Hello,
While continuing the last review of the Oncology OnRamp documentation and Cancer Modifier vocabulary, I found a few potentially missing concepts related to invasion and histopathologic patterns that seem clinically relevant for cancer staging and pathology workflows.
The following concepts appear difficult to map using the current Cancer Modifier vocabulary:
- Involvement of lactiferous duct
- Atelectasis AND/OR obstructive pneumonitis of entire lung associated with direct extension of malignant neoplasm
For the first concept, there is an existing “Pagetoid spread” concept, but pagetoid spread does not necessarily imply direct involvement of the lactiferous duct in all cases. Therefore, “Involvement of lactiferous duct” may need to exist as a separate concept.
For the second concept, this finding is clinically relevant in lung cancer because it contributes to T2 upstaging. Currently, I could only identify the following SNOMED CT concept(4294588 | Atelectasis AND/OR obstructive pneumonitis of entire lung associated with direct extension of malignant neoplasm), but could not find a corresponding Cancer Modifier concept.
I wanted to ask whether equivalent Cancer Modifier concepts already exist and I may have overlooked them. If not, I would like to ask whether these concepts might be reasonable candidates for addition.
Thank you!