ARCHETYPE TNM staging - Breast (Sixth edition) (openEHR-EHR-CLUSTER.tnm_staging-breast.v1)

ARCHETYPE ID	openEHR-EHR-CLUSTER.tnm_staging-breast.v1
Concept	TNM staging - Breast (Sixth edition)
Description	TNM staging classification for breast cancer (Sixth edition).
Use	Use of TNM Sixth Edition of colorectal cancer staging. The classification applies only to carcinomas and concerns the male as well as the female breast.
Misuse	Do not use for editions of TNM classification, other than Sixth edition.
Purpose	To record the TNM staging classification for colorectal cancer (Sixth edition).
References	American Joint Committee on Cancer. TNM schema files [Internet]. [cited 2009 Jul 27 ] Available from: http://www.cancerstaging.org/education/tnmschema/tnmschema.html Greene FL, Page DL, Fleming ID. et al, eds, for the American Joint Committee on Cancer. AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer-Verlag; 2002.
Copyright	© openEHR Foundation
Authors	Author name: Dr Ian McNicoll Organisation: Ocean Informatics Scotland Email: ian.mcnicoll@oceaninformatics.com Date originally authored: 2009-07-22
Other Details Language	Author name: Dr Ian McNicoll Organisation: Ocean Informatics Scotland Email: ian.mcnicoll@oceaninformatics.com Date originally authored: 2009-07-22
OtherDetails Language Independent	{references=American Joint Committee on Cancer. TNM schema files [Internet]. [cited 2009 Jul 27 ] Available from: http://www.cancerstaging.org/education/tnmschema/tnmschema.html Greene FL, Page DL, Fleming ID. et al, eds, for the American Joint Committee on Cancer. AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer-Verlag; 2002., MD5-CAM-1.0.1=C85EEBA7195DC37A3FC4F0954157706F}
Keywords	tumour, TNM, malignancy, cancer, staging, classification, grade, grading, stage, lymph node, metastasis, breast
Lifecycle	AuthorDraft
Language used	en
Citeable Identifier	1051.32.327
All	Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=TNM staging classification for breast cancer (Sixth edition)., archetypeConceptComment=null, otherContributors=Heather Leslie Ocean Informatics Australia Sam Heard Ocean Informatics Australia Koray Atalag, University of Auckland, New Zealand, originalLanguage=en, translators= Arabic (Syria): Mona Saleh , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={content=[], description=[], details=[], source=[], capabilities=[], other_participations=[], protocol=[], provider=[], activities=[], state=[], events=[], ism_transition=[], data=[], target=[], identities=[], items=[ResourceSimplifiedHierarchyItem [path=/items[at0002], code=at0002, itemType=CLUSTER, level=1, text=Clinical (cTNM), description=Clinical TNM pre-treatment classification based on physical examination, imaging and biopsies., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0003], code=at0003, itemType=ELEMENT, level=2, text=Primary tumour (T), description=Clincal assessment of the primary tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.43::TX [Primary tumour cannot be assessed.] at0.44::T0 [No evidence of primary tumour.] at0.45::Tis [Carcinoma in situ.] at0.46::Tis (DCIS) [Ductal carcinoma in situ.] at0.47::Tis (LCIS) [Lobular carcinoma in situ.] at0.48::Tis (Paget) [Paget disease of the nipple with no tumour.] at0.49::T1 [Tumour 2 cm or less in greatest dimension.] at0.50::T1mic [Microinvasion 0.1 cm or less in greatest dimension.] at0.51::T1a [More than 0.1 cm but not more than 0.5 cm in greatest dimension.] at0.52::T1b [More than 0.5 cm but not more than 1 cm in greatest dimension.] at0.53::T1c [More than 1 cm but not more than 2 cm in greatest dimension.] at0.54::T2 [Tumour more than 2 cm but not more than 5 cm in greatest dimension.] at0.55::T3 [Tumour more than 5 cm in greatest dimension.] at0.56::T4 [Tumour of any size with direct extension to chest wall or skin only as described in T4a to T4d.] at0.57::T4a [Extension to chest wall.] at0.58::T4b [Oedema (including peau d'orange), or ulceration of the skin of the breast, or satellite skin nodules confined to the same breast.] at0.59::T4c [Both 4a and 4b, above.] at0.60::T4d [Inflammatory carcinoma.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0004], code=at0004, itemType=ELEMENT, level=2, text=Regional lymph nodes (N), description=Clinical assessment of the regional lymph nodes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.61::NX [Regional lymph nodes cannot be assessed (e.g. previously removed). ] at0.62::N0 [No regional lymph node metastasis. ] at0.63::N1 [Metastasis in movable ipsilateral axillary lymph node(s). ] at0.64::N2 [Metastasis in fixed ipsilateral axillary lymph node(s) or in clinically apparent* ipsilateral internal mammary lymph node(s) in the absence of clinically evident axillary lymph node metastasis. ] at0.65::N2a [Metastasis in axillary lymph node(s) fixed to one another or to other structures. ] at0.66::N2b [Metastasis only in clinically apparent* internal mammary lymph node(s) and in the absence of clinically evident axillary lymph node metastasis. ] at0.67::N3 [Metastasis in ipsilateral infraclavicular lymph node(s) with or without axillary lymph node involvement; or in clinically apparent ipsilateral internal mammary lymph node(s) in the presence of clinically evident axillary lymph node metastasis; or metastasis in ipsilateral supraclavicular lymph node(s) with or without axillary or internal mammary lymph node involvement. ] at0.68::N3a [Metastasis in infraclavicular lymph node(s). ] at0.69::N3b [Metastasis in internal mammary and axillary lymph nodes. ] at0.70::N3c [Metastasis in supraclavicular lymph node(s). ] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0005], code=at0005, itemType=ELEMENT, level=2, text=Distant metastasis (M), description=Clinical assessment of distant metastasis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.71::MX [MX. Distant metastasis cannot be assessed. ] at0.72::M0 [No distant metastasis. ] at0.73::M1 [Distant metastasis. ] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0025], code=at0025, itemType=ELEMENT, level=2, text=Residual tumour (R), description=Clinical assessment of post-treatment residual tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0026::RX [Presence of residual tumour cannot be assessed.] at0027::R0 [No residual tumour.] at0028::R1 [Microscopic residual tumour.] at0029::R2 [Macroscopic residual tumour.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0010], code=at0010, itemType=ELEMENT, level=2, text=Clinical staging, description=The overall Clinical staging derived from each T, N and M component e.g T1aM0NX. May include additional TNM descriptors., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0014], code=at0014, itemType=ELEMENT, level=2, text=Clinical stage grouping, description=The TNM Clinical stage grouping., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.106::Stage 0 [Tis-N0-M0.] at0.100::Stage 1 [T1-N0-M0.] at0.99::Stage IIA [T0-N1-M0 : T1-N1-M0 ; T2-N0-M0] at0.102::Stage IIIC [Any T-N3-M0.] at0.103::Stage IIIB [T4-N0,N1,N2-M0.] at0.104::Stage IIIA [T0-N2-M0;T1-N2-M0;T3-N1,N2-M0.] at0.105::Stage IIB [T2-N1-M0;T3-N0-M0.] at0.101::Stage IV [Any T-Any N-M1.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0012], code=at0012, itemType=ELEMENT, level=2, text=Comment, description=A text comment on the Clinical staging., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006], code=at0006, itemType=CLUSTER, level=1, text=Pathological (pTNM), description=Pathological staging. Based on the clinical staging, results of procedures and pathological/histo-pathological assessment., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0007], code=at0007, itemType=ELEMENT, level=2, text=Primary tumour (pT), description=Pathological assessment of the primary tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.115::pTX [Primary tumour cannot be assessed.] at0.116::pT0 [No evidence of primary tumour.] at0.117::pTis [Carcinoma in situ.] at0.118::pTis (DCIS) [Ductal carcinoma in situ.] at0.119::pTis (LCIS) [Lobular carcinoma in situ.] at0.120::pTis (Paget) [Paget disease of the nipple with no tumour.] at0.121::pT1 [Tumour 2 cm or less in greatest dimension.] at0.122::pT1mic [Microinvasion 0.1 cm or less in greatest dimension.] at0.123::pT1a [More than 0.1 cm but not more than 0.5 cm in greatest dimension.] at0.124::pT1b [More than 0.5 cm but not more than 1 cm in greatest dimension.] at0.125::pT1c [More than 1 cm but not more than 2 cm in greatest dimension.] at0.126::pT2 [Tumour more than 2 cm but not more than 5 cm in greatest dimension.] at0.127::pT3 [Tumour more than 5 cm in greatest dimension.] at0.128::pT4 [Tumour of any size with direct extension to chest wall or skin only as described in T4a to T4d.] at0.129::pT4a [Extension to chest wall.] at0.130::pT4b [Oedema (including peau d'orange), or ulceration of the skin of the breast, or satellite skin nodules confined to the same breast.] at0.131::pT4c [Both 4a and 4b, above.] at0.132::pT4d [Inflammatory carcinoma.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0008], code=at0008, itemType=ELEMENT, level=2, text=Regional lymph node (pN), description=Pathological assessment of the regional lymph nodes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.74::pNX [Regional lymph nodes cannot be assessed (not removed for study or previously removed). ] at0.75::pN0 [No regional lymph node metastasis. ] at0.76::pN1mi [Micrometastasis (larger than 0.2 mm, but none larger than 2 mm in greatest dimension). ] at0.77::pN1 [Metastasis in 1-3 ipsilateral axillary lymph node(s), and/or in ipsilateral internal mammary nodes with microscopic metastasis detected by sentinel lymph node dissection but not clinically apparent. ] at0.78::pN1a [Metastasis in 1-3 axillary lymph node(s), including at least one larger than 2 mm in greatest dimension. ] at0.79::pN1b [Internal mammary lymph nodes with microscopic metastasis detected by sentinel lymph node dissection but not clinically apparent. ] at0.80::pN1c [Metastasis in 1-3 axillary lymph nodes and internal mammary lymph nodes with microscopic metastasis detected by sentinel lymph node dissection but not clinically apparent. ] at0.81::pN2 [Metastasis in 4-9 ipsilateral axillary lymph nodes, or in clinically apparent* ipsilateral internal mammary lymph node(s) in the absence of axillary lymph node metastasis. ] at0.82::pN2a [Metastasis in 4-9 axillary lymph nodes, including at least one that is larger than 2 mm. ] at0.83::pN2b [Metastasis in clinically apparent internal mammary lymph node(s), in the absence of axillary lymph node metastasis. ] at0.84::pN3 [Metastasis in 10 or more ipsilateral axillary lymph nodes; or in ipsilateral infraclavicular lymph nodes; or in clinically apparent ipsilateral internal mammary lymph nodes in the presence of one or more positive axillary lymph nodes; or in more than 3 axillary lymph nodes with clinically negative, microscopic metastasis in internal mammary lymph nodes; or in ipsilateral supraclavicular lymph nodes. ] at0.85::pN3a [Metastasis in 10 or more axillary lymph nodes (at least one larger than 2 mm) or metastasis in infraclavicular lymph nodes. ] at0.86::pN3b [Metastasis in clinically apparent internal mammary lymph node(s) in the presence of positive axillary lymph node(s); or metastasis in more than 3 axillary lymph nodes and in internal mammary lymph nodes with microscopic metastasis detected by sentinel lymph node dissection but not clinically apparent. ] at0.87::pN3c [Metastasis in supraclavicular lymph node(s). ] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0009], code=at0009, itemType=ELEMENT, level=2, text=Distant metastasis (pM), description=Pathological assessment of distant metastases., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.88::pMX [MX. Distant metastasis cannot be assessed. ] at0.89::pM0 [No distant metastasis. ] at0.90::pM1 [Distant metastasis. ] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0030], code=at0030, itemType=ELEMENT, level=2, text=Residual tumour (pR), description=Pathological assessment of post-treatment residual tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0031::pRX [Presence of residual tumour cannot be assessed.] at0032::pR0 [No residual tumour.] at0033::pR1 [Microscopic residual tumour.] at0034::pR2 [Macroscopic residual tumour.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0035], code=at0035, itemType=ELEMENT, level=2, text=Histopathological grading (G), description=TNM histopathological grading classification., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0038::GX [Grade of differentiation cannot be assessed.] at0039::G1 [Well differentiated.] at0040::G2 [Moderately differentiated.] at0041::G3 [Poorly differentiated.] at0042::G4 [Undifferentiated.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0011], code=at0011, itemType=ELEMENT, level=2, text=Pathological staging, description=The overall Pathological staging derived from each pT, pN and pM component. May include additional TNM descriptors., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0015], code=at0015, itemType=ELEMENT, level=2, text=Pathological stage grouping, description=The TNM Pathological stage grouping., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.114::Stage 0 [Tis-N0-M0.] at0.108::Stage 1 [T1-N0-M0.] at0.107::Stage IIA [T0-N1-M0 : T1-N1-M0 ; T2-N0-M0.] at0.113::Stage IIB [T2-N1-M0;T3-N0-M0.] at0.110::Stage IIIC [Any T-N3-M0.] at0.111::Stage IIIB [T4-N0,N1,N2-M0.] at0.112::Stage IIIA [T0-N2-M0;T1-N2-M0;T3-N1,N2-M0.] at0.109::Stage IV [Any T-Any N-M1.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0013], code=at0013, itemType=ELEMENT, level=2, text=Comment, description=A text comment on the Pathological staging., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], relationships=[], credentials=[], context=[], contacts=[]}, topLevelItems={items=ResourceSimplifiedHierarchyItem [path=ROOT_/, code=at0000.1, itemType=CLUSTER, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=items, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/items[at0002], code=at0002, itemType=CLUSTER, level=1, text=Clinical (cTNM), description=Clinical TNM pre-treatment classification based on physical examination, imaging and biopsies., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0003], code=at0003, itemType=ELEMENT, level=2, text=Primary tumour (T), description=Clincal assessment of the primary tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.43::TX [Primary tumour cannot be assessed.] at0.44::T0 [No evidence of primary tumour.] at0.45::Tis [Carcinoma in situ.] at0.46::Tis (DCIS) [Ductal carcinoma in situ.] at0.47::Tis (LCIS) [Lobular carcinoma in situ.] at0.48::Tis (Paget) [Paget disease of the nipple with no tumour.] at0.49::T1 [Tumour 2 cm or less in greatest dimension.] at0.50::T1mic [Microinvasion 0.1 cm or less in greatest dimension.] at0.51::T1a [More than 0.1 cm but not more than 0.5 cm in greatest dimension.] at0.52::T1b [More than 0.5 cm but not more than 1 cm in greatest dimension.] at0.53::T1c [More than 1 cm but not more than 2 cm in greatest dimension.] at0.54::T2 [Tumour more than 2 cm but not more than 5 cm in greatest dimension.] at0.55::T3 [Tumour more than 5 cm in greatest dimension.] at0.56::T4 [Tumour of any size with direct extension to chest wall or skin only as described in T4a to T4d.] at0.57::T4a [Extension to chest wall.] at0.58::T4b [Oedema (including peau d'orange), or ulceration of the skin of the breast, or satellite skin nodules confined to the same breast.] at0.59::T4c [Both 4a and 4b, above.] at0.60::T4d [Inflammatory carcinoma.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0004], code=at0004, itemType=ELEMENT, level=2, text=Regional lymph nodes (N), description=Clinical assessment of the regional lymph nodes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.61::NX [Regional lymph nodes cannot be assessed (e.g. previously removed). ] at0.62::N0 [No regional lymph node metastasis. ] at0.63::N1 [Metastasis in movable ipsilateral axillary lymph node(s). ] at0.64::N2 [Metastasis in fixed ipsilateral axillary lymph node(s) or in clinically apparent* ipsilateral internal mammary lymph node(s) in the absence of clinically evident axillary lymph node metastasis. ] at0.65::N2a [Metastasis in axillary lymph node(s) fixed to one another or to other structures. ] at0.66::N2b [Metastasis only in clinically apparent* internal mammary lymph node(s) and in the absence of clinically evident axillary lymph node metastasis. ] at0.67::N3 [Metastasis in ipsilateral infraclavicular lymph node(s) with or without axillary lymph node involvement; or in clinically apparent ipsilateral internal mammary lymph node(s) in the presence of clinically evident axillary lymph node metastasis; or metastasis in ipsilateral supraclavicular lymph node(s) with or without axillary or internal mammary lymph node involvement. ] at0.68::N3a [Metastasis in infraclavicular lymph node(s). ] at0.69::N3b [Metastasis in internal mammary and axillary lymph nodes. ] at0.70::N3c [Metastasis in supraclavicular lymph node(s). ] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0005], code=at0005, itemType=ELEMENT, level=2, text=Distant metastasis (M), description=Clinical assessment of distant metastasis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.71::MX [MX. Distant metastasis cannot be assessed. ] at0.72::M0 [No distant metastasis. ] at0.73::M1 [Distant metastasis. ] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0025], code=at0025, itemType=ELEMENT, level=2, text=Residual tumour (R), description=Clinical assessment of post-treatment residual tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0026::RX [Presence of residual tumour cannot be assessed.] at0027::R0 [No residual tumour.] at0028::R1 [Microscopic residual tumour.] at0029::R2 [Macroscopic residual tumour.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0010], code=at0010, itemType=ELEMENT, level=2, text=Clinical staging, description=The overall Clinical staging derived from each T, N and M component e.g T1aM0NX. May include additional TNM descriptors., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0014], code=at0014, itemType=ELEMENT, level=2, text=Clinical stage grouping, description=The TNM Clinical stage grouping., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.106::Stage 0 [Tis-N0-M0.] at0.100::Stage 1 [T1-N0-M0.] at0.99::Stage IIA [T0-N1-M0 : T1-N1-M0 ; T2-N0-M0] at0.102::Stage IIIC [Any T-N3-M0.] at0.103::Stage IIIB [T4-N0,N1,N2-M0.] at0.104::Stage IIIA [T0-N2-M0;T1-N2-M0;T3-N1,N2-M0.] at0.105::Stage IIB [T2-N1-M0;T3-N0-M0.] at0.101::Stage IV [Any T-Any N-M1.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0012], code=at0012, itemType=ELEMENT, level=2, text=Comment, description=A text comment on the Clinical staging., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006], code=at0006, itemType=CLUSTER, level=1, text=Pathological (pTNM), description=Pathological staging. Based on the clinical staging, results of procedures and pathological/histo-pathological assessment., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0007], code=at0007, itemType=ELEMENT, level=2, text=Primary tumour (pT), description=Pathological assessment of the primary tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.115::pTX [Primary tumour cannot be assessed.] at0.116::pT0 [No evidence of primary tumour.] at0.117::pTis [Carcinoma in situ.] at0.118::pTis (DCIS) [Ductal carcinoma in situ.] at0.119::pTis (LCIS) [Lobular carcinoma in situ.] at0.120::pTis (Paget) [Paget disease of the nipple with no tumour.] at0.121::pT1 [Tumour 2 cm or less in greatest dimension.] at0.122::pT1mic [Microinvasion 0.1 cm or less in greatest dimension.] at0.123::pT1a [More than 0.1 cm but not more than 0.5 cm in greatest dimension.] at0.124::pT1b [More than 0.5 cm but not more than 1 cm in greatest dimension.] at0.125::pT1c [More than 1 cm but not more than 2 cm in greatest dimension.] at0.126::pT2 [Tumour more than 2 cm but not more than 5 cm in greatest dimension.] at0.127::pT3 [Tumour more than 5 cm in greatest dimension.] at0.128::pT4 [Tumour of any size with direct extension to chest wall or skin only as described in T4a to T4d.] at0.129::pT4a [Extension to chest wall.] at0.130::pT4b [Oedema (including peau d'orange), or ulceration of the skin of the breast, or satellite skin nodules confined to the same breast.] at0.131::pT4c [Both 4a and 4b, above.] at0.132::pT4d [Inflammatory carcinoma.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0008], code=at0008, itemType=ELEMENT, level=2, text=Regional lymph node (pN), description=Pathological assessment of the regional lymph nodes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.74::pNX [Regional lymph nodes cannot be assessed (not removed for study or previously removed). ] at0.75::pN0 [No regional lymph node metastasis. ] at0.76::pN1mi [Micrometastasis (larger than 0.2 mm, but none larger than 2 mm in greatest dimension). ] at0.77::pN1 [Metastasis in 1-3 ipsilateral axillary lymph node(s), and/or in ipsilateral internal mammary nodes with microscopic metastasis detected by sentinel lymph node dissection but not clinically apparent. ] at0.78::pN1a [Metastasis in 1-3 axillary lymph node(s), including at least one larger than 2 mm in greatest dimension. ] at0.79::pN1b [Internal mammary lymph nodes with microscopic metastasis detected by sentinel lymph node dissection but not clinically apparent. ] at0.80::pN1c [Metastasis in 1-3 axillary lymph nodes and internal mammary lymph nodes with microscopic metastasis detected by sentinel lymph node dissection but not clinically apparent. ] at0.81::pN2 [Metastasis in 4-9 ipsilateral axillary lymph nodes, or in clinically apparent* ipsilateral internal mammary lymph node(s) in the absence of axillary lymph node metastasis. ] at0.82::pN2a [Metastasis in 4-9 axillary lymph nodes, including at least one that is larger than 2 mm. ] at0.83::pN2b [Metastasis in clinically apparent internal mammary lymph node(s), in the absence of axillary lymph node metastasis. ] at0.84::pN3 [Metastasis in 10 or more ipsilateral axillary lymph nodes; or in ipsilateral infraclavicular lymph nodes; or in clinically apparent ipsilateral internal mammary lymph nodes in the presence of one or more positive axillary lymph nodes; or in more than 3 axillary lymph nodes with clinically negative, microscopic metastasis in internal mammary lymph nodes; or in ipsilateral supraclavicular lymph nodes. ] at0.85::pN3a [Metastasis in 10 or more axillary lymph nodes (at least one larger than 2 mm) or metastasis in infraclavicular lymph nodes. ] at0.86::pN3b [Metastasis in clinically apparent internal mammary lymph node(s) in the presence of positive axillary lymph node(s); or metastasis in more than 3 axillary lymph nodes and in internal mammary lymph nodes with microscopic metastasis detected by sentinel lymph node dissection but not clinically apparent. ] at0.87::pN3c [Metastasis in supraclavicular lymph node(s). ] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0009], code=at0009, itemType=ELEMENT, level=2, text=Distant metastasis (pM), description=Pathological assessment of distant metastases., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.88::pMX [MX. Distant metastasis cannot be assessed. ] at0.89::pM0 [No distant metastasis. ] at0.90::pM1 [Distant metastasis. ] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0030], code=at0030, itemType=ELEMENT, level=2, text=Residual tumour (pR), description=Pathological assessment of post-treatment residual tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0031::pRX [Presence of residual tumour cannot be assessed.] at0032::pR0 [No residual tumour.] at0033::pR1 [Microscopic residual tumour.] at0034::pR2 [Macroscopic residual tumour.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0035], code=at0035, itemType=ELEMENT, level=2, text=Histopathological grading (G), description=TNM histopathological grading classification., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0038::GX [Grade of differentiation cannot be assessed.] at0039::G1 [Well differentiated.] at0040::G2 [Moderately differentiated.] at0041::G3 [Poorly differentiated.] at0042::G4 [Undifferentiated.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0011], code=at0011, itemType=ELEMENT, level=2, text=Pathological staging, description=The overall Pathological staging derived from each pT, pN and pM component. May include additional TNM descriptors., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0015], code=at0015, itemType=ELEMENT, level=2, text=Pathological stage grouping, description=The TNM Pathological stage grouping., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0.114::Stage 0 [Tis-N0-M0.] at0.108::Stage 1 [T1-N0-M0.] at0.107::Stage IIA [T0-N1-M0 : T1-N1-M0 ; T2-N0-M0.] at0.113::Stage IIB [T2-N1-M0;T3-N0-M0.] at0.110::Stage IIIC [Any T-N3-M0.] at0.111::Stage IIIB [T4-N0,N1,N2-M0.] at0.112::Stage IIIA [T0-N2-M0;T1-N2-M0;T3-N1,N2-M0.] at0.109::Stage IV [Any T-Any N-M1.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0013], code=at0013, itemType=ELEMENT, level=2, text=Comment, description=A text comment on the Pathological staging., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]