Recently I attended the FCRA Conference and Jennifer Ruhl presented the scenario below, providing clarifications on capturing these 2 data fields. Please review the CAnswer Forum post provided in the link below for explanation & clarifications.
Scenario:
Specimen A-J, I-N. Negative 14 cores per gross description (no counts available from final diagnosis)
- PROSTATE, RIGHT LATERAL, MID, NEEDLE BIOPSY:
-SMALL FOCUS OF PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3+3 (GRADE GROUP 1), INVOLVING 1 OF 1 CORE(<5%), TUMOR MEASURES <1MM
- PROSTATE, TARGET #1 NEEDLE BIOPSY:
-PROSTATIC ADENOCARCINOMA, GLEASON SCORE 4+3=7 (GRADE GROUP 3) WITH 80% PATTERN 4, INVOLVING 1 OF 5 CORES (80% OF ONE CORE), TUMOR MEASURES 8MM
-PERINEURAL INVASION IS PRESENT
Question: How would you code #of cores examined & #of cores positive?
- 2 positive/16 examined
- 2 positive/ 20 examined
Answer: 2 positive/16 examined
Rationale:
- Specimens A-J, I-N count as 0 cores positive 14 cores examined
- Specimen K counts as 1 core positive, 1 core examined
- Specimen 0 would be counted as 1 core positive, 1 core examined [In general, if you have a targeted biopsy or a region of interest (ROI), you count it as 1 core positive/1 core examined. This matches the NCCN guidelines.]
Please refer to the CAnswer Forum posts below and review Jennifer Ruhl, Chair of the NAACCR SSDI Workgroup answers regarding Prostate Cores Examined and Positive for guidance in appropriately capturing the data for these fields. CAnswer Forum posts Prostate: Cores examined and Cores positive , Prostate-How to count MRI fusion BX targeted cores, Prostate MRI Fusion Bx-Target is highest gleason