Certified Tumor Registrar (CTR) Practice Exam

After a patient's primary tumor is biopsied and then resected, the histology is coded from which specimen?

1. Biopsy

2. Last procedure

3. Most representative specimen

4. Primary tumor resection

The correct answer is: Most representative specimen

The most representative specimen provides the best basis for determining the appropriate histology code. In situations where multiple specimens may have been collected—such as a biopsy and a subsequent surgical resection—the specimen that most accurately reflects the tumor's characteristics should be prioritized. This is particularly relevant after treatment, as it captures any changes that may have occurred during the course of the disease or as a result of treatment effects. The resection specimen often offers the most complete representation of the tumor’s size, grade, and extent, which are critical for accurate coding and subsequent treatment planning. Relying on the most representative sample ensures comprehensive data collection, which is essential for cancer registries to maintain accurate records. While other specimens, such as the biopsy or the last procedure, may provide useful information, they do not encompass the complete view of the tumor's histological features as well as the primary tumor resection does. Thus, identifying and coding from the most representative specimen is aligned with best practices in cancer registration and ensures that accurate and meaningful data is collected.