**Note 1:** Leave Grade Post Therapy Clin (yc) blank when
* No neoadjuvant therapy
* Clinical or pathological case only
* Neoadjuvant therapy completed, no microscopic exam is done prior to surgery/resection of primary tumor
* There is only one grade available and it cannot be determined if it is clinical, pathological, post therapy clinical or post therapy pathological
**Note 2:** Assign the highest grade from the microscopically sampled specimen of the primary site following neoadjuvant therapy or primary systemic/radiation therapy.
**Note 3:** If there are multiple tumors with different grades abstracted as one primary, code the highest grade.
**Note 4:** Codes 1-3 take priority over A-D.
**Note 5:** For this grading system, the CAP Checklist refers to this as “histologic type,” instead of grade.
**Note 6:** Code 9 (unknown) when
* Microscopic exam is done after neoadjuvant therapy and grade from the primary site is not documented
* Microscopic exam is done after neoadjuvant therapy and there is no residual cancer
* Grade checked “not applicable” on CAP Protocol (if available) and no other grade information is available