Person with cancer—neoadjuvant therapy indicator, code N

Guide for use:

To be reported when therapy is received after a diagnosis of cancer and prior to primary surgical treatment.

This data item is used to flag cases in which tumour descriptors, for example solid tumour size, may be inaccurate due to shrinkage from neoadjuvant therapy.

Yes - indicates that the client has received neo-adjuvant therapy after a diagnosis of cancer and prior to primary surgical treatment

No - indicates that the client did not receive neo-adjuvant therapy after a diagnosis of cancer and prior to primary surgical treatment

For invasive breast cancer:

Information is obtained from

• Clinical notes on pathology report mentions that patient underwent chemotherapy prior to surgery
• Microscopy section of pathology report describes tumour changes as a result of neoadjuvant therapy (coder may be alerted to look for this detail by a long interval between biopsy and wider excision)
• Hospital notification indicates that admission if for chemotherapy only (and admission date is before that for surgery)

Origin:

National Breast and Ovarian Cancer Centre (NBOCC)

Australasian Association of Cancer Registries (AACR)

Australian Institute of Health and Welfare (AIHW)

Comments:

Preoperative chemotherapy and/or radiotherapy may be received after a diagnosis of cancer but before surgical treatment.

The effects of chemotherapy and/or radiotherapy prior to surgery will shrink the tumour and so the size of the tumour found from the subsequent surgical excision will be smaller than the original size of the tumour at the time of diagnosis. This impacts on the TNM-T and staging classification, and is important to take into account for analysis and research.