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{
  "id" : "extension_bak",
  "algorithm" : "eod_public",
  "version" : "1.1",
  "name" : "EOD Primary Tumor",
  "title" : "EOD Primary Tumor",
  "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:** Adherence, attachment, fixation, induration, and thickening are clinical evidence of extension to skin or subcutaneous tissue; assign code 200.\n\n**Note 3:** “Fixation, NOS” is involvement of pectoralis muscle; assign code 200.\n\n**Note 4:** For a clinical description of inflammation, erythema, edema, peau d’orange, or other terms describing skin changes without a stated diagnosis of inflammatory carcinoma, assign code 400.",
  "footnotes" : "(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\n\n(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.\n\n(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)\n\n(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: 3-30\n\n(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: 589-628",
  "last_modified" : "2018-04-19T21:51:26.658Z",
  "definition" : [ {
    "key" : "eod_primary_tumor",
    "name" : "Code",
    "type" : "INPUT"
  }, {
    "key" : "description",
    "name" : "Description",
    "type" : "DESCRIPTION"
  }, {
    "key" : "eod_2018_t",
    "name" : "EOD 2018 T",
    "type" : "ENDPOINT"
  }, {
    "key" : "ss2018_t",
    "name" : "SS2018 T",
    "type" : "ENDPOINT"
  } ],
  "rows" : [ [ "000", "In situ: noninfiltrating; intraepithelial\nIntraductal WITHOUT infiltration\nLobular neoplasia, grade 3 (LIN 3)", "JUMP:morphology_with_primary_tumor_for_ajcc_t_82996", "VALUE:IS" ], [ "050", "Paget disease of nipple WITHOUT underlying tumor", "VALUE:Tis(Paget)", "JUMP:behavior_with_primary_tumor_for_ss2018_t_69793" ], [ "070", "Paget disease of nipple WITH underlying DCIS tumor", "VALUE:Tis(DCIS)", "JUMP:behavior_with_primary_tumor_for_ss2018_t_69793" ], [ "100", "Any size tumor\n\nConfined to breast tissue and fat including nipple and/or areola\nLocalized, NOS\n\nEXCLUDES: skin invasion of breast, nipple and areola (see code 200)", "JUMP:tumor_size_with_primary_tumor_for_ajcc_t_16997", "VALUE:L" ], [ "200", "Any size tumor\n\nAttachment or fixation to pectoral muscle(s) or underlying tumor\nDeep fixation\nInvasion of\n- Pectoral fascia or muscle(s)\n- Subcutaneous tissue    \n\nLocal infiltration of dermal lymphatics adjacent to primary tumor involving skin by direct extension\n\nSkin infiltration of primary breast including skin of nipple and/or areola", "JUMP:tumor_size_with_primary_tumor_for_ajcc_t_16997", "VALUE:RE" ], [ "300", "Invasion of (or fixation to)\n- Chest wall\n- Intercostal or serratus anterior muscle(s)\n- Rib(s)", "VALUE:T4a", "VALUE:RE" ], [ "400", "Extensive skin involvement \nWITHOUT a stated diagnosis of inflammatory carcinoma\nWITH or WITHOUT dermal lymphatic filtration\n- Edema of skin\n- En cuirasse\n- Erythema\n- Inflammation of skin\n- Lenticular nodule(s)\n- Peau d'orange (\"pigskin\")\n- Satellite nodule(s)\n- Skin edema\n- Ulceration of skin of breast", "VALUE:T4b", "VALUE:RE" ], [ "450", "Diagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc., \ninvolving less than or equal to one-third (33%) of the skin of the breast or percentage not stated\nWITH or WITHOUT dermal lymphatic infiltration \n- En cuirasse\n- Satellite nodule(s)\n- Skin edema\n- Ulceration of skin of breast", "VALUE:T4b", "VALUE:RE" ], [ "500", "300 + (400 OR 450)", "VALUE:T4c", "VALUE:RE" ], [ "600", "Diagnosis of inflammatory carcinoma\nWITH a clinical description of inflammation, erythema, edema, peau d'orange, etc., \ninvolving greater than one-third (33%) or more of the skin of the breast\nWITH or WITHOUT dermal lymphatic infiltration\n- En cuirasse\n- Lenticular nodule(s)\n- Satellite nodule(s)\n- Ulceration of skin of breast", "VALUE:T4d", "VALUE:RE" ], [ "700", "Stated as “Inflammatory carcinoma” with no other information", "VALUE:T4d", "VALUE:RE" ], [ "800", "No evidence of primary tumor", "VALUE:T0", "VALUE:U" ], [ "999", "Unknown; extension not stated\nPrimary tumor cannot be assessed\nNot documented in patient record\n\nDeath Certificate Only", "VALUE:TX", "VALUE:U" ] ]
}




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