CS Lymph Nodes: Breast Cancer

Note 1: Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in the field Mets at DX.

Note 2: If the pathology report indicates that nodes are positive but size of the metastases is not stated, assume the metastases are greater than 0.2 mm and code the lymph nodes as positive in this field. Use code 60 in the absence of other information about regional nodes.

Note 3: If no lymph nodes were removed surgically, then use only the following codes for clinical evaluation of axillary nodes: 00 - Clinically negative 50 - Fixed/matted nodes, 60 - Clinically positive axillary nodes 99 - Unknown/not stated.

Note 4: If pre-surgical therapy was given and there is a clinical evaluation (positive or negative) of lymph nodes, then use only the following codes for clinical evaluation of axillary nodes: 00 - Clinically negative 50 - Fixed/matted nodes 60 - Clinically positive axillary nodes AND Code a '5' in the nodes evaluation field. If there is no clinical evaluation of nodes, use the information from the pathologic evaluation and code a '6' in the nodes evaluation field.

Note 5: Isolated tumor cells (ITC) are defined as single tumor cells or small clusters not greater than 0.2 mm, usually detected only by immunohistochemical (IHC) or molecular methods but which may be verified on H and E stains. ITCs do not usually show evidence of malignant activity (e.g., proliferation or stromal reaction). Lymph nodes with ITCs only are not considered positive lymph nodes.

Note 6: Codes 13-50 are used for positive axillary nodes without internal mammary nodes.

Code Description TNM SS77 SS2000
00 None; no regional lymph node involvement, including ITCs detected by immunohistochemistry or molecular methods ONLY. (See Note 5 and Site-specific Factors 4 and 5.) * NONE NONE
05 Regional lymph node(s) with (ITCs) detected on routine H and E stains. (See Note 5) N0(i+) NONE NONE
13 Axillary lymph node(s), ipsilateral, micrometastasis ONLY detected by immunohistochemical (IHC) means ONLY (at least one micrometastasis greater than 0.2 mm and all micrometastases less than or equal to 2 mm) N1mi RN RN
15
  • Axillary lymph node(s), ipsilateral, micrometastasis ONLY detected or verified on H&E (at least one micrometastasis greater than 0.2 mm and all micrometastases less than or equal to 2 mm)
  • Micrometastasis, NOS
 N1mi RN RN
25 Movable axillary lymph node(s), ipsilateral, positive with more than micrometastasis (i.e., at least one metastasis greater than 2 mm) ** RN RN
26 Stated as N1, NOS ** RN RN
28 Stated as N1, NOS ** RN RN
50
  • Fixed/matted ipsilateral axillary nodes, positive with more than micrometastasis (i.e., at least one metastasis greater than 2 mm)
  • Fixed/matted ipsilateral axillary nodes, NOS
 ** RN RN
60
  • Axillary/regional lymph node(s), NOS
  • Lymph nodes NOS
 ** RN RN
71 Internal mammary node(s), ipsilateral, positive on sentinel nodes but not clinically apparent (no positive imaging or clinical exam) without axillary lymph node(s), ipsilateral ** RN RN
72 Internal mammary node(s), ipsilateral, positive on sentinel nodes but not clinically apparent (no positive imaging or clinical exam) with axillary lymph node(s), ipsilateral ** RN RN
73 Internal mammary node(s), ipsilateral, positive on sentinel nodes but not clinically apparent (no positive imaging or clinical exam)
UNKNOWN if positive axillary lymph node(s), ipsilateral		 ** RN RN
74 Internal mammary node(s), ipsilateral, clinically apparent (on imaging or clinical exam) without axillary lymph node(s), ipsilateral N2b RN RN
75 Infraclavicular lymph node(s) (subclavicular) N3a D RN
76 Internal mammary node(s), ipsilateral, clinically apparent (on imaging or clinical exam) with axillary lymph node(s), ipsilateral, codes 15 to 60 with or without infraclavicular lymph node(s) N3b RN RN
77 Internal mammary node(s), ipsilateral, clinically apparent (on imaging or clinical exam)
UNKNOWN if positive axillary lymph node(s), ipsilateral		 N2b RN RN
78 (75) + (77) N3a D RN
79 Stated as N3, NOS N3NOS RN RN
80 Supraclavicular node(s) N3c D D
99
  • Unknown; not stated
  • Regional lymph node(s) cannot be assessed
  • Not documented in patient record
 NX U U

* For code 00 ONLY, the N category is assigned based on the coding of Site-Specific Factors 4 and 5 using the IHC MOL Table for this site.

** For codes 25, 26, 28, 50, 60, 71, 72, and 73 ONLY, the N category is assigned based on the value of Site-Specific Factor 3, Number of Positive Ipsilateral Axillary LymphNodes. See Lymph Nodes Positive Axillary Nodes Table.

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