EOD Regional Nodes

Notes

**Note 1:** Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in EOD Mets. **Note 2:** If the pathology report indicates that nodes are positive but size of the metastases is not stated, assume the metastases are greater than 0.2 mm and code the lymph nodes as positive in this field. **Note 3:** If regional nodes are removed and there is no mention of the level or another specific type, assume these are Level I-II and code appropriately. **Note 4:** Isolated tumor cells (ITCs) are defined as single tumor cells or small clusters not greater than 0.2 mm, usually detected by immunohistochemical (IHC) or molecular methods. ITCs do not usually show evidence of malignant activity (e.g., proliferation or stromal reaction). Lymph nodes with ITCs only are not counted as positive nodes. RT-PCR is a molecular method designed to find evidence of unique tumor or epithelial cell markers. + Codes 030, 050, and 070 are for nodes that are **pathologically negative** but are **positive** for ITCs or RT-PCR - Code 030: Negative nodes pathologically with positive ITCs OR positive ITCs AND positive RT-PCR - Code 050: Negative nodes pathologically with positive RT-PCR, negative ITCs - Code 070: Negative nodes pathologically, unknown if ITCs or RT-PCR **Note 5:** Codes 100-200 and 350 only apply to involved axillary level I and II lymph nodes. If internal mammary, infraclavicular (subclavicular, level III axillary, apical), or supraclavicular lymph nodes are involved, codes 100-200 and 350 may not be used. **Note 6:** Code 800 if regional lymph nodes are involved but there is no indication of the number of nodes involved. **Note 7:** **Regional lymph nodes include** - Axillary, NOS (ipsilateral) - Level I (low-axilla) (low) (superficial), NOS [adjacent to tail of breast] + Anterior (pectoral) + Lateral (brachial) + Posterior (subscapular) - Level II (mid-axilla) (central), NOS + Interpectoral (Rotter's) - Level III (high) (deep), NOS + Apical (subclavian) + Axillary vein - Fixed/matted axillary (level I and II) (ipsilateral) - Infraclavicular (subclavicular) (ipsilateral) - Internal mammary (parasternal) (ipsilateral) - Intramammary (ipsilateral) - Supraclavicular (transverse cervical) (ipsilateral)
Code Description SS2018 N
000 No clinical regional lymph node involvement NONE
030 PATHOLOGICAL assessment only ITCs only (malignant cell clusters no larger than 0.2 mm) in regional lymph node(s) NONE
050 PATHOLOGICAL assessment only Positive molecular findings by reverse transcriptase polymerase chain reaction (RT-PCR), no ITCs detected NONE
070 No regional lymph node involvement pathologically (lymph nodes removed and pathologically negative) WITHOUT ITCs or ITC testing unknown NONE
100 Micrometastasis, less than or equal to 2 mm Axillary (level I and II) lymph node(s), ipsilateral Detected by IHC or H&E (At least one micrometastasis greater than 0.2 mm or more than 200 cells) Micrometastasis, NOS RN
150 CLINICAL assessment only Clinically positive movable axillary (level I and II) lymph node(s), ipsilateral Positive needle core biopsy/FNA RN
200 PATHOLOGICAL assessment only Positive axillary (level I and II) lymph node(s), ipsilateral WITH more than micrometastasis (At least one metastasis greater than 2 mm, or size of metastasis not stated) WITHOUT internal mammary lymph node(s) or not stated RN
250 PATHOLOGICAL assessment only Internal mammary node(s), ipsilateral, positive on sentinel node biopsy but not clinically apparent (No positive imaging or clinical exam) WITHOUT axillary lymph node(s), ipsilateral RN
300 PATHOLOGICAL assessment only Internal mammary node(s), ipsilateral, positive on sentinel node biopsy but not clinically apparent (No positive imaging or clinical exam) WITH axillary lymph node(s), ipsilateral RN
350 CLINICAL assessment only Fixed/matted axillary (level I and II) (ipsilateral) RN
400 CLINICAL assessment only Internal mammary node(s), ipsilateral WITHOUT axillary (level I and II) lymph node(s), ipsilateral RN
500 Infraclavicular lymph node(s) (subclavicular) (level III axillary node(s)) (apical), ipsilateral WITH or WITHOUT axillary (level I and II) nodes(s) WITHOUT internal mammary node RN
600 Internal mammary node(s), ipsilateral, clinically apparent (On imaging or clinical exam) WITH axillary (level I, II, or III) lymph node(s), ipsilateral including infraclavicular RN
700 Supraclavicular node(s), ipsilateral D
800 Regional lymph node(s), NOS Lymph node(s), NOS RN
999 Unknown; regional lymph node(s) not stated Regional lymph node(s) cannot be assessed Not documented in patient record Death Certificate Only U
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