Tumor Tip of the Week 08-15-2025 Radiation Primary Treatment Volume Breast

08-15-2025

Scenario #1: Mastectomy

• Needle Bx RUOQ + invasive ductal carcinoma, Grade 3
• Right Modified Mastectomy w/ Lymph node Dissection
• Treated w AC-T Chemotherapy Regimen
• Photon External Beam to Chest wall and nodes 5000 cgy, 25 fx, 200/fx; electron boost 1000 cgy, 5 fx, 250/fx

Question: How will you code the Phase I-II Radiation Primary Treatment Volume?

• 04 Breast/ Chest wall lymph node regions
• 40 Breast-whole
• 41 Breast – partial
• 42 Chest wall

Answer: 42 Chest wall {Phase I & Phase II Record Code 42 Chest wall for Treatment volume following a mastectomy}

Scenario #2: Partial Mastectomy

• Needle Bx RUOQ + DCIS
• Right Breast Partial Mastectomy
• Photon External Beam to Breast 4005 cgy, 15 fx, 267/fx; 3D boost 1200 cgy, 5 fx, 240/fx

Question: How will you code the Phase I, II Radiation Primary Treatment Volume?

• 04 Breast/ Chest wall lymph node regions
• 40 Breast-whole
• 41 Breast – partial
• 42 Chest wall

Answer:

• Phase I 40 Breast-whole
• Phase II 41 Breast partial

References:

• STORE- Phase I-II-III Radiation Primary Treatment Volume coding instructions
• APPENDIX R: CTR Guide to Coding Radiation Therapy Treatment in the STORE