Malignant Neoplasm of the Breast B019

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/m/malignant-neoplasm-breast-b019-c50d05

Last amended

Rulebase for malignant neoplasm of the breast

<h5><strong>Current RMA Instruments</strong></h5><table border="1" cellpadding="0" cellspacing="1" width="100%"><tbody><tr><td><p><em><u><a href="http://www.rma.gov.au/assets/SOP/2023/a5acf4f5e0/084.pdf&quot; target="_blank">Reasonable Hypothesis SOP</a></u></em></p></td><td><p>84 of 2023 as amended</p></td></tr><tr><td><p><em><u><a href="http://www.rma.gov.au/assets/SOP/2023/db8fec7972/085.pdf&quot; target="_blank">Balance of Probabilities SOP</a></u></em></p></td><td><p>85 of 2023 as amended</p></td></tr></tbody></table><h5><strong>Changes from previous Instruments</strong></h5><p><strong><drupal-media data-entity-type="media" data-entity-uuid="5a467c37-bc20-4b5d-b973-c2e2e496d10b" data-view-mode="wysiwyg"></drupal-media></strong></p><h5>ICD Coding</h5><ul><li>ICD-10-AM Codes: C50, D05</li></ul><h5><strong>Brief description</strong></h5><p>This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.</p><h5><strong>Confirming the diagnosis</strong></h5><p>Diagnosis requires histology from a biopsy or surgical specimen.</p><p>The appropriate medical specialist is an oncologist or breast surgeon.</p><h5><strong>Additional diagnoses covered by SOP</strong></h5><ul><li>Breast adenocarcinoma</li><li>Breast carcinoma in situ – ductal, intraductal or lobular</li><li>Infiltrating ductal breast carcinoma</li><li>Metastatic breast cancer from a breast primary</li><li>Other histological breast carcinoma types – invasive lobular; ductal/lobular; mucinous; tubular; medullary; or papillary</li><li>Paget’s disease of the breast. This is a breast carcinoma of the nipple of the breast</li></ul><h5><strong>Conditions excluded from SOP </strong></h5><ul><li>Carcinoid tumour of the breast <sup>#</sup></li><li>Hodgkin's lymphoma of the breast *</li><li>Malignant neoplasm of the skin overlying the breast<ul><li>melanoma *</li><li>non-melanitic *<!-- --></li></ul></li><li>non-Hodgkin lymphoma of the breast *</li><li>Secondary metastasis to the breast (code to primary site)</li><li>Soft tissue sarcoma of the breast *</li></ul><p>* another SOP applies</p><p><sup>#</sup>  non-SOP condition</p><h5><strong>Clinical onset</strong></h5><p>Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.</p><h5><strong>Clinical worsening</strong></h5><p>The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.</p><h5> </h5><h5> </h5>

Source URL: https://clik.dva.gov.au/sop-information/sops-and-supporting-information-alphabetic-listing/m/malignant-neoplasm-breast-b019/rulebase-malignant-neoplasm-breast

A course of therapeutic radiation to the chest

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/course-therapeutic-radiation-chest

Alcohol consumption

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/alcohol-consumption

Atomic radiation

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/atomic-radiation

Cessation of breast feeding

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/cessation-breast-feeding

Diagnostic radiation to the breast

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/diagnostic-radiation-breast

First live birth or full-term pregnancy after age 30

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/first-live-birth-or-full-term-pregnancy-after-age-30

Hormone replacement therapy

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/hormone-replacement-therapy

Inability to obtain appropriate clinical management for breast cancer

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/inability-obtain-appropriate-clinical-management-breast-cancer

Inability to undertake any physical activity greater than 3 METs

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/inability-undertake-any-physical-activity-greater-3-mets

Nulliparous to age 30 years or over

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/nulliparous-age-30-years-or-over

Obesity

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/obesity

Taking oral contraceptives

Current RMA Instruments

Reasonable Hypothesis SOP

84 of 2023 as amended

Balance of Probabilities SOP

85 of 2023 as amended

Changes from previous Instruments

ICD Coding
  • ICD-10-AM Codes: C50, D05
Brief description

This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.

Confirming the diagnosis

Diagnosis requires histology from a biopsy or surgical specimen.

The appropriate medical specialist is an oncologist or breast surgeon.

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 *
  • Malignant neoplasm of the skin overlying the breast
    • melanoma *
    • non-melanitic *
  • non-Hodgkin lymphoma of the breast *
  • Secondary metastasis to the breast (code to primary site)
  • Soft tissue sarcoma of the breast *

* another SOP applies

#  non-SOP condition

Clinical onset

Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The disease has a very variable course and prognosis.  It is particularly amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.

 
 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-breast-b019-c50d05/rulebase-malignant-neoplasm-breast/taking-oral-contraceptives