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A cancer staging client library
{
"id" : "extension_bak",
"algorithm" : "cs",
"version" : "02.05.50",
"name" : "Extension",
"title" : "CS Extension",
"notes" : "**Note 1**: 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.\n\n**Note 2**: Consider adherence, attachment, fixation, induration, and thickening as clinical evidence of extension to skin or subcutaneous tissue, code 200.\n\n**Note 3**: Consider fixation, NOS as involvement of pectoralis muscle, code 300.\n\n**Note 4**: If CS Extension code is 000, then Behavior code must be 2; if CS Extension code is 050 or 070, then Behavior code may be 2 or 3; and if CS Extension code is 100, then Behavior code must be 3.\n\n**Note 5**: Inflammatory Carcinoma: AJCC includes the following text in the Cancer Staging Manual 7th Edition: \"Inflammatory carcinoma is a clinicopathologic entity characterized by diffuse erythema and edema (peau d'orange) of the breast, often without an underlying palpable mass. These clinical findings should involve the majority of the skin of the breast. Classically, the skin changes arise quickly in the affected breast. Thus the term of inflammatory carcinoma should not be applied to a patient with neglected locally advanced cancer of the breast presenting late in the course of her disease. On imaging, there may be a detectable mass and characteristic thickening of the skin over the breast. This clinical presentation is due to tumor emboli within dermal lymphatics, which may or may not be apparent on skin biopsy. The tumor of inflammatory carcinoma is classified T4d. It is important to remember that inflammatory carcinoma is primarily a clinical diagnosis. Involvement of the dermal lymphatics alone does not indicate inflammatory carcinoma in the absence of clinical findings. In addition to the clinical picture, however, a biopsy is still necessary to demonstrate cancer either within the dermal lymphatics or in the breast parenchyma itself.\"\n\n**Note 6**: For CS coding, the abstractor should record a stated diagnosis of inflammatory carcinoma, and also record any clinical statement of the character and extent of skin involvement in the text area. Code 600 should be used if there is a stated diagnosis of inflammatory carcinoma and a clinical description of the skin involvement is less than one-third (33%) of the skin of the breast. Code 725 should be used if there is a stated diagnosis of inflammatory carcinoma and a clinical description of the skin involvement is greater than or equal to one-third (33%) and less than or equal to one-half (50%) of the skin of the breast. Code 730 should be used if there is a stated diagnosis of inflammatory carcinoma and a clinical description of the skin involvement in more than one-half (50%) (majority or diffuse) of the skin of the breast. Cases with a stated diagnosis of inflammatory carcinoma but no such clinical description should be coded 750. A clinical description of inflammation, erythema, edema, peau d'orange, or other terms describing skin changes without a stated diagnosis of inflammatory carcinoma should be coded 512-585 depending on described extent of the condition.",
"footnotes" : "- For CS Extension codes 100-140, 200, and 300 ONLY, the T category is assigned based on value of CS Tumor Size as shown in the Extension Size Table for this schema.\n- For CS Extension codes 100-140, 200, and 300 ONLY, the T category is assigned based on value of CS Tumor Size as shown in the Extension Size Table for this schema.\n- For CS Extension codes 050 and 070 ONLY, Summary Stage 1977 and Summary Stage 2000 are assigned based on the value of Behavior Code ICD-O-3 as shown in the Extension Behavior Table for this schema.",
"last_modified" : "2015-05-27T16:19:06.034Z",
"definition" : [ {
"key" : "extension",
"name" : "Code",
"type" : "INPUT"
}, {
"key" : "description",
"name" : "Description",
"type" : "DESCRIPTION"
}, {
"key" : "ajcc7_t",
"name" : "AJCC 7 T",
"type" : "ENDPOINT"
}, {
"key" : "ajcc6_t",
"name" : "AJCC 6 T",
"type" : "ENDPOINT"
}, {
"key" : "t77",
"name" : "Summary Stage 1977 T",
"type" : "ENDPOINT"
}, {
"key" : "t2000",
"name" : "Summary Stage 2000 T",
"type" : "ENDPOINT"
} ],
"rows" : [ [ "000", "In situ: noninfiltrating; intraepithelial\nIntraductal WITHOUT infiltration\nLobular neoplasia", "VALUE:Tis", "VALUE:Tis", "VALUE:IS", "VALUE:IS" ], [ "050", "Paget disease of nipple \nWITHOUT underlying tumor", "VALUE:Tis", "VALUE:Tis", "JUMP:extension_behavior_xci", "JUMP:extension_behavior_xci" ], [ "070", "Paget Disease disease of nipple \nWITHOUT underlying invasive carcinoma pathologically", "VALUE:Tis", "VALUE:Tis", "JUMP:extension_behavior_xci", "JUMP:extension_behavior_xci" ], [ "100", "Confined to breast tissue and fat including nipple and/or areola\nLocalized, NOS", "JUMP:extension_size_xar", "JUMP:extension_size_xar", "VALUE:L", "VALUE:L" ], [ "110", "Stated as T1mi with no other information on extension", "JUMP:extension_size_xar", "JUMP:extension_size_xar", "VALUE:L", "VALUE:L" ], [ "120", "Stated as T1a with no other information on extension", "JUMP:extension_size_xar", "JUMP:extension_size_xar", "VALUE:L", "VALUE:L" ], [ "130", "Stated as T1b with no other information on extension", "JUMP:extension_size_xar", "JUMP:extension_size_xar", "VALUE:L", "VALUE:L" ], [ "140", "Stated as T1c with no other information on extension", "JUMP:extension_size_xar", "JUMP:extension_size_xar", "VALUE:L", "VALUE:L" ], [ "170", "Stated as T1 [NOS] with no other information on extension or size", "VALUE:T1NOS", "VALUE:T1NOS", "VALUE:L", "VALUE:L" ], [ "180", "Stated as T2 with no other information on extension or size", "VALUE:T2", "VALUE:T2", "VALUE:L", "VALUE:L" ], [ "190", "Stated as T3 with no other information on extension or size", "VALUE:T3", "VALUE:T3", "VALUE:L", "VALUE:L" ], [ "200", "Invasion of subcutaneous tissue\nLocal infiltration of dermal lymphatics adjacent to primary tumor involving skin by direct extension\nSkin infiltration of primary breast including skin of nipple and/or areola", "JUMP:extension_size_xar", "JUMP:extension_size_xar", "VALUE:RE", "VALUE:RE" ], [ "300", "Attachment or fixation to pectoral muscle(s) or underlying tissue\nDeep fixation\nInvasion of (or fixation to) pectoral fascia or muscle", "JUMP:extension_size_xar", "JUMP:extension_size_xar", "VALUE:RE", "VALUE:RE" ], [ "380", "OBSOLETE DATA CONVERTED V0203\nSee code 790\n\nStated as T4 [NOS] with no other information on extension", "ERROR:", "ERROR:", "ERROR:", "ERROR:" ], [ "390", "OBSOLETE DATA CONVERTED V0203\nSee code 410\n\nStated as T4a with no other information on extension", "ERROR:", "ERROR:", "ERROR:", "ERROR:" ], [ "400", "Invasion of (or fixation to):\n Chest wall\n Intercostal or serratus anterior muscle(s)\n Rib(s)\n\nSee codes 610 (obsolete), 612-615, and 620 (obsolete) for combinations with this code", "VALUE:T4a", "VALUE:T4a", "VALUE:RE", "VALUE:RE" ], [ "410", "Stated as T4a with no other information on extension", "VALUE:T4a", "VALUE:T4a", "VALUE:RE", "VALUE:RE" ], [ "510", "OBSOLETE DATA RETAINED V0200\n\nExtensive skin involvement, including:\nSatellite nodule(s) in skin of primary breast\nUlceration of skin of breast\nAny of the following conditions described as involving not more than 50% of the breast, or amount or percent of involvement not stated:\n Edema of skin\n En cuirasse\n Erythema\n Inflammation of skin\n Peau d'orange (\"pigskin\")", "ERROR:", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "512", "Extensive skin involvement, including:\nSatellite nodule(s) in skin of primary breast\nUlceration of skin of breast", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "514", "Any of the following conditions described as involving less than one-third (33%) of the breast \nWITHOUT a stated diagnosis of inflammatory carcinoma \nWITH or WITHOUT dermal lymphatic infiltration:\n Edema of skin\n En cuirasse\n Erythema\n Inflammation of skin\n Peau d'orange (\"pigskin\")", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "516", "514 + 512", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "518", "Any of the following conditions described as involving one third (33%) or more but less than or equal to half (50%) of the breast\nWITHOUT a stated diagnosis of inflammatory carcinoma \nWITH or WITHOUT dermal lymphatic infiltration:\n Edema of skin\n En cuirasse\n Erythema\n Inflammation of skin\n Peau d'orange (\"pigskin\")", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "519", "518 + 512", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "520", "Any of the following conditions described as involving more than 50% of the breast\nWITHOUT a stated diagnosis of inflammatory carcinoma \nWITH or WITHOUT dermal lymphatic infiltration:\n Edema of skin\n En cuirasse\n Erythema\n Inflammation of skin\n Peau d'orange (\"pigskin\")", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "575", "520 + 512", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "580", "Any of the following conditions with amount or percent of breast involvement not stated and \nWITHOUT a stated diagnosis of inflammatory carcinoma \nWITH or WITHOUT dermal lymphatic infiltration:\n Edema of skin\n En cuirasse\n Erythema\n Inflammation of skin\n Peau d'orange (\"pigskin\")", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "585", "580 + 512", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "590", "OBSOLETE DATA CONVERTED V0203\nSee code 605\n\nStated as T4b with no other information on extension", "ERROR:", "ERROR:", "ERROR:", "ERROR:" ], [ "600", "Diagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc., involving less than one-third (33%) of the skin of the breast,\nWITH or WITHOUT dermal lymphatic infiltration", "VALUE:T4b", "VALUE:T4d", "VALUE:RE", "VALUE:RE" ], [ "605", "Stated as T4b with no other information on extension ", "VALUE:T4b", "VALUE:T4b", "VALUE:RE", "VALUE:RE" ], [ "610", "OBSOLETE DATA RETAINED V0200\n\n(400) + (510)", "ERROR:", "VALUE:T4c", "VALUE:RE", "VALUE:RE" ], [ "612", "Any of (512-516) + 400", "VALUE:T4c", "VALUE:T4c", "VALUE:RE", "VALUE:RE" ], [ "613", "Any of (518-519) + 400", "VALUE:T4c", "VALUE:T4c", "VALUE:RE", "VALUE:RE" ], [ "615", "Any of (520-585) + 400", "VALUE:T4c", "VALUE:T4c", "VALUE:RE", "VALUE:RE" ], [ "620", "OBSOLETE DATA RETAINED V0200\n\n(400) + (520)", "ERROR:", "VALUE:T4c", "VALUE:RE", "VALUE:RE" ], [ "680", "Stated as T4c with no other information on extension", "VALUE:T4c", "VALUE:T4c", "VALUE:RE", "VALUE:RE" ], [ "710", "OBSOLETE DATA RETAINED V0200 \n\nDiagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc., involving not more than 50% of the skin of the breast, \nWITH or WITHOUT dermal lymphatic infiltration\nInflammatory carcinoma, NOS\n\nPrevious wording (V0100):\nDiagnosis of inflammatory carcinoma\nWITHOUT a clinical description of inflammation, erythema, edema, peau d'orange, etc., of more than 50% of the breast,\nWITH or WITHOUT dermal lymphatic infiltration\nInflammatory carcinoma, NOS", "ERROR:", "VALUE:T4d", "VALUE:RE", "VALUE:RE" ], [ "715", "OBSOLETE DATA RETAINED V0202\n\nDiagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc., involving not more than one-third (33%) of the skin of the breast,\nWITH or WITHOUT dermal lymphatic infiltration", "VALUE:T4b", "VALUE:T4d", "VALUE:RE", "VALUE:RE" ], [ "720", "OBSOLETE DATA CONVERTED V0102 \n\nDescription: Diagnosis of inflammatory carcinoma\nWITH a clinical diagnosis of inflammation, erythema, edema, peau d'orange, etc., of not more than 50% of the breast, \nWITH or WITHOUT dermal lymphatic infiltration\nInflammatory carcinoma, NOS\nNOTE: Code 720 has been combined with code 710.\nAny cases coded to 720 should be re-coded to code 710.\n\nPrevious wording (V0100):\nDiagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc. of LESS THAN OR EQUAL TO 50% of the breast, WITH or WITHOUT dermal lymphatic infiltration", "ERROR:", "ERROR:", "ERROR:", "ERROR:" ], [ "725", "Diagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc., involving one-third (33%) or more but less than or equal to one-half (50%) of the skin of the breast,\nWITH or WITHOUT dermal lymphatic infiltration", "VALUE:T4d", "VALUE:T4d", "VALUE:RE", "VALUE:RE" ], [ "730", "Diagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc., involving more than one-half (50%) of the skin of the breast,\nWITH or WITHOUT dermal lymphatic infiltration", "VALUE:T4d", "VALUE:T4d", "VALUE:RE", "VALUE:RE" ], [ "750", "Diagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc., but percent of involvement not stated, \nWITH or WITHOUT dermal lymphatic infiltration. \n\nNote: If percentage is known, code to 600, 725, or 730.\n\nDiagnosis of inflammatory carcinoma\nWITHOUT a clinical description of inflammation, erythema, edema, peau d'orange, etc., \nWITH or WITHOUT dermal lymphatic infiltration\n\nInflammatory carcinoma, NOS", "VALUE:T4d", "VALUE:T4d", "VALUE:RE", "VALUE:RE" ], [ "780", "Stated as T4d with no other information on extension", "VALUE:T4d", "VALUE:T4d", "VALUE:RE", "VALUE:RE" ], [ "790", "Stated as T4 [NOS] with no other information on extension ", "VALUE:T4NOS", "VALUE:T4NOS", "VALUE:RE", "VALUE:RE" ], [ "950", "No evidence of primary tumor", "VALUE:T0", "VALUE:T0", "VALUE:U", "VALUE:U" ], [ "999", "Unknown; extension not stated\nPrimary tumor cannot be assessed\nNot documented in patient record", "VALUE:TX", "VALUE:TX", "VALUE:U", "VALUE:U" ] ]
}