Description:

Enrollment Checklist NCT00433589 Genetic Testing or Clinical Assessment in Determining the Need for Chemotherapy in Women With Breast Cancer That Involves No More Than 3 Lymph Nodes Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=188F45BF-CE4C-20E2-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=188F45BF-CE4C-20E2-E044-0003BA3F9857

Keywords:
Versions (4) ▾
  1. 8/26/12
  2. 1/9/15
  3. 6/9/15
  4. 9/20/21
Uploaded on:

September 20, 2021

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License:
Creative Commons BY-NC 3.0 Legacy
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Enrollment Checklist NCT00433589

No Instruction available.

  1. StudyEvent: Enrollment Checklist
    1. No Instruction available.
Header
Checklist
Primary Surgery Type
Does the tumor involve the surgical margin
Was axillary dissection performed?
Histologic Grade
ER Status
PgR Status
HER-2/neu status
Performance Status
1000/uL
%
1000/uL
mg/dL
mg/dL
mg/dL
Kg
Other malignancy
Prior Treatment?
Is patient a woman of childbearing potential
Is the patient pregnant or nursing? (If yes:)
Consent given for specimen use?
Patient's Initial Consent given for tissue specimen use for research on the patient's cancer?
Patient's initial consent for sharing specimen(s) with outside researchers.

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