Form:	BBD Team Project Clinical v1.0

CDE ID	CDE Description
* 2777	Site participant ID (Go To: 422)
* 422	EDRN Site ID (Go To: 2709)
* 2709	Specimen identifier: (Go To: 423)
* 423	EDRN Protocol ID (Go To: 929)
* 929	EDRN Staff ID of the person who collected the data: (Go To: 3455)
* 3455	Data collected for: (Go To: 3407)
	Permissible Values (value): Validation (1)
	Discovery (2)
	Unknown (99)
* 3407	Date of surgery (MM/YYYY): (Go To: 1292)
* 1292	Height [in inches] (What is your total current height in inches?) (Go To: 1212)
* 1212	Weight (lbs) at time of diagnosis: (Go To: 3413)
* 3413	Has the participant had a mastectomy? (Go To: 2784)
	Permissible Values (value): No (0)
	Yes (1)
	Unknown (99)
* 2784	Family cancer history in first-degree relatives? (Go To: 1601)
	Permissible Values (value): No (0)
	Yes (1)
	Unknown (99)
* 1601	Have you ever used hormonal birth control (such as birth control pills)? (Go To: 3386)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 3385)
	Unknown (99)
* 3385	Was the participant using hormonal birth control at the referent time? (Go To: 3386)
	Permissible Values (value): No (0)
	Yes (1)
	Unknown (99)
* 3386	Did the participant ever use estrogen-only menopausal hormone therapy? (Go To: 3387)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 2789)
	Unknown (99)
* 2789	Estrogen-only therapy used? (Go To: 3387)
	Permissible Values (value): No (0)
	Yes (1)
	Unknown (99)
* 3387	Did the participant ever use estrogen+ progesterone therapy? (Go To: 3401)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 2799)
	Unknown (99)
* 2799	Estrogen + progesterone hormone therapy used? (Go To: 3401)
	Permissible Values (value): No (0)
	Yes (1)
	Unknown (99)
* 3401	Date of prior screening test (MM/YYYY): (Go To: 3391)
* 3391	Reason (or indication) for procedure that led to diagnosis: (Go To: 3374)
	Permissible Values (value): Screening (asymptomatic) (1)
	Additional evaluation (2)
	Surveillance (3)
	Symptomatic (4)
	Unknown (99)
* 3374	Breast condition: Check all that apply (Go To: 3371)
	Permissible Values (value): Abnormal mammogram/radiology exam (1)
	Abnormal mammogram with calcifications (2)
	Breast mass (patient or physician feels) (3)
	Other (3)
	Nipple inversion, retraction, induration (4)
	Pathologic/spontaneous nipple discharge (5)
	Incidental findings (10)
	N/A (98)
	Unknown (99)
* 3371	Site of breast condition: (Go To: 3389)
	Permissible Values (value): Left breast (1)
	Right breast (2)
	Bilateral (5)
	Other, specify: (97) (Go To: 3398)
	Unknown (99)
* 3398	Site of breast condition (Other, specify): (Go To: 3389)
* 3389	Breast quadrant(s) of disease: (Go To: 3372)
	Permissible Values (value): Upper inner (1)
	Upper outer (2)
	Lower inner (3)
	Lower outer (4)
	12:00 (5)
	3:00 (6)
	6:00 (7)
	9:00 (9)
	Central (10)
	Other (95)
	Unknown (99)
* 3372	Type of surgical procedure: (Go To: 3395)
	Permissible Values (value): Excisional biopsy (2)
	Incisional biopsy (3)
	Mastectomy (5)
	Lumpectomy (6)
	Axillary lymph node dissection (7)
	Core biopsy (needle) (9)
	Unknown (99)
* 3395	Benign Breast Disease (BBD) diagnosis: (Go To: 2286)
* 2286	Hormone therapy received? (Go To: 3410)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 3402)
	Refused (88)
	Unknown (99)
* 3402	Hormone therapy start date (MM/YYYY): (Go To: 2285)
* 2285	Hormone therapy name: (Go To: 3410)
	Permissible Values (value): Raloxifene (6)
	Tamoxifen (7)
	Aromatase inhibitor (24)
	Other, specify: (97) (Go To: 2475)
	Unknown (99)
* 2475	Hormone therapy name (Other, specify): (Go To: 3410)
* 3410	Other treatment received? (Go To: 1097)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 3003)
	Unknown (99)
3003	Treatment or therapy name: (Go To: 1097)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)