Descripción:

PACCT-1 TAILORx On-Study Form Hormone Therapy With or Without Combination Chemotherapy in Treating Women Who Have Undergone Surgery for Node-Negative Breast Cancer (The TAILORx Trial) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=05D9BCF6-1191-5BFE-E044-0003BA3F9857

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=05D9BCF6-1191-5BFE-E044-0003BA3F9857
Palabras clave:
  1. 26/8/12 26/8/12 -
  2. 9/1/15 9/1/15 - Martin Dugas
  3. 18/6/15 18/6/15 -
Subido en:

26 de agosto de 2012

DOI:
Para solicitar uno, por favor iniciar sesión.
Licencia :
Creative Commons BY-NC 3.0 Legacy
Comentarios del modelo :

Puede comentar sobre el modelo de datos aquí. A través de las burbujas de diálogo en los grupos de elementos y elementos, puede agregar comentarios específicos.

Comentarios de grupo de elementos para :

Comentarios del elemento para :

Para descargar modelos de datos, debe haber iniciado sesión. Por favor iniciar sesión o Registrate gratis.

Breast Cancer NCT00310180 On-Study - PACCT-1 TAILORx On-Study Form - 2430915v1.0

No Instruction available.

  1. StudyEvent: PACCT-1 TAILORx On-Study Form
    1. No Instruction available.
Unnamed1
Reporting Period
Unnamed2
Menopausal status (NOTE: See TAILORx Forms Completion Guidelines for defintions)
Breast: Surgical Procedures
Most Extensive Primary Surgery (check one)
Was sentinel node sampling performed
Was axillary dissection performed?
Breast: Disease Description
Mammogram (Breast cancer was detectable by the following answer yes or no for each of the following:)
Physical Exam
Other
Tumor Laterality
Histologic Grade (For breast cancer, a combined histologic grade is used according to SBR/Elston classification)
Nuclear Grade
Receptor Status, ER (as defined by local laboratory; borderline results should be reported as positive)
Receptor Status, PgR
Pathologic N Stage (CRF says "TNM Nodal Staging" - CDE is Recommended Term)
After receiving the treatment assignment, indicate which treatment(s) patient has agreed to receive (Choose all that apply)
Footer Module

Similar models

Utilice este formulario para comentarios, preguntas y sugerencias.

Los campos marcados con * son obligatorios.

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