CS Stage and TNM pN Breast

[Cathryn Phillips]

We are continuing to require collection of CS into 2016, as well as TNM. In a case with neoadjuvant breast cancer, a patient with positive clinical nodes, complete response. There appears to be a conflict related to TNM Path N, SSF 3, 4, 5:

A patient had a positive LN aspiration, followed by neo-adjuvant chemo, followed by lumpectomy with no residual disease, with LN removal (0+/10 LNS)

We code Regional Nodes Positive = 95 ( positive aspiration),
Regional Nodes Exam = 10
CS lymph nodes =257 (clinical eval > yp eval)
CS lymph nodes eval = 5 (clinical > yp )
Site Spec Factor 3 # positive ispilateral axillary LNS as 095
Site Spec Factor 4 IHC of LNS 987 ( CS LYMPH nodes not coded 000)
Site Spec Factor 5 MOL of LNS 987( CS LYMPH nodes not coded 000)
Site Spec Factor 21REsonse to Neoadjuvant Rx 010 (complete)
With the AJCC path coded as pT0,pN0, cM0, stage group 99, clinical stage descriptor 4 ( after tx)

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