Form:BRS-I Imaging v2.4


CDE IDCDE Description
* 1063Site 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: 955)
* 955Date of imaging test (MM/DD/YYYY): (Go To: 4761)
* 4761Image type (breast) (Go To: 3144)
 
Permissible Values (value):Full field digital mammography FFDM/2D (1)
 
 Digital breast tomosynthesis DBT/3D (2)
* 3144Number of loops: (Go To: 3200)
 
Permissible Values (value):1 (1)
 
 2 (2)
 
 3 (3)
 
 4 (4)
 
 5 (5)
 
 6 (6)
 
 7 (7)
 
 8 (8)
 
 9 (9)
 
 10 (10)
 
 11 (11)
 
 12 (12)
 
 13 (13)
 
 14 (14)
 
 15 (15)
* 3200Line number or identifier (system-generated): (Go To: 4762)
   4762Identifier linking to associated image file (Go To: 4763)
   4763Identifier linking to associated file (Go To: 4897)
* 4897Breast lesion rating (Go To: 4881)
* 4881Final action associated with the ROI (Go To: 5674)
 
Permissible Values (value):Biopsy (1)
 
 Resolved with ultrasound (2)
 
 Resolved with MRI (3)
 
 Resolved with mammogram (4)
 
 Resolved by other means (95)
 
 Unknown (99)
* 5674Was this finding visible on a mammography? (Go To: 5675)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 5675Modalities other than mammography on which this finding was visible. Check all that apply (Go To: 4764)
 
Permissible Values (value):Ultrasound (1)
 
 MRI (4)
 
 Other (95)
 
 Not applicable (98)
* 4764Type of finding (check all that apply) (Go To: 4746)
 
Permissible Values (value):Mass (1) (Go To: 4746)
 
 Calcification (2) (Go To: 4750)
 
 Asymmetry (4) (Go To: 5665)
 
 Architectural distortion (6) (Go To: 2289)
 
 Other, specify: (97) (Go To: 4765)
* 4765Type of finding (other, specify) (Go To: 2289)
* 4746Shape of breast mass (Go To: 4747)
 
Permissible Values (value):Oval (1)
 
 Round (2)
 
 Irregular (3)
 
 Not reported (90)
* 4747Margin type of mass (Go To: 4748)
 
Permissible Values (value):Circumscribed (1)
 
 Obscured (2)
 
 Microlobulated (3)
 
 Indistinct (4)
 
 Spiculated (5)
 
 Not reported (90)
* 4748Density of mass (Go To: 5664)
 
Permissible Values (value):High density (1)
 
 Equal density (2)
 
 Low density (3)
 
 Fat containing (4)
 
 Not reported (90)
* 4750Benign breast calcification type (Go To: 4752)
 
Permissible Values (value):Skin (1)
 
 Vascular (2)
 
 Course or popcorn like (3)
 
 Large rod like (4)
 
 Round (5)
 
 Rim (6)
 
 Dystrophic (7)
 
 Milk of calcium (8)
 
 Suture (9)
 
 Not applicable (98)
* 4752Calcification morphology type (Go To: 4753)
 
Permissible Values (value):Amorphous (1)
 
 Coarse heterogeneous (2)
 
 Fine pleomorphic (3)
 
 Fine linear or fine linear branching (4)
 
 Not applicable (98)
* 4753Calcification distribution (Go To: 5664)
 
Permissible Values (value):Diffuse (1)
 
 Regional (2)
 
 Grouped (3)
 
 Linear (4)
 
 Segmental (5)
 
 Not applicable (98)
* 5665Asymmetry type (Go To: 5664)
 
Permissible Values (value):Asymmetry (1)
 
 Global asymmetry (2)
 
 Focal asymmetry (3)
 
 Developing asymmetry (4)
* 5664Associated findings (check all that apply) (Go To: 2289)
 
Permissible Values (value):Associated architectural distortion (1)
 
 Associated calcification (2) (Go To: 5669)
 
 Associated asymmetry (3) (Go To: 5672)
 
 Not applicable (98)
* 5669Benign calcification type (associated calcification): (Go To: 5670)
 
Permissible Values (value):Skin (1)
 
 Vascular (2)
 
 Course or popcorn like (3)
 
 Large rod like (4)
 
 Round (5)
 
 Rim (6)
 
 Dystrophic (7)
 
 Milk of calcium (8)
 
 Suture (9)
 
 Not applicable (98)
* 5670Calcification morphology type (associated calcification) (Go To: 5671)
 
Permissible Values (value):Amorphous (1)
 
 Coarse heterogeneous (2)
 
 Fine pleomorphic (3)
 
 Fine linear or fine linear branching (4)
 
 Not applicable (98)
* 5671Calcification distribution (associated calcification) (Go To: 2289)
 
Permissible Values (value):Diffuse (1)
 
 Regional (2)
 
 Grouped (3)
 
 Linear (4)
 
 Segmental (5)
 
 Not applicable (98)
* 5672Asymmetry type (associated asymmetry) (Go To: 2289)
 
Permissible Values (value):Asymmetry (1)
 
 Global asymmetry (2)
 
 Focal asymmetry (3)
 
 Developing asymmetry (4)
* 2289Body laterality: (Go To: 4745)
 
Permissible Values (value):Right (1)
 
 Left (2)
 
 Not reported (90)
* 4745Depth of lesion or anomaly (Go To: 3390)
 
Permissible Values (value):Anterior (1)
 
 Middle (2)
 
 Posterior (3)
 
 Not reported (90)
* 3390Breast quadrant(s) of procedure: (Go To: 4766)
 
Permissible Values (value):Upper inner (1)
 
 Upper outer (2)
 
 Lower inner (3)
 
 Lower outer (4)
 
 Not reported (90)
* 4766Clock face value (check all that apply) (Go To: 4759)
 
Permissible Values (value):1:00 (1)
 
 2:00 (2)
 
 3:00 (3)
 
 4:00 (4)
 
 5:00 (5)
 
 6:00 (6)
 
 7:00 (7)
 
 8:00 (8)
 
 9:00 (9)
 
 10:00 (10)
 
 11:00 (11)
 
 12:00 (12)
 
 Central (13)
 
 Not reported (90)
* 4759Distance from the nipple (cm) (Go To: 3158)
   3158Loop-specific comments: (Go To: 4744)
* 4744Breast composition (Go To: 5666)
 
Permissible Values (value):Almost entirely fatty (1)
 
 Fibroglandular density (2)
 
 Heterogeneously dense (3)
 
 Extremely dense (4)
* 5666Associated features (right) (Check all that apply) (Go To: 5667)
 
Permissible Values (value):None (0)
 
 Skin retraction (1)
 
 Nipple retraction (2)
 
 Trabecular thickening (3)
 
 Skin thickening (4)
 
 Axillary adenopathy (5)
* 5667Associated features (left) (Check all that apply) (Go To: 1097)
 
Permissible Values (value):None (0)
 
 Skin retraction (1)
 
 Nipple retraction (2)
 
 Trabecular thickening (3)
 
 Skin thickening (4)
 
 Axillary adenopathy (5)
   1097Comments (do not include any participant identifiers) (Go To: End of Form)