ID

830

Descrizione

FORM 9 - RECURRENCE AND CONTRALATERAL BREAST CANCER REPORT Quality Of Life Companion Study For JMA27 (NCIC-MA.27): A Randomized Phase III Trial Of Exemestane Versus Anastrozole With Or Without Celecoxib In Postmenopausal Women With Receptor Positive Primary Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ABE31B86-C179-5457-E034-0003BA12F5E7

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ABE31B86-C179-5457-E034-0003BA12F5E7

Keywords

versioni (3)
  1. 26/08/12 26/08/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
  3. 20/09/21 20/09/21 -
Caricato su

26 agosto 2012

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00090974 Follow-Up - FORM 9 - RECURRENCE AND CONTRALATERAL BREAST CANCER REPORT - 2058833v3.0

Inglese

Submit within 6 weeks of the date of diagnosis.

1 moduli  
  1. StudyEvent: FORM 9 - RECURRENCE AND CONTRALATERAL BREAST CANCER REPORT
    1. Submit within 6 weeks of the date of diagnosis.
Patient Information
Descrizione

Patient Information

Patient Study ID, Coordinating Group
Descrizione

PatientStudyID,CoordinatingGroup

Tipo di dati

text

Patient Initials (first - middle - last)
Descrizione

PatientInitialsName

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Patient Medical Record Number
Descrizione

PatientMedicalRecordNumber

Tipo di dati

text

Investigator Name
Descrizione

InvestigatorName

Tipo di dati

text

Institution Name
Descrizione

InstitutionName

Tipo di dati

text

Registered Investigator (NCI Investigator #)
Descrizione

RegisteredInvestigator

Tipo di dati

text

Disease Status
Descrizione

Disease Status

Has the patient been diagnosed with first local-regional recurrence?
Descrizione

ProgressionInd,FirstLocal-Regional

Tipo di dati

text

Date of First Local-Regional Progression (yyyy mmm dd)
Descrizione

ProgressionDate,FirstLocal-Regional

Tipo di dati

date

Has the patient been diagnosed with first distant recurrence/progression?
Descrizione

ProgressionInd,FirstDistant

Tipo di dati

text

Date of First Distant Progression (yyyy mmm dd)
Descrizione

ProgressionDate,FirstDistant

Tipo di dati

date

Has the patient been diagnosed with contralateral breast cancer? (since submission of the last follow-up form)
Descrizione

Hasthepatientbeendiagnosedwithcontralateralbreastcancer?

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Date of Diagnosis of Contralateral Breast Cancer (yyyy mmm dd)
Descrizione

ContralateralBreastCancerDiagnosisDate

Tipo di dati

date

Alias
NCI Thesaurus ObjectClass
C12971
UMLS 2011AA ObjectClass
C0006141
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus ObjectClass
C25307
UMLS 2011AA ObjectClass
C0441988
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Supporting Documentation
Descrizione

Supporting Documentation

Comments
Descrizione

Comments

COMMENTS
Descrizione

Comments

Tipo di dati

text

Investigator Signature
Descrizione

Investigator Signature

Investigator Signature
Descrizione

InvestigatorSignature

Tipo di dati

text

Alias
NCI Thesaurus Property
C25678
UMLS 2011AA Property
C1519316
NCI Thesaurus ObjectClass
C17089
UMLS 2011AA ObjectClass
C0035173
Person Completing Form, Last Name
Descrizione

PersonCompletingForm,LastName

Tipo di dati

text

Person Completing Form, First Name
Descrizione

PersonCompletingForm,FirstName

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Form Completion Date, Original (yyyy mmm dd)
Descrizione

FormCompletionDate,Original

Tipo di dati

date

Unnamed1
Descrizione

Unnamed1

Patient Study ID, Coordinating Group
Descrizione

PatientStudyID,CoordinatingGroup

Tipo di dati

text

Patient Initials (first - middle - last)
Descrizione

PatientInitialsName

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Recurrence Table
Descrizione

Recurrence Table

Site(s) Local-Regional, Ipsilateral Breast (Check)
Descrizione

Local-RegionalBreastIpsilateralProgressionInd-3

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C12971
UMLS 2011AA ObjectClass
C0006141
NCI Thesaurus ObjectClass
C25388
UMLS 2011AA ObjectClass
C1947913
NCI Thesaurus Property
C25331
NCI Thesaurus Property
C25308
UMLS 2011AA Property
C0441989
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Definite Date (yyyy-mmm-dd)
Descrizione

PriorRecentRecurrenceDate

Tipo di dati

date

Alias
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C25279
UMLS 2011AA Property
C0332162
Site(s) Local-Regional, Chest Wall (Check)
Descrizione

Local-RegionalBreastChestWallProgressionInd-3

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C12971
UMLS 2011AA ObjectClass
C0006141
NCI Thesaurus ObjectClass
C25388
UMLS 2011AA ObjectClass
C1947913
NCI Thesaurus Property
C25331
NCI Metathesaurus Property
CL035093
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ValueDomain
C25755
UMLS 2011AA ValueDomain
C0871261
Site(s) Local-Regional, Regional Nodes/axilla (Check)
Descrizione

Site(s)Local-Regional,RegionalNodes/axilla,IND

Tipo di dati

text

Site(s) Distant, Lung (Check)
Descrizione

Sitesofprogression,lung

Tipo di dati

text

Site(s) Distant, Liver (Check)
Descrizione

Sitesofprogression,liver

Tipo di dati

text

Site(s) Distant, Bone (Check)
Descrizione

Sitesofprogression,bone

Tipo di dati

text

Site(s) Distant, Central Nervous System (Check)
Descrizione

Sitesofprogression,CNS(Brain)

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C25331
NCI Thesaurus ObjectClass
C12438
UMLS 2011AA ObjectClass
C0927232
Site(s) Distant, Bone Marrow (Check)
Descrizione

Site(s)Distant,BoneMarrow

Tipo di dati

text

Site(s) Distant, Ascites (Check)
Descrizione

Site(s)Distant,Ascites

Tipo di dati

text

Site(s) Distant, Pleural Effusion (Check)
Descrizione

Site(s)Distant,PleuralEffusion

Tipo di dati

text

Site(s) Distant, First Other, Specify (Check)
Descrizione

Site(s)Distant,FirstOther,Specify

Tipo di dati

text

Site(s) Distant, Second Other, Specify (Check)
Descrizione

Site(s)Distant,SecondOther,Specify

Tipo di dati

text

Alias
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus ObjectClass
C25331
NCI Thesaurus Property
C25321
UMLS 2011AA Property
C0443203
NCI Thesaurus ObjectClass
C25666
UMLS 2011AA ObjectClass
C0205436
Site(s) Distant, Second Other, Specify
Descrizione

ProgressionSite,Other

Tipo di dati

text

Site(s) Distant, Second Other, Specify
Descrizione

ProgressionSite,Other

Tipo di dati

text

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Suspected Date (yyyy-mmm-dd)
Descrizione

ProgressionSuspectedBeginDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Definite Date (yyyy-mmm-dd)
Descrizione

RecurrenceDate

Tipo di dati

date

Ccrr Module For Form 9 - Recurrence And Contralateral Breast Cancer Report
Descrizione

Ccrr Module For Form 9 - Recurrence And Contralateral Breast Cancer Report

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Similar models

Submit within 6 weeks of the date of diagnosis.

1 moduli
  1. StudyEvent: FORM 9 - RECURRENCE AND CONTRALATERAL BREAST CANCER REPORT
    1. Submit within 6 weeks of the date of diagnosis.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Patient Information
PatientStudyID,CoordinatingGroup
Item
Patient Study ID, Coordinating Group
text
PatientInitialsName
Item
Patient Initials (first - middle - last)
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
PatientMedicalRecordNumber
Item
Patient Medical Record Number
text
InvestigatorName
Item
Investigator Name
text
InstitutionName
Item
Institution Name
text
RegisteredInvestigator
Item
Registered Investigator (NCI Investigator #)
text
Item Group
Disease Status
Item
Has the patient been diagnosed with first local-regional recurrence?
text
CL.1
Code List
Has the patient been diagnosed with first local-regional recurrence?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
ProgressionDate,FirstLocal-Regional
Item
Date of First Local-Regional Progression (yyyy mmm dd)
date
Item
Has the patient been diagnosed with first distant recurrence/progression?
text
CL.2
Code List
Has the patient been diagnosed with first distant recurrence/progression?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
ProgressionDate,FirstDistant
Item
Date of First Distant Progression (yyyy mmm dd)
date
Item
Has the patient been diagnosed with contralateral breast cancer? (since submission of the last follow-up form)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.3
Code List
Has the patient been diagnosed with contralateral breast cancer? (since submission of the last follow-up form)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
ContralateralBreastCancerDiagnosisDate
Item
Date of Diagnosis of Contralateral Breast Cancer (yyyy mmm dd)
date
C12971 (NCI Thesaurus ObjectClass)
C0006141 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25307 (NCI Thesaurus ObjectClass)
C0441988 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item Group
Supporting Documentation
Item Group
Comments
Comments
Item
COMMENTS
text
Item Group
Investigator Signature
InvestigatorSignature
Item
Investigator Signature
text
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)
PersonCompletingForm,LastName
Item
Person Completing Form, Last Name
text
PersonCompletingForm,FirstName
Item
Person Completing Form, First Name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
FormCompletionDate,Original
Item
Form Completion Date, Original (yyyy mmm dd)
date
Item Group
Unnamed1
PatientStudyID,CoordinatingGroup
Item
Patient Study ID, Coordinating Group
text
PatientInitialsName
Item
Patient Initials (first - middle - last)
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
Item Group
Recurrence Table
Item
Site(s) Local-Regional, Ipsilateral Breast (Check)
text
C12971 (NCI Thesaurus ObjectClass)
C0006141 (UMLS 2011AA ObjectClass)
C25388 (NCI Thesaurus ObjectClass)
C1947913 (UMLS 2011AA ObjectClass)
C25331 (NCI Thesaurus Property)
C25308 (NCI Thesaurus Property)
C0441989 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.4
Code List
Site(s) Local-Regional, Ipsilateral Breast (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PriorRecentRecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25279 (NCI Thesaurus Property)
C0332162 (UMLS 2011AA Property)
Item
Site(s) Local-Regional, Chest Wall (Check)
text
C12971 (NCI Thesaurus ObjectClass)
C0006141 (UMLS 2011AA ObjectClass)
C25388 (NCI Thesaurus ObjectClass)
C1947913 (UMLS 2011AA ObjectClass)
C25331 (NCI Thesaurus Property)
CL035093 (NCI Metathesaurus Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus ValueDomain)
C0871261 (UMLS 2011AA ValueDomain)
CL.5
Code List
Site(s) Local-Regional, Chest Wall (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Local-Regional, Regional Nodes/axilla (Check)
text
CL.6
Code List
Site(s) Local-Regional, Regional Nodes/axilla (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, Lung (Check)
text
CL.7
Code List
Site(s) Distant, Lung (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, Liver (Check)
text
CL.8
Code List
Site(s) Distant, Liver (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, Bone (Check)
text
CL.9
Code List
Site(s) Distant, Bone (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, Central Nervous System (Check)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25331 (NCI Thesaurus Property)
C12438 (NCI Thesaurus ObjectClass)
C0927232 (UMLS 2011AA ObjectClass)
CL.10
Code List
Site(s) Distant, Central Nervous System (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, Bone Marrow (Check)
text
CL.11
Code List
Site(s) Distant, Bone Marrow (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, Ascites (Check)
text
CL.12
Code List
Site(s) Distant, Ascites (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, Pleural Effusion (Check)
text
CL.13
Code List
Site(s) Distant, Pleural Effusion (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, First Other, Specify (Check)
text
CL.14
Code List
Site(s) Distant, First Other, Specify (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Site(s) Distant, Second Other, Specify (Check)
text
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25331 (NCI Thesaurus ObjectClass)
C25321 (NCI Thesaurus Property)
C0443203 (UMLS 2011AA Property)
C25666 (NCI Thesaurus ObjectClass)
C0205436 (UMLS 2011AA ObjectClass)
CL.15
Code List
Site(s) Distant, Second Other, Specify (Check)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
ProgressionSite,Other
Item
Site(s) Distant, Second Other, Specify
text
ProgressionSite,Other
Item
Site(s) Distant, Second Other, Specify
text
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
ProgressionSuspectedBeginDate
Item
Suspected Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
RecurrenceDate
Item
Definite Date (yyyy-mmm-dd)
date
Item Group
Ccrr Module For Form 9 - Recurrence And Contralateral Breast Cancer Report
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