequent lymph node dissection? See Discussion. | A breast cancer patient had an FNA of an axillary lymph node positive for metastases. A modified radical mastectomy with lymph node dissection showed six lymph nodes negative for metastases. Example 1: Patient received neoadjuvant chemotherapy prior to mastectomy and lymph node dissection. Example 2: Patient received no neoadjuvant therapy. This question is answered for EOD in SINQ 20031059. What is the answer for Collaborative Stage? |
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.Include all nodes examined by the pathologist in Regional lymph nodes positive and Regional lymph nodes examined, unless there is disease progression. These fields are cumulative -- record the total number of regional nodes positive and examined during first course of treatment. Preoperative treatment does not affect the coding of these fields. An FNA alone, positive for regional lymph node metastasis is coded as 95 for number positive and 95 for number examined. For the case examples above, assuming there has been no disease progression, include all nodes positive and all nodes examined from both the FNA and the lymph node dissection in the counts. Code number of regional nodes positive as 01, number examined as 07 for both examples. |
2005 |
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20051101 | CS Extension--Cervix: How are "positive pelvic washings" coded for a cervical primary? | 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. According to the CS Steering Committee, positive pelvic washings for primary cervical cancer are not part of the staging criteria in the collaborative staging system (nor in TNM and FIGO). Document positive pelvic washings in a text field. The CS steering committee will add a statement to CS extension to clarify this for cervix uteri. |
2005 | |
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20051115 | Histology (Pre-2007)--All Sites: How are "malignant cells" in a cytology or "probably malignancy" in a CT scan coded? | For tumors diagnosed prior to 2007:
Assign code 8001/3 [Tumor cells, malignant] when the only information available is a cytology report stating "malignant cells." Assign code 8000/3 [Neoplasm, malignant] when then only information available is a CT report stating "probable malignancy." See ICD-O-3 page 27 for an explanation of "cancer" [8000] and "carcinoma" [8010].
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. |
2005 | |
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20051020 | CS Extension/CS Site Specific Factor--Breast: How is extension (localized or unknown) and SSF6 (entire tumor in situ or 888) coded for an in situ breast primary in which bone metastasis is diagnosed 4 months following the mastectomy? See Discussion. | In situ breast primary with bone mets. No mets work up prior to mastectomy done 2/04. Path: 2.5 cm mass: ductal carcinoma in situ, solid type, with comedonecrosis (no invasive carcinoma found in mastectomy specimen). Bone scan done 4/04 showed compression fractures. MRI 6/04 showed diffuse metastatic disease of the bones. | 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. First, determine whether the bone mets in this case are progression of disease. If the patient was asymptomatic at the time of the mastectomy, the bone mets are disease progression, not initial stage. If the initial stage includes the bone mets and they are not disease progression, extension must be coded to at least 10. Code site-Specific Factor 6 to 040 [Size of entire tumor coded, size of invasive component not stated]. |
2005 |
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20051069 | CS Extension/CS Mets at Dx--Pineal Gland: In Collaborative Stage, how is positive cerebral spinal fluid 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.Assign CS Mets at DX code 40 [Distant metastases] for a pineal gland primary with positive cerebral spinal fluid. |
2005 |
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