Beschrijving:

NSABP PROTOCOL B-39: ON-STUDY FORM Radiation Therapy in Treating Women Who Have Undergone Surgery For Ductal Carcinoma In Situ or Stage I or Stage II Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E74657B5-A500-0931-E034-0003BA3F9857

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E74657B5-A500-0931-E034-0003BA3F9857
Trefwoorden:
  1. 26-08-12 26-08-12 -
  2. 09-01-15 09-01-15 - Martin Dugas
  3. 05-07-15 05-07-15 -
Geüploaded op:

26 augustus 2012

DOI:
Voor een aanvraag inloggen.
Licentie :
Creative Commons BY-NC 3.0 Legacy
Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Breast Cancer NCT00103181 On-Study - NSABP PROTOCOL B-39: ON-STUDY FORM - 2295516v3.0

Submit form as soon as possible after patient has been randomized.

  1. StudyEvent: NSABP PROTOCOL B-39: ON-STUDY FORM
    1. Submit form as soon as possible after patient has been randomized.
Unnamed1
Unnamed2
Are data amended (check box if yes, and circle amended items)
Unnamed3
Core (or Tru Cut) Needle Biopsy
Excisional Biopsy or Lumpectomy
Resection of Lumpectomy Margins (If more than one, list final resection.)
Sentinel Node Biopsy
Axillary Dissection or Axillary Sampling
Unnamed4
Tumor Laterality
Are the final margins of the resected specimen histologically free of invasive tumor and DCIS
Disease Stage
ER
PgR
Histologic Grade (Use combined histologic grade SBR/Elston classification.)
Is gross disease unifocal or multifocal (Answer without regard to whether disease is DCIS only, invasive only, or mixed DCIS/invasive.)
Pathologic Primary Tumor Size (Answer without regard to whether disease is DCIS only, invasive only, or mixed DCIS/invasive.)
The Invasive Tumor
Histologic Type

Similar models

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial