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Bilateral Breast Radiotherapy Form (Form 24-BR) Brain Function in Premenopausal Women Receiving Tamoxifen With or Without Ovarian Function Suppression for Early-Stage Breast Cancer on Clinical Trial IBCSG-2402 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0162063B-84EB-2286-E044-0003BA3F9857
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https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0162063B-84EB-2286-E044-0003BA3F9857Keywords:
Versions (2)
- 8/27/12 8/27/12 -
- 1/9/15 1/9/15 - Martin Dugas
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January 9, 2015
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Breast Cancer NCT00659373 Treatment - Bilateral Breast Radiotherapy Form (Form 24-BR) - 2411259v1.0
BREAST RADIOTHERAPY FORM (Form 24-R) Instructions: Submit this form upon completion of radiotherapy or if radiotherapy was planned and not given. Mark your selection with an ?X? in the appropriate box(es). Use minus one (-1) to indicate that an answer is unknown, unobtainable, or not done.
- StudyEvent: Bilateral Breast Radiotherapy Form (Form 24-BR)