Description:

ACOSOG-Z1071 OPEN Registration Worksheet Surgery to Remove the Sentinel Lymph Node and Axillary Lymph Nodes After Chemotherapy in Treating Women With Stage II, Stage IIIA, or Stage IIIB Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=80369EB7-995B-793A-E040-BB89AD437095

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=80369EB7-995B-793A-E040-BB89AD437095

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Versions (3) ▾
  1. 8/27/12
  2. 1/9/15
  3. 9/17/21
Uploaded on:

September 17, 2021

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License:
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00881361 Registration - ACOSOG-Z1071 OPEN Registration Worksheet - 3014456v1.0

No Instruction available.

  1. StudyEvent: ACOSOG-Z1071 OPEN Registration Worksheet
    1. No Instruction available.
Patient Information
Gender of a Person
Ethnicity
Race
Method of Payment
General Information
Has patient previously been registered to an ACOSOG study
Was HIPAA Authorization included in Study Informed Consent
Eligibility Checklist
Age >= 18 years
ECOG Performance Status 0-1 (Zubrod)
ECOG Performance Status (Zubrod 0 or 1)
Female (NOTE: Men are excluded from this study because the number of men with breast cancer is insufficient to provide a statistical basis for assessment of effects in this subpopulation of people with breast cancer)
Histologic diagnosis of invasive breast cancer, clinical stage T0-4 N1-2 M0 (excluding inflammatory breast cancer)
FNA biopsy or core needle biopsy of an axillary node documenting nodal disease at time of diagnosis and prior to preoperative chemotherapy
Preoperative chemotherapy must be completed or planned for patient (NOTE: Patients enrolling on studies involving preoperative chemotherapy through cooperative groups or institutional studies may be eligible for this study, provided sentinel node surgery prior to preoperative chemotherapy was not required in the other studies)
No prior ipsilateral axillary surgery, such as excisional biopsy of lymph node(s) or treatment of hidradenitis
No prior SLN surgery/excisional lymph node biopsy for pathological confirmation of axillary status

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