Residual Cancer Burden Class
Description
Residual Cancer Burden (RCB) is a score that measures the amount of cancer remaining in the breast and the regional lymph nodes after neoadjuvant therapy and surgical resection. The RCB score is based on 4 independent prognostic factors measuring the primary tumor bed and 2 independent factors measuring the lymph nodes.
* See Residual Cancer Burden (RCB) Score for further information on these prognostic factors.
Based on the RCB score, patients are then divided into four different classes. These classes are used to determine the likelihood of a patient being cancer free after treatment.
* RCB-0 (pathologic complete response). No residual invasive cancer is present.
* RCB-1 (minimal burden). Very little residual invasive cancer is present.
* RCB-2 (moderate burden). A moderate amount of residual invasive cancer is present.
* RCB-3 (extensive burden). A large amount of residual invasive cancer is present.
Rationale
Neoadjuvant therapy is now standard of care for HER2+ and triple negative breast carcinoma. Quantification of residual disease after neoadjuvant therapy determines further patient management in this setting. The Residual Cancer Burden (RCB) is the most validated measure of volume of residual disease post neoadjuvant for breast cancer and has prognostic value.
Additional Info
**Source documents:** pathology report, CAP synoptic report
For further information, refer to the **Breast Resection cancer protocol** published by the College of American Pathologists for the AJCC Staging System *Breast*.
Notes
***Any questions regarding this SSDI are to be posted in the AJCC CAnswer Forum***
**Note 1:** **Effective years**
* This SSDI is effective for diagnosis years 2026+.
* For cases diagnosed 2018-2025, this SSDI must be blank.
**Note 2:** **Criteria for coding**
* A surgical resection **must be done** after the completion of Neoadjuvant Therapy to assign codes 0-3.
**Note 3:** **CAP Protocol or Synoptic Pathology Report**
* Only record the information from the CAP Protocol or synoptic pathology report
* See code 9 if there is no mention of RCB Class on the CAP protocol or synoptic pathology report
Coding Guidelines
1. **Codes 0-3: Recording the RCB Class**
* Record the RCB Class as stated in the synoptic pathology report
2. **Code 5: RCB Class not documented**
* Surgical resection is performed, but the RCB Class is not documented in the **post-neoadjuvant surgical pathology report.**
3. **Code 6: Planned surgical resection is cancelled/not done**
* Patient had complete response to neoadjuvant therapy, and the surgical resection was cancelled
* Patient had neoadjuvant therapy, didn't complete it and then refused surgical resection
* ***Excludes***: Unknown if surgical resection done (see code 9)
4. **Code 7: No neoadjuvant therapy**
* ***Excludes***: surgical resection cancelled (code 6) or unknown if planned surgical resection was performed (code 9)
* Non-invasive neoplasm (behaviors /0, /1, /2)
* Autopsy only
5. **Code 9: Unknown**
* Unknown if neoadjuvant therapy administered
* Unknown if planned surgical resection performed after neoadjuvant therapy
* ***Excludes***: surgical resection done, RCB Class unknown (code 5), surgical resection cancelled (code 6)
Default
8
Metadata
SSDI 2026–
| Code |
Description |
| 0 |
RCB-0 (pCR) |
| 1 |
RCB-I |
| 2 |
RCB-II |
| 3 |
RCB-III |
| 5 |
Neoadjuvant therapy completed and surgical resection performed, response not documented or unknown
* Results cannot be determined |
| 6 |
Neoadjuvant therapy administered and planned surgical resection not performed |
| 7 |
No neoadjuvant therapy
Non-invasive neoplasm (behaviors /0, /1, /2)
Autopsy only |
| 8 |
Not applicable: information not collected for this case
(If this item is required by your standard setter, use of code 8 will result in an edit error) |
| 9 |
Unknown if neoadjuvant therapy administered
Unknown if surgical resection performed after neoadjuvant therapy |
| <BLANK> |
Must be blank if diagnosis year is before 2026 |
