Code

Description

00

None; no surgery of primary site; autopsy only

19

Local tumor destruction, NOS

Note: No specimen was sent to pathology for surgical events coded 19 (principally for cases diagnosed prior to January 1, 2003).

Procedures coded 20-24 remove the gross primary tumor and some of the breast tissue (breast-conserving or preserving). There may be microscopic residual tumor.

Specimen sent to pathology for surgical events coded 20-80.

20

Partial mastectomy, NOS; less than total mastectomy, NOS [formerly SEER code 10]

21

Partial mastectomy WITH nipple resection [formerly SEER code 11 = nipple resection]

22

Lumpectomy or excisional biopsy [formerly SEER code 12]

23

Reexcision of the biopsy site for gross or microscopic residual disease

24

Segmental mastectomy (including wedge resection, quadrantectomy, tylectomy)

30

Subcutaneous mastectomy

Note: A subcutaneous mastectomy, also called a nipple sparing mastectomy, is the removal of breast tissue without the nipple and areolar complex or overlying skin.  It is performed to facilitate immediate breast reconstruction. Cases coded 30 may be considered to have undergone breast reconstruction.

40

Total (simple) mastectomy, NOS

41

WITHOUT removal of uninvolved contralateral breast

43

WITH reconstruction NOS

44

Tissue

45

Implant

46

Combined (Tissue and Implant)

42

WITH removal of uninvolved contralateral breast

47

WITH reconstruction NOS

48

Tissue

49

Implant

75

Combined (Tissue and Implant)

Notes:

• SEER Note: “Tissue” for reconstruction is defined as human tissue such as muscle (latissimus dorsi or rectus abdominis) or skin in contrast to artificial prostheses (implants). Placement of a tissue expander at the time of original surgery indicates that reconstruction is planned as part of the first course of treatment.

• A total (simple) mastectomy removes all breast tissue, the nipple, and areolar complex. An axillary dissection is not done, but sentinel lymph nodes may be removed.  

• For single primaries only, code removal of involved contralateral breast under the data item Surgical Procedure/Other Site or Surgical Procedure/Other Site at This Facility.

• SEER Note: Example: Inflammatory carcinoma involving both breasts. Bilateral simple mastectomies. Code Surgery of Primary Site 41 and code Surgical Procedure of Other Site 1.

• If contralateral breast reveals a second primary, each breast is abstracted separately. The surgical procedure is coded 41 for the first primary. The surgical code for the contralateral breast is coded to the procedure performed on that site.

• Reconstruction that is planned as part of first course treatment is coded 43-49 or 75, whether it is done at the time of mastectomy or later.

76

50

51

53

54

Tissue

55

Implant

56

Combined (Tissue and Implant)

52

With removal of uninvolved contralateral breast

57

58

Tissue

59

Implant

63

Combined (Tissue and Implant)

Notes:

• Removal of all breast tissue, the nipple, the areolar complex, and variable amounts of breast skin in continuity with the axilla. The specimen may or may not include a portion of the pectoralis major muscle.

• SEER Note: “In continuity with” or “en bloc” means that all the tissues were removed during the same procedure, but not necessarily in a single specimen. “Tissue” for reconstruction is defined as human tissue such as muscle (latissimus dorsi or rectus abdominis) or skin in contrast to artificial prostheses (implants). Placement of a tissue expander at the time of original surgery indicates that reconstruction is planned as part of the first course of treatment. Assign code 51 or 52 if a patient has an excisional biopsy and axillary dissection followed by a simple mastectomy during the first course of therapy. Code the cumulative result of the surgeries, which is a modified radical mastectomy in this case. Code the most invasive, extensive or definitive surgery in Surgery of Primary Site.

• If contralateral breast reveals a second primary, it is abstracted separately. The surgical procedure is coded 51 for the first primary. The surgical code for the contralateral breast is coded to the procedure performed on that site.

• For single primaries only, code removal of involved contralateral breast under the data item Surgical Procedure/Other Site or Surgical Procedure/Other Site at This Facility.

60

Radical mastectomy, NOS

61

Without removal of uninvolved contralateral breast

64

Reconstruction, NOS

65

Tissue

66

Implant

67

Combined (Tissue and Implant)

62

With removal of uninvolved contralateral breast

SEER Note: Removal of breast tissue, nipple, areolar complex, variable amount of skin, pectoralis minor, pectoralis major. Includes en bloc axillary dissection. For single primaries only, code removal of involved contralateral breast under the data item "Surgery of other regional sites, distant sites, or distant lymph nodes."

68

Reconstruction, NOS

69

Tissue

73

Implant

74

Combined (Tissue and Implant)

70

Extended radical mastectomy

SEER Note: Involves removal of breast tissue, nipple, areolar complex, variable amount of skin, pectoralis minor, and/or pectoralis major, as well as en bloc axillary dissection. “Tissue” for reconstruction is defined as human tissue such as muscle (latissimus dorsi or rectus abdominis) or skin in contrast to artificial prostheses (implants). Placement of a tissue expander at the time of original surgery indicates that reconstruction is planned as part of the first course of treatment

71

Without removal of uninvolved contralateral breast

72

With removal of uninvolved contralateral breast

80

Mastectomy, NOS

90

Surgery, NOS

99

Unknown if cancer-directed surgery performed; death certificate only