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20071079 | MP/H Rules/Recurrence--Breast: Do we use a pathologists comment of "recurrent ductal carcinoma" found in the pathology report for a new specimen to determine whether the new specimen actually represents a new primary or recurrent disease? See Discussion. | The patient had a left breast cancer LIQ, ductal with DCIS. Nodes (-) diagnosed in 1998 Treatment: Lumpectomy-clear margins Refused radiation Hormone therapy: Tamoxifen
Present: June 2007 Left breast-invasive ductal ca, UOQ Pathology report comments: Recurrent ductal ca. Left axillary nodes (+) |
For cases diagnosed 2007 or later, apply the 2007 MP/H breast rules. Go to the multiple tumors module and begin with rule M4. Stop at rule M5: tumors diagnosed more than 5 years apart are multiple primaries. The only time you can accept a pathologist's statement of recurrence is when the statement is made based on a review of the slides from the previous diagnosis compared to the slides from the current diagnosis. |
2007 |
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20071025 | Radiation Therapy: How is radiation coded when it is "recommended" but the patient dies before radiation is started? See Discussion. | Code 0 seems appropriate but then we would lose the fact that it had been recommended. All of the other modalities give an option for 'recommended but patient died prior to treatment.' Is there a reason this option is not given for radiation? | Code Radiation (Rx Summ--Radiation) to 0 [None; diagnosed at autopsy].
SEER does not collect the Reason For No Radiation field. However, those who abstract using software that captures this data item can identify these cases. Code 5 [radiation not administered because patient died] reflects this situation.
Radiation (Rx Summ-Radiation) is a SEER field. This field is derived from the data collected in Rad-Boost Rx Modality and Rad-Regional TX Modality. These fields do not include a choice for "radiation not given because the patient died prior to treatment." Therefore, this information cannot be coded in the Radiation field. |
2007 |
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20071074 | MP/H Rules/Multiple Primaries--Lung: How many primaries should be reported when an "adenocarcinoma" is discovered in one of several new nodules at the scar in a lung and it is less than a year after a wedge resection for a diagnosis of "bronchioalveolar adenocarcinoma" in the same lung? See Discussion. | In March 2006 patient diagnosed with bronchioalveolar adenocarcinoma [8250/3] and had wedge resection. In November 2006 a CT chest shows nodules at the scar suspicious for recurrence. In January, 2007, there was a biopsy of one of the nodules showing adenocarcinoma [8140/3]. Is this part of the original disease process diagnosed in March 2006 or should it be abstracted as a new primary based on 2007 MP/H rules (histology is different at the first 3 digits)? |
For cases diagnosed 2007 or later:
Try to obtain more information/clarification on the 2007 diagnosis -- for example, is it metastasis? Based only on the information provided for this case, the 2007 diagnosis is a separate primary. Use the 2007 MP/H rules to assess the 2007 diagnosis. Begin with rule M3 in the multiple tumors section. Stop at rule M11, multiple primaries. |
2007 |
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20071131 | Cell indicator--Lymphoma: If the primary site for a lymphoma is stated to be the lymph nodes but there is no biopsy of a lymph node, can the immunophenotype designation for a lymphoma be coded based on a bone marrow or liver biopsy indicating "diffuse large B-cell lymphoma"? | For cases diagnosed prior to 1/1/2010: The cell indicator or immunophenotype designation for lymphomas may be coded from pathology reports on tissue from bone marrow or liver when there is no tissue from the primary site. Code information on cell type from any available source. See the Appendix C of the 2007 SEER manual, Coding Guidelines for Lymphomas, pages C-1055 to C-1056 for more information about coding this field for lymphomas. For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2007 | |
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20071088 | Type of Multiple Tumors--Lung: Is this field coded to 40 [Multiple invasive] or 80 [Unk in situ or invasive] when only one nodule is biopsied of multiple existing nodules for a reported single lung primary? See Discussion. | The right lung has 4 tumor nodules in the upper lobe. Biopsy of one tumor is positive for moderately differentiated adenocarcinoma. No other work up performed. Should code 40 be used because we dont know the behavior of the other nodules? |
The best code to use in this case is 40 [multiple invasive]. For lung only, it is assumed that all of the tumors are the same histology and that all are invasive. | 2007 |
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20071101 | Multiplicity Counter/CS Tumor Size: The Multiplicity Counter rule 6c states "Use code 99 when the tumor is described as diffuse". Is code 99 used in all circumstances when tumor size is coded to 998? See Discussion. | The CS manual lists esophagus, stomach, familila/familial polyposis (colon), lung, and breast as the only circumstances when code 998 is valid. If this is correct, then if TS is coded to 998, then Multiplicity Counter must be 99. | If the number of tumors is known, code the number in Multiplicity Counter. If the number of tumors is not known, assign code 99. If "diffuse" is the only information available to describe the tumor, assign code 99. | 2007 |
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20071128 | MP/H Rules--Urinary: How many primaries are abstracted when a patient has a May 2000 invasive papillary transitional cell carcinoma of the bladder, a November 2004 invasive papillary transitional cell carcinoma of the right ureter and a May 2007 urothelial carcinoma in situ of both the left and right ureters? | For cases diagnosed 2007 or later: Using the pre-2007 multiple primary rules, the PTCC of the bladder in 2000 and the invasive TCC of the right ureter in Nov. 2004 would have been abstracted as separate primaries.
Use the 2007 MP/H rules to evaluate the May 2007 diagnosis. Start with rule M3. Stop at rule M8. The May 2007 diagnosis is the same primary.
Rule M4 does not apply because of the 2000 bladder primary. A clarification will be added to M4 to stress that for the urinary rules, any urinary tumor up to the present point in time is counted when applying this rule. |
2007 | |
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20071001 | CS Site Specific Factor/Melanoma: How is CS SSF1 (depth of invasion) coded for a melanoma that demonstrates dermal invasion to a depth of "less than .2 mm" be coded to 999 [unknown]? See Discussion. | The path report says "superficial spreading malignant melanoma; 2 areas of papillary dermal invasion to depth of less than .2mm." The revised CS pages include codes for "less than" a certain tumor size, but these are not included in the depth of invasion SSF. Using 999 results in an unstageable melanoma, when we know it is "less than .2mm". |
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 SSF1 (depth of invasion) to 019 [.19mm]. For any case with an SSF1 code in the range of 001-100 mm, the T category will be determined using CS extension and SSF2 [ulceration]. All cases with an SSF1 code in the range of 001-100 mm will map to a T1 (either T1NOS, T1a or T1b). |
2007 |
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20071097 | Multiplicity Counter--Thyroid: How is multiplicity counter to be coded for a thyroid cancer presenting as multiple foci? See Discussion. | Thyroidectomy showed papillary thyroid carcinoma. Path diagnosis: tumor focality: multifocal. Path described 3 foci of tumor on each side. The main tumor mass in right thyroid was 1.5 cm. Smaller foci of tumor ranged in size from .1 cm to 1.0 cm. Per guidelines, "we still don't count foci as tumors for the purpose of these rules, even if there is more than one." The 1 cm tumor was probably macroscopic in size. Do we count it in the multiplicity counter? Do we count only the 1.5 cm main tumor mass? | If the number of tumors is known, code the number in Multiplicity Counter. If foci are measured, include them in the multiplicity counter. If the only information available is "multiple foci" assign code 99. For the case above, code 06 in the multiplicity counter (3 tumors on each side). |
2007 |
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20071084 | MP/H Rules/Histology--Prostate: How is an "acinar adenocarcinoma with focal large duct adenocarcinoma" coded? | For cases diagnosed 2007 or later: As long as this is NOT urothelial carcinoma extending to the prostatic ducts, code histology to 8140/3 [adenocarcinoma] using rule H10. Do not code histologies designated as "focal." |
2007 |
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