TNM Path N, SSF 3, 4, 5 Breast with p0i+

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    AnonymousLoretta Huston
    Spectator

    Our registry is collecting both Collaborative Stage and TNM through 2017 cases. One of our reporting facilities had the following scenario:

    Breast case with lumpectomy, sentinel lymph node biopsy and 00/02 SLN positive; however 1 LN had ITCs <200 cells detected by H&E hematoxylin and eosin stains.
    They coded pathologic stage pT1c pN0(i+), stage descriptor 0
    CS Lymph Nodes as 050 and LN Eval 3
    Nodes Positive 00, Nodes Examined 02
    SSF3 000
    SSF4 987
    SSF5 987

    This causes the edit “TNM Path N, SSF 3, 4, 5 Breast (COC)” to fail. We also tried SSF’s 4 & 5 as 000 since nodes were technically negative on H&E and it was a sub-set of pN0, but this did not pass the edit either. We could find no combination of codes to accurately capture the ITCs found on H&E stains and the pN0i+ designation, without causing this and/or the “CS Lymph Nodes, SSF 4, 5, Breast Schema” edit to fail. Does the TNM edit need to be modified?

    _______

    Response from NAACCR:

    The edit has now been modified to allow SSF’s 4&5 to be 987 when pN0i+.

    However, the correction won’t be available until we release v18. You might want to have your registrar hold the case until the next update is available.

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