03-31-2023 Tumor Size-When Reported as a “Between” or “Range”
Scenario #1: 2023-Tumor size reported as a Range + Neoadjuvant Therapy
- Mammogram: RUOQ Breast 2-3 cm mass
- FNA proves to be + patient is treated with neoadjuvant chemotherapy
- Lumpectomy shows no residual tumor
Question: How would you code Tumor Size Clinical, Tumor Size Pathologic, Tumor Size Summary?
Answer & Rationale:
| Field | Answer | Rationale | V23 Required Status https://www.naaccr.org/data-standards-data-dictionary/ |
| Tumor Size Clinical | 030 | SEER Program Coding and Staging Manual 2023- Record the higher tumor size when stated as a range. Example: Tumor size is 8-10 mm or tumor size is 8 to 10 mm. Code size as 010 since 10 mm is the higher of the values in the range | This field is only required by SEER & the Canadian Cancer Registries, if you are not abstracting for a SEER state or CCCR, it is not required to filled out. |
| Tumor Size Pathologic | 000 | SEER Program Coding and Staging Manual 2023 Assign code 000 when a. No residual tumor is found i. Neoadjuvant therapy has been administered and the resection shows no residual tumor | This field is only required by SEER & the Canadian Cancer Registries, if you are not abstracting for a SEER state or CCCR, it is not required to filled out. |
| Tumor Size Summary | 025 | STORE 2023– If neoadjuvant therapy followed by surgery, do not record the size from the pathologic specimen. Code the largest size of tumor prior to neoadjuvant treatment If tumor size is reported to be between two sizes, record tumor size as the midpoint between the two: i.e., add the two sizes together and then divide by two (“between 2 and 3 cm” is coded as 025). Special Note–STORE does not have separate instructions when tumor size recorded as a range-follow the instructions for tumor size reported between 2 sizes. CAnswer Forum Post https://cancerbulletin.facs.org/forums/forum/fords-national-cancer-data-base/store/other-general-questions/138394-tumor-size-summary-when-given-in-a-range#post138678 | This field is required by NPCR, CoC, and Supplementary/ Recommended for SEER. |
Scenario #2 2023: Tumor size reported as “Between” + Neoadjuvant Therapy
- Mammogram: Mass noted RUOQ size between 2 and 3 cm
- FNA proves to be + patient is treated with neoadjuvant chemotherapy
- Lumpectomy show .9cm residual tumor
Question: How would you code Tumor Size Clinical, Tumor Size Pathologic, Tumor Size Summary?
Answer & Rationale:
| Field | Answer | Rationale | V23 Required Status https://www.naaccr.org/data-standards-data-dictionary/ |
| Tumor Size Clinical | 025 | SEER Program Coding and Staging Manual 2023- Record “between” tumor sizes as the midpoint between the two measurements when tumor size is reported to be between two sizes; i.e., add the two sizes together and divide by two Note: The word ‘between’ must be stated to use this instruction. Example: Tumor size is “between 2 and 3 cm.” Code size as 025 since 2 + 3 = 5 divided by 2 = 2.5 cm (25 mm). | This field is only required by SEER & the Canadian Cancer Registries, if you are not abstracting for a SEER state or CCCR, it is not required to filled out. |
| Tumor Size Pathologic | 999 | SEER Program Coding and Staging Manual 2023 Assign code 999 when Neoadjuvant therapy has been administered. Do not use a post-neoadjuvant size to code path tumor size | This field is only required by SEER & the Canadian Cancer Registries, if you are not abstracting for a SEER state or CCCR, it is not required to filled out. |
| Tumor Size Summary | 025 | STORE 2023– If neoadjuvant therapy followed by surgery, do not record the size from the pathologic specimen. Code the largest size of tumor prior to neoadjuvant treatment If tumor size is reported to be between two sizes, record tumor size as the midpoint between the two: i.e., add the two sizes together and then divide by two (“between 2 and 3 cm” is coded as 025). | This field is required by NPCR, CoC, and Supplementary/ Recommended for SEER. |