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Question: 20120082
Status
Final

References
Source 1:   2007 MP/H Rules
pgs:  
Notes:   M12
Source 2:  
pgs:  
Notes:  


Question
MP/H Rules/Multiple primaries--Breast: Please tell me if this is one or two breast primaries. See discussion.

Discussion
Patient has 2 tumors in the left breast -- one at 2:00 and one at 3:00. The final diagnosis from the left mastectomy is: multifocal (2 foci) invasive ductal carcinoma (mpT1c N0 see template) with associated intermediate grade ductal carcinoma in situ located between the invasive foci.

Larger 2:00 focus: moderately diff ductal carcinoma with mucinous differentiation (1.4cm.)

Smaller 3:00 focus: Moderately to poorly diff ductal carcinoma (1.2 cm.)

I would code the 2:00 tumor as 8523/3 and the 3:00 tumor as 8500/3. I do not know whether to invoke rule M11 (since 8523 is not in Tables 1 or 2) or rule M12. M11 would make this a single primary; M12 makes this 2 primaries.

Answer
According to rule M12, this is two primaries. Ductal carcinoma with mucinous differentiation, 8523/3, and ductal ca, 8500/3, differ at the third digit. Duct ca with mucinous diff is not a specific type of duct ca -- it is duct ca mixed with another type of ca (mucinous in this case.)

History


Last Updated
11/18/2012

Date Finalized
11/18/2012