Description:

SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0307) Zoledronate, Clodronate, or Ibandronate in Treating Women Who Have Undergone Surgery for Stage I, Stage II, or Stage III Breast Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DEB8F801-4279-2F2B-E034-0003BA12F5E7

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DEB8F801-4279-2F2B-E034-0003BA12F5E7

Keywords:
Versions (2) ▾
  1. 8/26/12
  2. 1/9/15
Uploaded on:

January 9, 2015

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00127205 Follow-Up - SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0307) - 2277562v3.0

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  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0307)
    1. No Instruction available.
Header
Notice Of Progression - Adjuvant
Has the patient been diagnosed with opposite breast cancer since submission of last follow-up form?
Has the patient been diagnosed with first local-regional recurrence since submission of last follow-up form?
Site(s) of First Local-Regional Progression (select all that apply)
Has the patient been diagnosed with first distant recurrence/progression since submission of last follow-up form?
Site(s) of First Distant Progression
If the patient has been previously diagnosed with first distant recurrence/progression at a site other than bone, has the patient been diagnosed with a subsequent bone recurrence since submission of last follow-up form?
How was this progression information obtained?
How was this progression information obtained?
Has the patient had a fracture since submission of the last follow-up form?
indicate site (If yes,)
Was the fracture traumatic (from greater than standing height)?
Has the patient had osteonecrosis or osteomyelitis of the jaw since submission of the last follow-up form?
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