Sentinel Lymph Nodes Positive

Field Length: 2

Effective for cases diagnosed January 1, 2018 and later.

Description
Records the exact number of sentinel lymph nodes biopsied by the pathologist and found to contain metastases. This data item is required for CoC-accredited facilities as of cases diagnosed 01/01/2018 and later. This data item is required for breast and melanoma cases only.

Rationale
It is a known fact that sentinel lymph node biopsies have been under-reported. Additionally, the timing and results of sentinel lymph node biopsy procedures are used in quality of care measures. This data item can be used to more accurately assess the number of positive sentinel lymph nodes biopsied separate from the number of positive lymph nodes identified during additional subsequent regional node dissection procedures, if performed.

Coding Instructions

1. Document the total number of positive nodes identified during the sentinel node procedure in this data item when, during a sentinel node biopsy procedure a few non-sentinel nodes happen to be sampled and are positive; i.e., record the total number of positive nodes from the sentinel node biopsy procedure regardless of whether the nodes contain dye or colloidal material (tracer or radiotracer)

2. Record the number of positive sentinel nodes biopsied in this data item and record the total number of positive regional (which includes sentinel) lymph nodes biopsied/dissected in Regional Nodes Positive [NAACCR Item #820] when both sentinel and additional regional nodes are examined via sentinel node biopsy and subsequent regional node dissection

3. Record the results from the positive sentinel node biopsy procedure when a positive aspiration of sentinel lymph node(s) AND a positive sentinel node biopsy procedure were performed for same patient

4. FOR BREAST ONLY

a. Use code 97 in this data item and record the total number of positive regional lymph nodes biopsied/dissected (both sentinel and regional) in Regional Nodes Positive (NAACCR Item #820) when a sentinel lymph node biopsy is performed during the same procedure as the regional node dissection. When both are performed during the same procedure, code 97 has priority over the number of positive lymph nodes.

b. Sentinel lymph nodes are negative when only positive Isolated Tumor Cells (ITCs) are identified

5. FOR CUTANEOUS MELANOMA ONLY

a. Record the total number of positive sentinel nodes identified in this data item and record the total number of positive regional lymph nodes identified (which includes the number of positive sentinel nodes documented in this data item) in Regional Nodes Positive (NAACCR Item #820) when a sentinel lymph node biopsy is performed during the same procedure as the regional node dissection

i. The CAP Protocol for melanoma captures both the number of positive sentinel nodes as well as the number of positive regional nodes (i.e., the number of positive sentinel nodes is captured) when the sentinel lymph node biopsy is performed during the same procedure as the regional node dissection

b. Sentinel lymph nodes are positive when only positive Isolated Tumor Cells (ITCs) are identified

6. The number of sentinel lymph nodes biopsied and found positive will typically be found in the pathology report; radiology reports, or documented by the physician. Determination of the exact number of sentinel lymph nodes positive may require assistance from the managing physician for consistent coding.

7. The number of sentinel nodes positive should be less than or equal to the total number of Regional Nodes Positive [NAACCR Item #820]

8. mi (microscopic or micro mets) sentinel lymph nodes are positive