EOD Primary Tumor
Additional Info
Synonyms for in situ:
* Confined to epithelium
* Ductal carcinoma in situ (DCIS)
* Intracystic
* Intraductal
* Intraepidermal
* Intraepithelial
* Lobular carcinoma in situ (LCIS)
* Lobular neoplasia
* Lobular noninfiltrating
* Noninfiltrating
* Noninvasive
* No stromal involvement
* Papillary intraductal
* Papillary non infiltrating
Notes
**Note 1:** **Dimpling, tethering**
* Changes such as dimpling of the skin, tethering, and nipple retraction are caused by tension on Cooper's ligament(s), not by actual skin involvement.
* They do not alter the classification.
**Note 2:** **Clinical evidence ONLY descriptions**
* Adherence, attachment, fixation, induration, and thickening are clinical evidence of extension to skin or subcutaneous tissue; assign code 200 if that is the only information available.
* Do not use these descriptions for pathological assessment of the breast.
**Note 3:** **Fixation, NOS**
* **"Fixation", NOS** is involvement of pectoralis muscle; assign code 200.
**Note 4:** **Inflammatory carcinoma**
* Inflammatory carcinoma is a clinical diagnosis. It is defined as greater than 33% of a breast involved WITH erythema, edema, peau d'orange, or other terms describing skin changes.
* See codes **400 and 500** for descriptions of inflammation **WITHOUT** a diagnosis of inflammatory carcinoma.
* See code **600** for a diagnosis of inflammatory carcinoma
| Code |
Description |
SS2018 T |
| 000 |
In situ: noninfiltrating; intraepithelial
Intraductal WITHOUT infiltration
Lobular neoplasia, grade 3 (LIN 3) |
IS |
| 050 |
Paget disease of nipple WITHOUT underlying tumor |
Behavior with Primary Tumor for SS2018 T |
| 070 |
Paget disease of nipple WITH underlying DCIS tumor |
Behavior with Primary Tumor for SS2018 T |
| 100 |
Any size tumor
Confined to breast tissue and fat including nipple and/or areola
Localized, NOS
EXCLUDES: skin invasion of breast, nipple and areola (see code 200) |
L |
| 200 |
Any size tumor
Attachment or fixation to pectoral muscle(s) or underlying tumor
Deep fixation
Invasion of
- Pectoral fascia or muscle(s)
- Subcutaneous tissue
Local infiltration of dermal lymphatics adjacent to primary tumor involving skin by direct extension
Skin infiltration of primary breast including skin of nipple and/or areola |
RE |
| 300 |
Chest wall
Intercostal or serratus anterior muscle(s)
Ipsilateral rib(s) (contiguous involvement only) (see EOD Mets for noncontiguous involvement) |
RE |
| 400 |
Extensive skin involvement
**WITHOUT a stated diagnosis of inflammatory carcinoma**
WITH or WITHOUT dermal lymphatic filtration
- Edema of skin
- En cuirasse
- Erythema
- Inflammation of skin
- Lenticular nodule(s)
- Peau d'orange ("pigskin")
- Satellite nodule(s)
- Skin edema
- Ulceration of skin of breast |
RE |
| 450 |
**OBSOLETE** - Please use 400 |
RE |
| 500 |
300 + 400
Extensive skin involvement
**WITHOUT a stated diagnosis of inflammatory carcinoma**
WITH invasion of
- Chest wall
- Intercostal or serratus anterior muscle(s)
- Ipsilateral rib(s) (contiguous involvement only) (see EOD Mets for noncontiguous involvement) |
RE |
| 600 |
**Diagnosis of inflammatory carcinoma**
WITH a clinical description of inflammation, erythema, edema, peau d'orange, etc.,
WITH or WITHOUT dermal lymphatic infiltration
- En cuirasse
- Lenticular nodule(s)
- Satellite nodule(s)
- Ulceration of skin of breast |
RE |
| 700 |
**OBSOLETE** - Please use 600 |
RE |
| 800 |
No evidence of primary tumor |
U |
| 999 |
Unknown; extension not stated
Primary tumor cannot be assessed
Not documented in medical record
Death Certificate Only |
U |
(1) Fritz AG, Ries LAG (eds). **SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998)**, National Cancer Institute, NIH Pub. No. 98-2313, Bethesda, MD, 1998
(2) Young JL Jr, Roffers SD, Ries LAG, Fritz AG, Hurlbut AA (eds.). **SEER Summary Staging Manual-2000: Codes and Coding Instructions**, National Cancer Institute, NIH Pub. No. 01-4969, Bethesda, MD, 2001.
(3) Collaborative Stage Work Group of the American Joint Committee on Cancer. **Collaborative Stage Data Collection System User Documentation and Coding Instructions, version 02.05**. American Joint Committee on Cancer (Chicago, IL)
(4) Gress, D.M., Edge, S.B., Gershenwald, J.E., et al. **Principles of Cancer Staging**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
(5) Hortobagyi, G.N., Giuliano, A., et al. **Breast**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
