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Question: 20130089 Status
Final

References
Source 1:   2007 MP/H Rules
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Source 2:  
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Question
MP/H--Breast: See discussion section. What histology code do I use for the left breast?

Discussion
11/6/12 US guided biopsy left breast & left axilla with invasive ductal carcinoma. At the same time, the right breast & right axilla were biopsied, also revealing invasive ductal carcinoma. The patient underwent 6 months of chemotherapy. May 2013 patient underwent bilateral mastectomies. Left mastectomy specimen showed invasive lobular cancer, pleomorphic type with 11 axillary LNs negative. Right mastectomy no residual malignancy & 11 LNs negative.

Answer
Code duct and lobular CA 8522/3.

A biopsy produces a small amount of tissue and, in this case, found the invasive duct but not the lobular carcinoma. The chemotherapy will be more effective in shrinking or eliminating the duct carcinoma, which explains why no duct was left when the patient had a mastectomy. In this case, we need to think about the findings and process. The lobular carcinoma was present prior to the chemotherapy. However, from the small sample, only duct was identified in the biopsy. After neoadjuvant chemo, only the lobular was left.

History


Last Updated
07/18/2013

Date Finalized
08/12/2013