Scenario: 2023 Breast Primary
- 02-28-2023 Mammogram: 2.2cm mass 1 o’clock right breast, recommend core biopsy BI-RADS CAT IV: suspicious.
- 03-02-2023 Core biopsy right breast: infiltrating ductal carcinoma
Question: What is the date of diagnosis?
- 02-28-2023
- 03-02-2023
Answer: 03-02-2023*
{That is the interpretation the date of this tip posting. Please keep referring to the most current postings of the manuals to see if things change. All questions regarding this issue should be directed to either the CAnswer Forum or SEER Ask A Registrar.}
Rationale:
· STORE 2023 Posted 02/28/2023 https://www.facs.org/quality-programs/cancer-programs/national-cancer-database/ncdb-call-for-data/
o Page 46 Case Eligibility: All Rads are still being discussed amongst standard setters. An update on coding the Date of Diagnosis will be released once decided. Registrars should follow current rules in STore to assign Date of diagnosis. CoC does not collect rads alone, a positive biopsy must confirm the diagnosis, the Date of Diagnosis is the date of the biopsy.
· SEER Appendix E1 – 2023 SEER Program Coding and Staging Manual https://seer.cancer.gov/tools/codingmanuals/
o NON-REPORTABLE EXAMPLES
Breast cases designated BIRADS 4, 4A, 4B, 4C or BIRADS 5 without any additional information
· The American College of Radiology defines Category 4 as “Suspicious.” The descriptions in categories 4, 4a, 4b, and 4c are not diagnostic of malignancy. They all represent a percentage of likelihood, the highest being 4c which is greater than 50% but less than 95% likelihood of malignancy. The ACR states “This category is reserved for findings that do not have the classic appearance of malignancy but are sufficiently suspicious to justify a recommendation for biopsy.” Category 5 is “Highly Suggestive of Malignancy.” “Suggestive” is not reportable ambiguous terminology. ACR states that Category 5 has a “very high probability” of malignancy, but again, it is not diagnostic
· SEER Program Coding and Staging Manual 2023 https://seer.cancer.gov/tools/codingmanuals/
o Note: Appendix E in the 2023 SEER Program Manual lists which PI-RADS, BI-RADS, and LI-RADS are reportable versus non-reportable. If reportable, use the date of the imaging procedure as the date of diagnosis when this is the earliest date and there is no information to dispute the imaging findings.
- TIP: A NEW VERSION OF THE STORE 2023 WAS POSTED 02/28/2023 -make sure you have the most current latest posting. https://www.facs.org/quality-programs/cancer-programs/national-cancer-database/ncdb-call-for-data/
*Fl registrars refer to FCDS manual for specific instructions regarding this scenario.