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shr.oncology Value Sets

BreastSiteVS

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

BreastSpecimenTypeVS

The type of specimen obtained from the breast.

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

BreastSpecimenCollectionMethodVS

The surgical method used to obtain the tissue sample.

Code Display CodeSystem
9911007 Core needle biopsy (procedure) http://snomed.info/sct
48635004 Fine needle biopsy (procedure) http://snomed.info/sct
172043006 Simple mastectomy (procedure) http://snomed.info/sct
237372000 Excisional biopsy of breast (procedure) http://snomed.info/sct

BreastCancerTypeVS

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 CodeSystem
86049000 Malignant neoplasm, primary (morphologic abnormality) http://snomed.info/sct
68956006 Carcinoma in situ (morphologic abnormality) http://snomed.info/sct
65692009 Spindle cell carcinoma (morphologic abnormality) http://snomed.info/sct
128631001 Carcinoma with osteoclast-like giant cells (morphologic abnormality) http://snomed.info/sct
74364000 Small cell carcinoma (morphologic abnormality) http://snomed.info/sct
59529006 Squamous cell carcinoma in situ (morphologic abnormality) http://snomed.info/sct
35917007 Adenocarcinoma, no subtype (morphologic abnormality) http://snomed.info/sct
11671000 Adenoid cystic carcinoma (morphologic abnormality) http://snomed.info/sct
30156004 Cribriform carcinoma (morphologic abnormality) http://snomed.info/sct
19665009 Tubular adenoma (morphologic abnormality) http://snomed.info/sct
55937004 Neuroendocrine carcinoma (morphologic abnormality) http://snomed.info/sct
128662002 Adenocarcinoma with mixed subtypes (morphologic abnormality) http://snomed.info/sct
89439007 Oxyphilic adenoma (morphologic abnormality) http://snomed.info/sct
3839000 Lipid-rich carcinoma (morphologic abnormality) http://snomed.info/sct
74280008 Glycogen-rich carcinoma (morphologic abnormality) http://snomed.info/sct
36318001 Apocrine adenoma (morphologic abnormality) http://snomed.info/sct
78424008 Sebaceous adenoma (morphologic abnormality) http://snomed.info/sct
39892006 Mucoepidermoid tumor (morphologic abnormality) http://snomed.info/sct
33170000 Mucinous adenoma (morphologic abnormality) http://snomed.info/sct
86616005 Intraductal carcinoma, noninfiltrating (morphologic abnormality) http://snomed.info/sct
36425007 Comedocarcinoma (morphologic abnormality) http://snomed.info/sct
41919003 Juvenile carcinoma of the breast (morphologic abnormality) http://snomed.info/sct
30566004 Noninfiltrating intraductal papillary adenocarcinoma (morphologic abnormality) http://snomed.info/sct
47488001 Intracystic papillary adenoma (morphologic abnormality) http://snomed.info/sct
128696009 Intraductal micropapillary carcinoma (morphologic abnormality) http://snomed.info/sct
8509 Solid papillary carcinoma BreastCancerTypeCS
32913002 Medullary carcinoma (morphologic abnormality) http://snomed.info/sct
128698005 Atypical medullary carcinoma (morphologic abnormality) http://snomed.info/sct
58477004 Infiltrating ductular carcinoma (morphologic abnormality) http://snomed.info/sct
35232005 Infiltrating duct and lobular carcinoma (morphologic abnormality) http://snomed.info/sct
128700001 Infiltrating duct mixed with other types of carcinoma (morphologic abnormality) http://snomed.info/sct
128701002 Infiltrating lobular mixed with other types of carcinoma (morphologic abnormality) http://snomed.info/sct
128702009 Polymorphous low grade adenocarcinoma (morphologic abnormality) http://snomed.info/sct
32968003 Inflammatory carcinoma http://snomed.info/sct
2985005 Paget's disease, mammary (morphologic abnormality) http://snomed.info/sct
82591005 Paget's disease and infiltrating duct carcinoma of breast (morphologic abnormality) http://snomed.info/sct
54666007 Paget's disease and intraductal carcinoma of breast (morphologic abnormality) http://snomed.info/sct
15176003 Adenocarcinoma with squamous metaplasia (morphologic abnormality) http://snomed.info/sct
8571 Metaplastic carcinoma with mesenchymal differentiation BreastCancerTypeCS
733875004 Fibromatosis-like metaplastic carcinoma (morphologic abnormality) http://snomed.info/sct
128704005 Adenocarcinoma with neuroendocrine differentiation (morphologic abnormality) http://snomed.info/sct
128705006 Metaplastic carcinoma (morphologic abnormality) http://snomed.info/sct
69291002 Myoepithelioma (morphologic abnormality) http://snomed.info/sct
128765009 Adenomyoepithelioma (morphologic abnormality) http://snomed.info/sct

BreastCancerDetectionVS

Basis for cancer detection, from HL7 CDA® R2 Implementation Guide: Clinical Oncology Treatment Plan and Summary, Release 1 - US Realm Standard for Trial Use Release 3, October 2016, Volume 2 — Templates and Supporting Material.

Code Display CodeSystem
360156006 Screening http://snomed.info/sct
160237006 History/Symptoms http://snomed.info/sct
261087003 Incidental http://snomed.info/sct

BreastCancerStageVS

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 CodeSystem
redacted A dummy code. BreastCancerStageCS

MorphologyBehaviorVS

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

StagingMethodVS

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

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

StageTimingPrefixVS

When staging was done, relative to treatment events.

Code Display CodeSystem
cli Staging performed prior to surgery, based on evidence such as physical examination, imaging, and/or biopsy. StageTimingPrefixCS
path Staging performed based on examination of tissue samples removed during surgery, in addition to physical examination and imaging. StageTimingPrefixCS
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. StageTimingPrefixCS
postther_path Post-therapeutic (post-neoadjuvant) pathologic staging, based on tissue samples removed during surgery after the first treatment with systemic drugs or radiation. StageTimingPrefixCS

ReceptorVS

Description TBD

Code Display CodeSystem
All codes descending from 116647005 Receptor (substance) http://snomed.info/sct

StainingIntensityVS

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

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

NottinghamCombinedGradeVS

Combined score from the Nottingham grading system.

Code Display CodeSystem
369790002 Nottingham Combined Grade I: 3-5 points (finding) http://snomed.info/sct
369791003 Nottingham Combined Grade II: 6-7 points (finding) http://snomed.info/sct
369792005 Nottingham Combined Grade III: 8-9 points (finding) http://snomed.info/sct

NottinghamNullVS

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 CodeSystem
LA27219-7 Only microinvasion present (not graded) http://loinc.org
LA27220-5 No residual invasive carcinoma after presurgical (neoadjuvant) therapy http://loinc.org
missing_indeterminate The value cannot be determined, for some unspecified reason. NottinghamNullCS

NuclearGradeVS

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

HER2ISHMethodVS

Value set containing In Situ Hybridization methods of determining HER2 status

Code Display CodeSystem
single HER2 by Single Probe Assay In Situ Hybridization test HER2ISHMethodCS
dual HER2 by Dual Probe Assay In Situ Hybridization test HER2ISHMethodCS

HER2byIHCScoreVS

Value set containing possible scores resulting from determining HER2 status by immunohistochemistry. Based on LNC#LL4396-9 answer list.

Code Display CodeSystem
LA6111-4 0 http://loinc.org
LA11841-6 1+ http://loinc.org
LA11842-4 2+ http://loinc.org
LA11843-2 3+ http://loinc.org
LA11884-6 Indeterminate http://loinc.org

HER2StatusVS

HER2 status overall result

Code Display CodeSystem
not_amplified Negative/Not Amplified (IHC Score 0) HER2StatusCS
negative Negative (IHC Score 1+) HER2StatusCS
equivocal Equivocal (IHC Score 2+) HER2StatusCS
positive Positive/Amplified (IHC Score 3+) HER2StatusCS

DegreeOfLymphaticInvolvementVS

Description TBD

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

TubuleFormationScoreVS

Value set containing the extent (scope) of tubule formation.

Code Display CodeSystem
369778004 Breast tubule formation: Majority of tumor >75% (score = 1) http://snomed.info/sct
369779007 Breast tubule formation: Moderate 10% to 75% (score = 2) http://snomed.info/sct
369780005 Breast tubule formation: Minimal <10% (score = 3) http://snomed.info/sct

NuclearPleomorphismScoreVS

Value set containing the scores for nuclear pleomorphism.

Code Display CodeSystem
384735004 Nuclear pleomorphism: small regular nuclei (score=1) http://snomed.info/sct
384737007 Nuclear pleomorphism: moderate increase in size, etc (score = 2) http://snomed.info/sct
384738002 Nuclear pleomorphism: marked variation in size, nucleoli, chromatin clumping, etc (score = 3) http://snomed.info/sct

MitoticCountScoreVS

Value set containing the scores for Nottingham Histologic Score Mitotic Rate

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

OncotypeDxInvasiveRiskScoreInterpretationVS

Intepretation of OncotypeDX Recurrence Score for invasive cancers.

Code Display CodeSystem
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. OncotypeDxInvasiveRiskScoreInterpretationCS
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. OncotypeDxInvasiveRiskScoreInterpretationCS
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. OncotypeDxInvasiveRiskScoreInterpretationCS

OncotypeDxDCISRiskScoreInterpretationVS

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

Code Display CodeSystem
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. OncotypeDxDCISRiskScoreInterpretationCS
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. OncotypeDxDCISRiskScoreInterpretationCS
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. OncotypeDxDCISRiskScoreInterpretationCS

MammaprintRiskScoreInterpretationVS

Intepretation of Mammaprint Recurrence Score

Code Display CodeSystem
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. MammaprintRiskScoreInterpretationCS
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. MammaprintRiskScoreInterpretationCS

RecurrenceRiskScoreInterpretationVS

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

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

PositiveNegativeVS

Value set containing the values positive and negative. VSAC value set OID 2.16.840.1.113762.1.4.1166.62.

Code Display CodeSystem
10828004 Positive http://snomed.info/sct
260385009 Negative http://snomed.info/sct

PositiveNegativeEquivocalVS

Interpretation of a test result as positive, negative or equivocal.

Code Display CodeSystem
10828004 Positive (qualifier value) http://snomed.info/sct
42425007 Equivocal (qualifier value) http://snomed.info/sct
260385009 Negative (qualifier value) http://snomed.info/sct