Module 9: Breast Malignancies

The NPCR Education and Training Series (NETS) is a series of educational tools for state trainers to support central cancer registries in their role of providing education to staff and reporters. For more information about how you may use the NETS modules, please see Guidelines for Using the NETS Modules.

The breast cancer advanced abstracting module consists of five parts:

1. Introduction
2. Diagnosis
3. Stage of Disease
4. Treatment
5. Follow-up, Outcomes and Quality Review

There are four difficult breast cancer cases consisting of de-identified physician dictation, four participant abstract forms and four completed abstracts with speaker’s notes. Participants will need a FORDS manual and copies of the breast cancer sections of the AJCC Cancer Staging Manual, 6th ed., Collaborative Staging Manual, Multiple Primaries and Histologies Manual and the SEER Summary Staging Manual 2000. For more information, please see Instructions for Presenters.

The abstract for the sample cases follows the FORDS manual in organization. Most of the items should be completed with the appropriate data codes used by NPCR and the CoC. Some of the items are pre-filled. These items are underlined on the speaker’s abstract. It is suggested that the AJCC TNM staging items be completed with the actual stage or staging component instead of the code for the stage to facilitate discussion. Otherwise, participants can enter data on the abstract however their cancer registry software requires. Do the appropriate section of the abstract after each section of the slide presentation. Complete Cancer Identification on the abstract after presenting the Introduction and Diagnosis sections of the presentation. Complete Stage of Disease on the abstract after presenting Stage of Disease in the presentation.

Participants are to assume that the documentation in the sample cases is the entire medical record and abstract what is documented. The final questions ask if additional information will need to be tracked down to complete the abstract. Close to the end there are ‘abstracted by’ and ‘date abstracted.’ Normally the date abstracted should be within six months of diagnosis or presentation. For the sake of the exercise, participants should just use their own initials and the date they completed the abstract.

The sample cases are expected to raise several questions and topics for discussion. The final section of the slide presentation is shorter than the others sections and should allow time at the end for general discussion.

Case Studies and Exercise Worksheets

The exercises that follow are taken from actual medical charts that have been de-identified to protect patient privacy and are used as part of the learning process. Drug names are trademarked and listed as they actually appear in their medical records.

• Breast Advanced Case 1 (PDF-215KB)
• Breast Case 1 Answer (PDF-485KB)
• Breast Case Abstract Sheet Case 1 (PDF-304KB)



• Breast Advanced Case 2 (PDF-259KB)
• Breast Case 2 Answer (PDF-360KB)
• Breast Case Abstract Sheet Case 2 (PDF-175KB)



• Breast Advanced Case 3 (PDF-295KB)
• Breast Case 3 Answer (PDF-396KB)
• Breast Case Abstract Sheet Case 3 (PDF-385KB)



• Breast Advanced Case 4 (PDF-178KB)
• Breast Case 4 Answer (PDF-379KB)
• Breast Case Abstract Sheet Case 4 (PDF-315KB)



• Breast Advanced Case 5 (PDF-173KB)
• Breast Case 5 Answer (PDF-202KB)
• Breast Case Abstract Sheet Case 5 (PDF-176KB)

Please note: Some of these publications are available for download only as *.pdf files. These files require Adobe Acrobat Reader in order to be viewed. Please review the information on downloading and using Acrobat Reader software.