ID
712
Description
IBCSG Long Term Follow-Up Recurrence Form (18-LTF-RC) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=889C7665-5F9A-48C7-E040-BB89AD436937
Link
Keywords
Versions (2)
- 8/26/12 8/26/12 -
- 6/20/17 6/20/17 - Martin Dugas
Uploaded on
August 26, 2012
DOI
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License
Creative Commons BY-NC 3.0
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Breast Cancer Follow-Up - IBCSG Long Term Follow-Up Recurrence Form (18-LTF-RC) - 3108571v1.0
Complete this form for patients with a proven recurrence. Use minus one (-1) to indicate that an answer is unknown unobtainable or not done
- StudyEvent: IBCSG Long Term Follow-Up Recurrence Form (18-LTF-RC)
Description
Proven Recurrence/metastasis Or Contralateral Invasive Breast Cancer
Description
BreastCancerRecurrenceAnatomicSite
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C13717
- UMLS 2011AA ValueDomain
- C1515974
- NCI Thesaurus Property
- C38155
- UMLS 2011AA Property
- C0277556
- NCI Thesaurus ObjectClass
- C4872
- UMLS 2011AA ObjectClass
- C0678222
Description
BreastCarcinomaRecurrentDiseaseSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C38155
- UMLS 2011AA Property
- C0277556
- NCI Thesaurus ObjectClass
- C4872
- UMLS 2011AA ObjectClass
- C0678222
Description
MetastaticRecurrentDiseaseInitialDiagnosisDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C14174
- UMLS 2011AA ObjectClass
- C0036525
- NCI Thesaurus ObjectClass
- C14173
- UMLS 2011AA ObjectClass
- C2945760
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus Property
- C25536
- UMLS 2011AA Property
- C1555582
- NCI Thesaurus Property
- C15220
- UMLS 2011AA Property
- C0011900
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Description
Hormone Receptor Analysis
Description
EstrogenReceptorProgesteroneReceptorAnalysisPerformedInd-2
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25391
- UMLS 2011AA ObjectClass
- C0936012
- NCI Thesaurus ObjectClass
- C17069
- UMLS 2011AA ObjectClass
- C0034804
- NCI Thesaurus ObjectClass
- C17075
- UMLS 2011AA ObjectClass
- C0034833
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
BreastCarcinomaRecurrentDiseaseSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C38155
- UMLS 2011AA Property
- C0277556
- NCI Thesaurus ObjectClass
- C4872
- UMLS 2011AA ObjectClass
- C0678222
Description
SpecimenCollectedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25452
- NCI Thesaurus Property
- C25275
- UMLS 2011AA Property
- C2745955
Description
EstrogenReceptorPositivePercentage
Data type
double
Measurement units
- %
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
Description
ProgesteroneReceptorPositivePercentage
Data type
double
Measurement units
- %
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C17075
- UMLS 2011AA ObjectClass
- C0034833
- NCI Thesaurus Property
- C25554
- UMLS 2011AA Property
- C0441889
Description
ERLevelTumorStatus
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C3262
- UMLS 2011AA ValueDomain
- C0027651
- NCI Thesaurus ObjectClass
- C17069
- UMLS 2011AA ObjectClass
- C0034804
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
- NCI Thesaurus Property
- C25554
- UMLS 2011AA Property
- C0441889
Description
PgRStatusType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C17075
- UMLS 2011AA ObjectClass
- C0034833
- NCI Metathesaurus Property
- C0678257
Description
Footer Module
Description
InvestigatorDesignatedSignatureText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C25678
- UMLS 2011AA Property
- C1519316
- NCI Thesaurus ObjectClass
- C17089
- UMLS 2011AA ObjectClass
- C0035173
- NCI Thesaurus Property
- C25479
- UMLS 2011AA Property
- C1524084
Description
InvestigatorSignatureDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25678
- UMLS 2011AA Property
- C1519316
- NCI Thesaurus ValueDomain
- C25367
- NCI Thesaurus ObjectClass
- C17089
- UMLS 2011AA ObjectClass
- C0035173
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- StudyEvent: IBCSG Long Term Follow-Up Recurrence Form (18-LTF-RC)
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