E2108 End-of-Study Form Early Surgery or Standard Palliative Therapy in Treating Patients With Stage IV Breast Cancer Source Form: NCI FormBuilder:

  1. 8/26/12 8/26/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
Uploaded on:

January 9, 2015

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Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT01242800 Off Treatment - E2108 End-of-Study Form - 3128917v1.0

INSTRUCTIONS : At the time of death or withdrawal, complete this form and submit original to the ECOG Coordinating Center. Keep a copy for your files

Reporting Period
Vital Status
Patient's Vital Status
Primary Cause of Death (if applicable)
Section I
Reason Treatment Ended (this step)

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