Description:

NSABP Protocol B-42 - Optional Letrozole Registration Program Worksheet (See Protocol Appendix A) Letrozole in Treating Postmenopausal Women Who Have Received Hormone Therapy for Hormone Receptor-Positive Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=17AF72B9-3E1D-4613-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=17AF72B9-3E1D-4613-E044-0003BA3F9857

Keywords:
Versions (2) ▾
  1. 12/18/14
  2. 1/9/15
Uploaded on:

January 9, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00382070 Treatment - NSABP Protocol B-42 - Optional Letrozole Registration Program Worksheet - 2494275v1.0

This paper worksheet may be completed to faciliate the entry of the information in NSABP Coordinator Online. Partially completed forms may be saved in Coordinator Online. DO NOT SUBMIT THIS WORKSHEET VIA FAX OR MAIL.

Header
Unnamed2
Eligibility Criteria (All must be met)
Has the patient authorized the release of Protected Health Information to the NSABP?
Adjuvant Hormonal Therapy History
Prior aromatase inhibitor therapy (Has patient received AI)
Did this patient receive any tamoxifen?
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