Po/02/01 Registration of size of breast cancers

Site: Breast
Implementation date: 01/01/2003
Implement from diagnosis date: 01/01/2003

Agreed by: UKACR EC

Date agreed by: 20/02/2002Recording the size of breast cancers is an important issue in several instances: the RCPath Minimum Dataset, NHS BSP Pathology Guidance, the NHS BSP K62 definitions, the Cancer Registry Minimum Dataset and the National Cancer Dataset.

The Group agreed that it is important to make a recommendation that could be used by all these activities to achieve consistent recording of breast cancer size.

The C&CG therefore recommend the following:1) When present, size measured by all modalities should be recorded and when necessary the measurement from the most reliable modality is to be used, using the following hierarchy:
a) Pathology: microscopic size
b) Pathology: macroscopic size
c) Magnetic resonance imaging
d) Ultrasound
e) Mammography
f) Clinical examination
2) If no pathological size is available, or if the only pathological size is on a specimen following therapy, the size to be used should be the highest in the hierarchy from items d) to f).

3) The size recorded should relate to the invasive component of the tumour only.

4) If the tumour has not been completely excised (e.g. in an excision biopsy or a lumpectomy), the measurement of size should still be recorded and flagged as incomplete (where registration systems allow). This size should then be used in preference to that from imaging and/or clinical examination.

5) If there are two tumours in one breast:
a) If they are of the same morphology, the size of the largest tumour should be recorded and the multifocality noted.
b) If the morphologies are not the same, the size of both tumours should be recorded (and both registered)
There is no need for size (or stage) in phyllodes tumours, sarcomas or lymphomas occurring in the breast.