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Malignant Neoplasm of the Breast B019

Document
Last amended 
25 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
96 of 2014
Balance of Probabilities SOP
97 of 2014
Changes from Previous Instruments:

SOP Bulletin 178

ICD Coding:
  • ICD-9-CM Codes: 174, 175, 233.0
  • ICD-10-AM Codes: C50, D05

This is a primary malignant neoplasm of the breast epithelial tissue. Note that this SOP applies to males as well as females.

Is specific diagnostic evidence required to apply the SOP?Yes.

This diagnosis is based on histology. The relevant medical specialist is an oncologist or breast surgeon.

Are there sub-factors that require specific information? – No. 

There are factors that apply only to males and postmenopausal females, and only to death from malignant neoplasm of the breast.

Additional diagnoses covered by SOP
  • Breast adenocarcinoma
  • Breast carcinoma in situ – ductal, intraductal or lobular.
  • Infiltrating ductal breast carcinoma
  • Metastatic breast cancer from a breast primary
  • Other histological breast carcinoma types – invasive lobular; ductal/lobular; mucinous; tubular; medullary; or papillary.
  • Paget’s disease of the breast. This is a breast carcinoma of the nipple of the breast.
Conditions excluded from SOP
  • Carcinoid tumour of the breast
  • Hodgkin's lymphoma of the breast, ICD code 201.9
  • Malignant neoplasm of the skin overlying the breast
    • melanoma, ICD code 172
    • non-melanotic, ICD code 173.5
  • non-Hodgkin's lymphoma of the breast, ICD code 202.8
  • Secondary metastasis to the breast
  • Soft tissue sarcoma of the breast, ICD code 171.8
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then seek medical officer advice about further investigation.