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shr.oncology Code Systems

BreastSiteCS

Topography of the breast. Codes are drawn from ICD-O-3. Codes are presented as local codes due to the lack of a ICD-O-3 terminology server available to the FHIR IG publisher.

Code Display
C50.0 Nipple
C50.1 Central portion of the breast.
C50.2 Upper inner quadrant
C50.3 Lower inner quadrant
C50.4 Upper outer quadrant
C50.5 Lower outer quadrant
C50.6 Axillary tail of breast
C50.8 Overlapping lesion of breast
C50.9 Breast, not otherwise specified (NOS)

BreastSpecimenTypeCS

The type of specimen obtained from the breast.

Code Display
aspirate Aspirate
core Core biopsy specimen
excision Excision specimen without wire loc
wire Excision specimen with wire loc
duct Nipple duct excision
mastectomy Total mastectomy

BreastCancerTypeCS

Histologic types of breast cancer. Codes are drawn from ICD-O-3. Codes are presented as local codes due to the lack of a ICD-O-3 terminology server available to the FHIR IG publisher.

Code Display
8509 Solid papillary carcinoma
8571 Metaplastic carcinoma with mesenchymal differentiation

BreastCancerStageCS

Codes representing the overall stage of the cancer, based on criteria defined by the staging system being used. The preferred staging system is American Joint Committee on Cancer, 8th Edition, Breast Cancer Chapter. Codes and descriptions have been redacted due to copyright restrictions.

Code Display
redacted A dummy code.

MorphologyBehaviorCS

The morphologic behavior of the cancer. These are the suffix to the ICD-O-3 histologic type codes. Codes are presented as local codes due to the lack of a ICD-O-3 terminology server available to the FHIR IG publisher.

Code Display
0 Benign
1 Uncertain whether benign or malignant
2 In situ
3 Malignant, primary site
6 Malignant, metastatic site
9 Malignant, uncertain whether primary or metastatic site

StagingMethodCS

The methodology or standard used to assign the cancer's overall stage.

Code Display
ajcc_v7 AJCC Cancer Staging Manual 7th Edition
ajcc_v8 AJCC Cancer Staging Manual 8th Edition
seer_eod SEER Extent of Disease 2018
seer_ss77 SEER Summary Stage 1977
seer_ss00 SEER Summary Stage 2000
seer_ss18 SEER Summary Stage 2018

StageTimingPrefixCS

When staging was done, relative to treatment events.

Code Display
cli Staging performed prior to surgery, based on evidence such as physical examination, imaging, and/or biopsy.
path Staging performed based on examination of tissue samples removed during surgery, in addition to physical examination and imaging.
postther_cli Post-therapeutic (post-neoadjuvant) clinical staging based on clinical examination after the first treatment with systemic drugs or radiation, when no surgery has been performed.
postther_path Post-therapeutic (post-neoadjuvant) pathologic staging, based on tissue samples removed during surgery after the first treatment with systemic drugs or radiation.

StainingIntensityCS

Part of the Allred scoring, based on the intensity of that staining, on a scale of 0 (Negative) to 3 (Strong).

Code Display
none None/Negative
weak Weak
moderate Moderate
strong Strong

NottinghamNullCS

Data absent reasons (null values) for Nottingham Combined Grade scores. Removes non-applicable values from the ExceptionValueVS, and adds values that align with LOINC normative answer list LL4561-8

Code Display
missing_indeterminate The value cannot be determined, for some unspecified reason.

NuclearGradeCS

The nuclear grade describes how closely the nuclei of cancer cells look like the nuclei of normal breast cells. In general, the higher the nuclear grade, the more abnormal the nuclei are and the more aggressive the tumor cells tend to be. The nuclear grade is a part of overall tumor grade.

Code Display
G1 Grade I - low grade or well differentiated
G2 Grade II - Intermediate/moderate grade or moderately differentiated
G3 Grade III - High grade or pooly differentiated

HER2ISHMethodCS

Value set containing In Situ Hybridization methods of determining HER2 status

Code Display
single HER2 by Single Probe Assay In Situ Hybridization test
dual HER2 by Dual Probe Assay In Situ Hybridization test

HER2StatusCS

HER2 status overall result

Code Display
not_amplified Negative/Not Amplified (IHC Score 0)
negative Negative (IHC Score 1+)
equivocal Equivocal (IHC Score 2+)
positive Positive/Amplified (IHC Score 3+)

DegreeOfLymphaticInvolvementCS

Description TBD

Code Display
microscopic Only a few cancer cells are in the node.
gross The cancer can be seen or felt without aid of microscopy.
extracapsular Cancer has pread outside the wall of the node.

MitoticCountScoreCS

Value set containing the scores for Nottingham Histologic Score Mitotic Rate

Code Display
score_1 <= 3 mitoses per mm2
score_2 >=4 and <=7 mitoses per mm2
score_3 >= 8 mitoses per mm2

OncotypeDxInvasiveRiskScoreInterpretationCS

Intepretation of OncotypeDX Recurrence Score for invasive cancers.

Code Display
low_risk Recurrence Score lower than 18: The cancer has a low risk of recurrence. The benefit of chemotherapy is likely to be small and will not outweigh the risks of side effects.
intermediate_risk Recurrence Score of 18 up to and including 30: The cancer has an intermediate risk of recurrence. It’s unclear whether the benefits of chemotherapy outweigh the risks of side effects.
high_risk Recurrence Score greater than or equal to 31: The cancer has a high risk of recurrence, and the benefits of chemotherapy are likely to be greater than the risks of side effects.

OncotypeDxDCISRiskScoreInterpretationCS

Intepretation of OncotypeDX DCIS (Ductal Carcinoma In Situ) Recurrence Score

Code Display
low_risk Recurrence Score lower than 38: The cancer has a low risk of recurrence. The benefit of chemotherapy is likely to be small and will not outweigh the risks of side effects.
intermediate_risk Recurrence Score of 39 up to and including 54: The cancer has an intermediate risk of recurrence. It’s unclear whether the benefits of chemotherapy outweigh the risks of side effects.
high_risk Recurrence Score greater than or equal to 55: The cancer has a high risk of recurrence, and the benefits of chemotherapy are likely to be greater than the risks of side effects.

MammaprintRiskScoreInterpretationCS

Intepretation of Mammaprint Recurrence Score

Code Display
low_risk Score between 0.0 and +1.0, meaning a patient has on average a 10% chance that her cancer will recur within 10 years without any additional adjuvant treatment, either hormonal therapy or chemotherapy.
high_risk Score between -1.0 and 0.0, meaning a patient has a 29% chance that her cancer will recur within 10 years without any additional adjuvant treatment, either hormonal therapy or chemotherapy.

RecurrenceRiskScoreInterpretationCS

Interpretations of risk as high, intermediate, or low. Answer set taken from LOINC LL3198-0

Code Display
LA19541-4 High risk of recurrence.
LA22380-2 Intermediate risk of recurrence.
LA19542-2 Low risk of recurrence.