Form:BBD Team Project Outcomes v1.0


CDE IDCDE Description
* 2777Site participant ID (Go To: 422)
* 422EDRN Site ID (Go To: 423)
* 423EDRN Protocol ID (Go To: 929)
* 929EDRN Staff ID of the person who collected the data: (Go To: 1219)
* 1219Date of contact (MM/DD/YYYY): (Go To: 4012)
* 4012Diagnosed with LCIS? (Go To: 2636)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3214)
 
 N/A (98)
 
 Unknown (99)
* 3214Number of subform loops to record 2: (Go To: 3201)
 
Permissible Values (value):1 (1)
 
 2 (2)
 
 3 (3)
 
 4 (4)
* 3201Line number or identifier 2 (system-generated): (Go To: 4013)
* 4013Timing of LCIS diagnosis: (Go To: 4014)
 
Permissible Values (value):First primary diagnosis (1)
 
 Recurrence of first primary diagnosis (2)
 
 Second primary diagnosis (3)
 
 Recurrence of second primary diagnosis (4)
* 4014LCIS diagnosis date (MM/YYYY): (Go To: 4015)
* 4015Pathologic primary LCIS tumor size (cm): (Go To: 2636)
* 2636Diagnosed with DCIS? (Go To: 2823)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3144)
 
 N/A (98)
 
 Unknown (99)
* 3144Number of loops: (Go To: 3200)
 
Permissible Values (value):0 (0)
 
 1 (1)
 
 2 (2)
 
 3 (3)
 
 4 (4)
* 3200Line number or identifier (system-generated): (Go To: 3417)
* 3417Timing of DCIS diagnosis: (Go To: 3403)
 
Permissible Values (value):First primary diagnosis (1)
 
 Recurrence of first primary diagnosis (2)
 
 Second primary diagnosis (3)
 
 Recurrence of second primary diagnosis (4)
* 3403DCIS diagnosis date (MM/YYYY): (Go To: 1658)
* 1658Pathologic primary DCIS tumor size (cm): (Go To: 2823)
* 2823Diagnosed with breast cancer? (Go To: 1425)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 1333)
 
 Unknown (99)
* 1333Date of diagnosis (MM/YYYY): (Go To: 3371)
* 3371Site of breast condition: (Go To: 3389)
 
Permissible Values (value):Left breast (1)
 
 Right breast (2)
 
 Bilateral (5)
 
 Other, specify: (97) (Go To: 3399)
 
 Unknown (99)
* 3399Site of invasive breast cancer (Other, specify): (Go To: 3389)
* 3389Breast quadrant(s) of disease: (Go To: 3388)
 
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)
* 3388Is pathology available? (Go To: 1425)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 1643)
 
 Unknown (99)
* 1643Histological type (breast): (Go To: 3375)
 
Permissible Values (value):Adenoid Cystic (1)
 
 Ductal (4)
 
 Lobular (5)
 
 Papillary (6)
 
 Micropapillary (7)
 
 Metaplastic (8)
 
 Metastatic to breast (9)
 
 Medullary (10)
 
 Mucinous (colloid) (11)
 
 Malignant phyllodes tumor (12)
 
 Tubular (13)
 
 Apocrine (14)
 
 Ductal/Lobular (15)
 
 Mixed, specify: (16) (Go To: 3416)
 
 Other, specify: (97) (Go To: 1644)
 
 Unknown (99)
* 3416Breast histological type; mixed, specify: (Go To: 3375)
* 1644Histological type, other specify (breast): (Go To: 3375)
* 3375Tumor grade: (Go To: 1675)
 
Permissible Values (value):Low grade (well differentiated) (1)
 
 Intermediate grade (moderately differentiated) (2)
 
 High grade (poorly differentiated) (3)
 
 High grade (undifferentiated) (4)
 
 Unknown (99)
* 1675Final estrogen receptor status diagnosis: (Go To: 1680)
 
Permissible Values (value):Positive (1)
 
 Negative (2)
 
 Indeterminate (7)
 
 Unknown (99)
* 1680Final progesterone receptor status diagnosis: (Go To: 1685)
 
Permissible Values (value):Positive (1)
 
 Negative (2)
 
 Indeterminate (7)
 
 Unknown (99)
* 1685Final diagnosis with HER2/neu: (Go To: 1703)
 
Permissible Values (value):Positive (1)
 
 Negative (2)
 
 Equivocal (3)
 
 Unknown (99)
* 1703Pathologic primary invasive tumor size (cm): (Go To: 1687)
* 1687Total number of lymph nodes examined : (Go To: 2462)
* 2462Number of positive nodes: (Go To: 1425)
* 1425Is participant alive? (Go To: 3409)
 
Permissible Values (value):No (0) (Go To: 3408)
 
 Yes (1)
 
 Unknown (99)
* 3408Date of death (MM/YYYY): (Go To: 1097)
* 3409Date of last contact (MM/YYYY): (Go To: 1097)
   1097Comments (do not include any participant identifiers) (Go To: End of Form)