Description:

NSABP Protocol B-43 Worksheet for On-Study Form NCT00769379 Radiation Therapy With or Without Trastuzumab in Treating Women With Ductal Carcinoma In Situ Who Have Undergone Lumpectomy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3978C2FD-DE23-3859-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3978C2FD-DE23-3859-E044-0003BA3F9857

Keywords:
Versions (4) ▾
  1. 8/27/12
  2. 1/9/15
  3. 7/3/15
  4. 7/3/15
Uploaded on:

July 3, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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NSABP Protocol B-43 Worksheet for On-Study Form NCT00769379

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  1. StudyEvent: NSABP Protocol B-43 Worksheet for On-Study Form
    1. No Instruction available.
Header
Tumor assessment
Tumor Laterality
Margins at time of lumpectomy
Was lumpectomy margins re-excised? (If not free,)
Margins after final re-excision
DCIS type
Necrosis
Is DCIS size documented
Unit of Measurement
Is measurement gross or microscopic?
Was axillary staging done
Patient History (at Entry)
Hyperlipidemia requiring medical therapy
Diabetes requiring medical therapy
Hypertension requiring medical therapy
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