CALGB: 49907 ON-STUDY FORM Comparison of Combination Chemotherapy Regimens in Treating Older Women Who Have Undergone Surgery for Breast Cancer Source Form: NCI FormBuilder:



  1. 12/18/14 12/18/14 - Martin Dugas
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December 18, 2014


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  1. StudyEvent: CALGB: 49907 ON-STUDY FORM
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Amended data?
Surgical Procedures
Most extensive primary surgery (mark one with an X)
Sentinel node biopsy?
Sentinel node biopsy results (per protocol)
Was axillary dissection performed?
Tumor laterality (mark one with an X)
Receptor status, ER (If measured in fmols/mg cytosol protein >=10 is positive. If other measures are used apply institutional standards; borderline results should be reported as positive)
Receptor status, PgR
Histologic grade (combined histologic grade is used according to SRE/Elston classification)
Prior breast cancer prevention therapy?
If Yes, what type (prior breast cancer prevention therapy) (mark all that apply with an X)

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