| [604] | 1 | English French Notes Complete/Exclude
|
|---|
| 2 | 59. WAS ENTIRE SPECIMEN SUBMITTED
|
|---|
| 3 | TO PATHOLOGY..................: NA
|
|---|
| 4 | 60. IF MARGINS ARE FREE, WHAT IS
|
|---|
| 5 | THE DISTANCE..................: NA
|
|---|
| 6 | TO PATHOLOGY..................: Unknown
|
|---|
| 7 | THE DISTANCE..................: Unknown
|
|---|
| 8 | 948 59. WAS ENTIRE SPECIMEN SUBMITTED TO PATHOLOGY..................
|
|---|
| 9 | 949 60. IF MARGINS ARE FREE, WHAT IS THE DISTANCE..................
|
|---|
| 10 | 61. SCOPE OF REGIONAL LYMPH NODE
|
|---|
| 11 | 62. NUMBER OF REGIONAL LYMPH NODES
|
|---|
| 12 | 63. SURGERY OF OTHER REGIONAL
|
|---|
| 13 | SITE(S), DISTANT SITE(S),
|
|---|
| 14 | OR DISTANT LYMPH NODE(S)......:
|
|---|
| 15 | 66. MICROSCOPIC STATUS OF FINAL
|
|---|
| 16 | MARGIN AFTER RESECTION........: NA
|
|---|
| 17 | MARGIN AFTER RESECTION........: Unknown
|
|---|
| 18 | MARGIN AFTER RE-EXCISION......: NA
|
|---|
| 19 | MARGIN AFTER RE-EXCISION......: Unknown
|
|---|
| 20 | 951 66. MICROSCOPIC STATUS OF FINAL MARGIN AFTER RE-EXCISION......
|
|---|
| 21 | GO TO ITEM:
|
|---|
| 22 | RADIATION THERAPY
|
|---|
| 23 | 67. RADIATION THERAPY.............:
|
|---|
| 24 | 68. PRE-RADIATION THERAPY
|
|---|
| 25 | MAMMOGRAM OF PATIENT..........: Not done
|
|---|
| 26 | MAMMOGRAM OF PATIENT..........: Unknown if done
|
|---|
| 27 | 952 68. PRE-RADIATION THERAPY MAMMOGRAM OF PATIENT..........
|
|---|
| 28 | 69. DATE RADIATION STARTED........:
|
|---|
| 29 | 70. DATE RADIATION ENDED..........:
|
|---|
| 30 | 71. SITES IRRADIATED..............:
|
|---|
| 31 | 72. (F) cGy DOSE TO WHOLE BREAST
|
|---|
| 32 | OR CHEST WALL.................:
|
|---|
| 33 | 73. (F) BOOST RADIATION...........:
|
|---|
| 34 | 361 70. DATE RADIATION ENDED..........
|
|---|
| 35 | 953 71. SITES IRRADIATED..............
|
|---|
| 36 | OR CHEST WALL.................: (Data Item for Females Only)
|
|---|
| 37 | 73. (F) BOOST RADIATION...........: (Data Item for Females Only)
|
|---|
| 38 | 954 72. (F) cGy DOSE TO WHOLE BREAST OR CHEST WALL.................
|
|---|
| 39 | 443 73. (F) BOOST RADIATION...........
|
|---|
| 40 | 74. REASON FOR NO RADIATION ......:
|
|---|
| 41 | HORMONE THERAPY
|
|---|
| 42 | 75. HORMONE THERAPY...............:
|
|---|
| 43 | 76. DATE HORMONE THERAPY STARTED..:
|
|---|
| 44 | 77. (M) SPECIFIC HORMONE THERAPY..: (Data Item for Males Only)
|
|---|
| 45 | 77. (M) SPECIFIC HORMONE THERAPY...: None
|
|---|
| 46 | 77. (M) SPECIFIC HORMONE THERAPY...: Unknown
|
|---|
| 47 | 955 77. (M) SPECIFIC HORMONE THERAPY..
|
|---|
| 48 | 79. DATE CHEMOTHERAPY STARTED.....:
|
|---|
| 49 | 80. CHEMOTHERAPEUTIC REGIME
|
|---|
| 50 | CONTAINING DOXORUBICIN.......: NA, no chemotherapy
|
|---|
| 51 | CONTAINING DOXORUBICIN.......: Unknown
|
|---|
| 52 | 956 80. CHEMOTHERAPEUTIC REGIME CONTAINING DOXORUBICIN........
|
|---|
| 53 | 81. DATE OF FIRST RECURRENCE
|
|---|
| 54 | 82. TYPE OF FIRST RECURRENCE
|
|---|
| 55 | 81. TYPE OF FIRST RECURRENCE
|
|---|
| 56 | 82. DATE OF FIRST RECURRENCE
|
|---|
| 57 | TABLE VI - FIRST RECURRENCE
|
|---|
| 58 | 70 81. DATE OF FIRST RECURRENCE
|
|---|
| 59 | 71 82. TYPE OF FIRST RECURRENCE
|
|---|
| 60 | 83. DATE OF LAST CONTACT OR DEATH
|
|---|
| 61 | 84. VITAL STATUS
|
|---|
| 62 | 85. CANCER STATUS
|
|---|
| 63 | 86. COMPLETED BY
|
|---|
| 64 | 87. REVIEWED BY CANCER COMMITTEE
|
|---|
| 65 | TABLE VII - STATUS AT LAST CONTACT
|
|---|
| 66 | 83. DATE OF LAST CONTACT OR DEATH..:
|
|---|
| 67 | 15 84. VITAL STATUS...................
|
|---|
| 68 | 85. CANCER STATUS..................:
|
|---|
| 69 | 81 86. COMPLETED BY...................
|
|---|
| 70 | 82 87. REVIEWED BY CANCER COMMITTEE...
|
|---|
| 71 | 1. INSTITUTION ID NUMBER............: H6
|
|---|
| 72 | 2. ACCESSION NUMBER.................:
|
|---|
| 73 | 3. SEQUENCE NUMBER..................:
|
|---|
| 74 | 4. POSTAL CODE AT DIAGNOSIS.........:
|
|---|
| 75 | 5. DATE OF BIRTH....................:
|
|---|
| 76 | 7. SPANISH ORIGIN...................:
|
|---|
| 77 | 9. PRIMARY PAYER AT DIAGNOSIS.......:
|
|---|
| 78 | 10. FAMILY HISTORY OF BREAST CANCER:
|
|---|
| 79 | MATERNAL AUNT...................:
|
|---|
| 80 | MATERNAL GRANDMOTHER............:
|
|---|
| 81 | ONE SISTER ONLY.................:
|
|---|
| 82 | MORE THAN ONE SISTER............:
|
|---|
| 83 | POSTIVE FAMILY HISTORY, NOS.....:
|
|---|
| 84 | 11. (F) PERSONAL HISTORY OF BREAST
|
|---|
| 85 | 12. SYNCHRONOUS BREAST CANCER........:
|
|---|
| 86 | 13. PERSONAL HISTORY OF OTHER CANCER:
|
|---|
| 87 | 14. (F) HORMONE REPLACEMENT THERAPY..:
|
|---|
| 88 | 15. (F) HOW MANY YEARS OF HORMONE
|
|---|
| 89 | REPLACEMENT THERAPY..............:
|
|---|
| 90 | TABLE II - INITIAL DIAGNOSIS
|
|---|
| 91 | 16. CLASS OF CASE....................:
|
|---|
| 92 | 17. DIAGNOSTIC EVALUATION:
|
|---|
| 93 | 18. (F) TYPE OF MAMMOGRAM:
|
|---|
| 94 | A. MAMMOGRAM GIVEN, TYPE UNKNOWN:
|
|---|
| 95 | B. SCREENING MAMMOGRAM..........:
|
|---|
| 96 | C. DIAGNOSTIC MAMMOGRAM.........:
|
|---|
| 97 | D. MAGNIFICAITON MAMMOGRAM......:
|
|---|
| 98 | 19. (F) PRESENTATION OF MOST
|
|---|
| 99 | DEFINITIVE MAMMOGRAM.............:
|
|---|
| 100 | 20. DATE OF INITIAL DIAGNOSIS........:
|
|---|
| 101 | 21. DATE OF PATHOLOGIC DIAGNOSIS.....:
|
|---|
| 102 | 22. PRIMARY SITE (ICD-O-2)...........:
|
|---|
| 103 | 24. BEHAVIOR CODE (ICD-O-2)..........:
|
|---|
| 104 | 25. IF INVASIVE DUCTUAL CARCINOMA
|
|---|
| 105 | REPORTED, IS DCIS ALSO PRESENT...:
|
|---|
| 106 | 27. ARCHITECTURE PATTERN IF DCIS
|
|---|
| 107 | IS PRESENT.......................:
|
|---|
| 108 | 28. NUCLEAR GRADE IF DCIS IS
|
|---|
| 109 | 29. DIAGNOSTIC CONFIRMATION..........:
|
|---|
| 110 | 30. (M) LEVEL OF INVOLVEMENT:
|
|---|
| 111 | CHEST WALL......................:
|
|---|
| 112 | PECTORAL MUSCLES................:
|
|---|
| 113 | DIAGNOSTIC AND STAGING PROCEDURES
|
|---|
| 114 | 31. BIOPSY PROCEDURE.................:
|
|---|
| 115 | 33. PALPABILITY OF PRIMARY...........:
|
|---|
| 116 | 34. FIRST DETECTED BY................:
|
|---|
| 117 | TABLE III - TUMOR MARKERS AND PROGNOSTIC TESTS
|
|---|
| 118 | 35. (M) DNA INDEX/PLOIDY.............:
|
|---|
| 119 | 36. ESTROGEN RECEPTOR PROTEIN........:
|
|---|
| 120 | 37. PROGESTERONE RECEPTOR PROTEIN....:
|
|---|
| 121 | 38. (M) ANDROGEN RECEPTOR PROTEIN....:
|
|---|
| 122 | 39. TYPE OF TEST.....................:
|
|---|
| 123 | Print Breast Cancer PCE
|
|---|
| 124 | (Data Item for Females Only)
|
|---|
| 125 | (Data Item for Males Only)
|
|---|
| 126 | TABLE IV - EXTENT OF DISEASE AND AJCC STAGE
|
|---|
| 127 | 40. SIZE OF TUMOR (mm)...............:
|
|---|
| 128 | 41. SIZE OF DCIS TUMOR (mm)..........:
|
|---|
| 129 | 42. REGIONAL NODES EXAMINED..........:
|
|---|
| 130 | 43. REGIONAL NODES POSITIVE..........:
|
|---|
| 131 | SENTINEL NODES
|
|---|
| 132 | 44. SENTINEL NODES BIOPSY............:
|
|---|
| 133 | 45. NUMBER OF SENTINEL NODES
|
|---|
| 134 | 46. NUMBER OF SENTINEL NODES
|
|---|
| 135 | 47. SENTINEL NODE DETECTED BY........:
|
|---|
| 136 | 48. AJCC CLINICAL STAGE (cTNM):
|
|---|
| 137 | AJCC STAGE......................:
|
|---|
| 138 | 49. AJCC PATHOLOGIC STAGE (pTNM):
|
|---|
| 139 | 50. STAGED BY:
|
|---|
| 140 | CLINICAL STAGE..................:
|
|---|
| 141 | PATHOLOGIC STAGE................:
|
|---|
| 142 | TABLE V - FIRST COURSE OF TREATMENT
|
|---|
| 143 | 51. DATE OF FIRST COURSE TREATMENT...:
|
|---|
| 144 | 52. DATE OF NON CANCER-DIRECTED
|
|---|
| 145 | 53. NON CANCER-DIRECTED SURGERY......:
|
|---|
| 146 | 54. DATE OF (FIRST) CANCER-
|
|---|
| 147 | DIRECTED SURGERY.................:
|
|---|
| 148 | 55. SURGICAL APPROACH................:
|
|---|
| 149 | 56. SURGERY OF PRIMARY SITE..........:
|
|---|
| 150 | 57. SPECIMEN RADIOGRAPH..............:
|
|---|
| 151 | 58. SURGICAL MARGINS.................:
|
|---|
| 152 | 59. WAS ENTIRE SPECIMEN SUBMITTED
|
|---|
| 153 | TO PATHOLOGY.....................:
|
|---|
| 154 | 60. IF MARGINS ARE FREE, WHAT IS
|
|---|
| 155 | THE DISTANCE.....................:
|
|---|
| 156 | 61. SCOPE OF REGIONAL LYMPH NODE
|
|---|
| 157 | 62. NUMBER OF REGIONAL LYMPH NODES
|
|---|
| 158 | 63. SURGERY OF OTHER REGIONAL
|
|---|
| 159 | SITE(S), DISTANT SITE(S),
|
|---|
| 160 | OR DISTANT LYMPH NODE(S).........:
|
|---|
| 161 | 66. MICROSCOPIC STATUS OF FINAL
|
|---|
| 162 | MARGIN AFTER RE-EXCISION.........:
|
|---|
| 163 | 67. RADIATION THERAPY................:
|
|---|
| 164 | 68. PRE-RADIATION THERAPY
|
|---|
| 165 | MAMMOGRAM OF PATIENT.............:
|
|---|
| 166 | 69. DATE RADIATION STARTED...........:
|
|---|
| 167 | 70. DATE RADIATION ENDED.............:
|
|---|
| 168 | 71. SITES IRRADIATED.................:
|
|---|
| 169 | 72. (F) cCy DOSE TO WHOLE BREAST
|
|---|
| 170 | OR CHEST WALL....................:
|
|---|
| 171 | 73. BOOST RADIATION..................:
|
|---|
| 172 | 74. REASON FOR NOT RADIATION.........:
|
|---|
| 173 | HORMONE THERAPY
|
|---|
| 174 | 75. HORMONE THERAPY..................:
|
|---|
| 175 | 76. DATE HORMONE THERAPY STARTED.....:
|
|---|
| 176 | 77. (M) SPECIFIC HORMONE THERAPY.....:
|
|---|
| 177 | 79. DATE CHEMOTHERAPY STARTED........:
|
|---|
| 178 | 80. CHEMOTHERAPEUTIC REGIME
|
|---|
| 179 | CONTAINING DOXORUBICIN...........:
|
|---|
| 180 | TABLE VI - FIRST RECURRENCE
|
|---|
| 181 | 81. DATE OF FIRST RECURRENCE.........:
|
|---|
| 182 | 82. TYPE OF FIRST RECURRENCE.........:
|
|---|
| 183 | TABLE VII - STATUS AT LAST CONTACT
|
|---|
| 184 | 83. DATE OF LAST CONTACT OR DEATH....:
|
|---|
| 185 | 84. VITAL STATUS.....................:
|
|---|
| 186 | 85. CANCER STATUS....................:
|
|---|
| 187 | 86. COMPLETED BY.....................:
|
|---|
| 188 | 87. REVIEWED BY CANCER COMMITTEE.....:
|
|---|
| 189 | The Accession Year is not 1997.
|
|---|
| 190 | The Diagnostic Confirmation code is not 1, 2 or 4.
|
|---|
| 191 | There is no HISTOLOGY for this primary.
|
|---|
| 192 | The BEHAVIOR code is not 2 (in situ) or 3 (malignant).
|
|---|
| 193 | The Histology of
|
|---|
| 194 | is not eligible.
|
|---|
| 195 | 9:Print Colorectal Cancer PCE
|
|---|
| 196 | Patient Care Evaluation Study of Colorectal Cancer
|
|---|
| 197 | ACCESSION NUMBER
|
|---|
| 198 | SEQUENCE NUMBER
|
|---|
| 199 | POSTAL CODE AT DIAGNOSIS
|
|---|
| 200 | FAMILY HISTORY OF COLORECTAL CANCER
|
|---|
| 201 | PERSONAL HISTORY OF COLORECTAL CANCER
|
|---|
| 202 | MULTIPLE COLON/RECTUM PRIMARIES 1997
|
|---|
| 203 | PERSONAL HISTORY OF NON-COLORECTAL CANCER
|
|---|
| 204 | PREVIOUS TAH/BSO
|
|---|
| 205 | OTHER PRIOR CONDITIONS
|
|---|
| 206 | ACCESSION NUMBER.....................:
|
|---|
| 207 | SEQUENCE NUMBER......................:
|
|---|
| 208 | 9POSTAL CODE AT DIAGNOSIS.............
|
|---|
| 209 | DATE OF BIRTH........................:
|
|---|
| 210 | 9SPANISH ORIGIN.......................
|
|---|
| 211 | 18PRIMARY PAYER AT DIAGNOSIS...........
|
|---|
| 212 | 700FAMILY HISTORY OF COLORECTAL CANCER..
|
|---|
| 213 | 701PERSONAL HISTORY OF COLORECTAL CANCER
|
|---|
| 214 | 702MULTIPLE COLON/RECTUM PRIMARIES 1997.
|
|---|
| 215 | PERSONAL HISTORY OF NON-COLORECTAL CANCER:
|
|---|
| 216 | 706 OVARIAN CARCINOMA, PERITONEAL SITE.
|
|---|
| 217 | 710PREVIOUS TAH/BSO.....................
|
|---|
| 218 | OTHER PRIOR CONDITIONS:
|
|---|
| 219 | 714 PRIOR POLYPS.......................
|
|---|
| 220 | DURATION OF SIGNS/SYMPTOMS PRESENT AT INITIAL DIAGNOSIS (months)
|
|---|
| 221 | INITIAL METHODS OF DIAGNOSIS
|
|---|
| 222 | REASON LEADING TO EVENTUAL DX
|
|---|
| 223 | DIAGNOSTIC EVALUATION
|
|---|
| 224 | LEVEL OF TUMOR BY ENDOSCOPIC EXAM
|
|---|
| 225 | LEVEL OF RECTAL TUMOR
|
|---|
| 226 | PRIMARY SITE
|
|---|
| 227 | HISTOLOGY/BEHAVIOR CODE
|
|---|
| 228 | DIAGNOSTIC CONFIRMATION
|
|---|
| 229 | TABLE II- INITIAL DIAGNOSIS
|
|---|
| 230 | CLASS OF CLASS...................:
|
|---|
| 231 | 717 BOWEL OBSTRUCTION..............
|
|---|
| 232 | 718 CHANGE IN BOWEL HABIT..........
|
|---|
| 233 | 719 EMER PRESENTATION-OBSTRUCTION..
|
|---|
| 234 | 722 OCCULT BLOOD ONLY IN STOOL.....
|
|---|
| 235 | 725 RECTAL BLEEDING (MELENA).......
|
|---|
| 236 | INITIAL METHODS OF DIAGNOSIS:
|
|---|
| 237 | 729 SCREENING DIGITAL RECTAL EXAM..
|
|---|
| 238 | 730 SCREENING PHYSICAL EXAM........
|
|---|
| 239 | 732REASON LEADING TO EVENTUAL DX....
|
|---|
| 240 | DIAGNOSTIC EVALUATION:
|
|---|
| 241 | 733 BARIUM ENEMA, DOUBLE CONTRAST..
|
|---|
| 242 | 734 BARIUM ENEMA, SINGLE CONTRAST..
|
|---|
| 243 | 735 BARIUM ENEMA, NOS..............
|
|---|
| 244 | 736 BIOPSY OF PRIMARY SITE.........
|
|---|
| 245 | 737 BIOPSY OF METASTATIC SITE......
|
|---|
| 246 | 421 CT SCAN OF CHEST...............
|
|---|
| 247 | 738 CT SCAN OF LIVER...............
|
|---|
| 248 | 739 CT SCAN OF PRIMARY SITE........
|
|---|
| 249 | 741 CHEST ROENTGENOGRAM............
|
|---|
| 250 | 743 DIGITAL RECTAL EXAM............
|
|---|
| 251 | 744 FLEXIBLE SIGMOIDOSCOPY.........
|
|---|
| 252 | 745 INTRAVENOUS PYELOGRAM (IVP)....
|
|---|
| 253 | 746 SERUM-LIVER FUNCTION TEST......
|
|---|
| 254 | 749 STOOL GUAIAC (OCCULT BLOOD)....
|
|---|
| 255 | 752LEVEL OF TUMOR BY ENDOSCOPIC EXAM
|
|---|
| 256 | 753LEVEL OF RECTAL TUMOR............
|
|---|
| 257 | PRIMARY SITE.....................:
|
|---|
| 258 | HISTOLOGY/BEHAVIOR CODE..........:
|
|---|
| 259 | 26DIAGNOSTIC CONFIRMATION..........
|
|---|
| 260 | SIZE OF TUMOR (mm)
|
|---|
| 261 | CLINICAL STAGED BY
|
|---|
| 262 | PATHOLOGIC STAGED BY
|
|---|
| 263 | MARGIN OF RESECTION
|
|---|
| 264 | DISTANCE TO CLOSEST MUCOSAL MARGIN
|
|---|
| 265 | DISTANCE TO CLOSEST RADIAL MARGIN
|
|---|
| 266 | BLOOD VESSEL OR LYMPHATIC INVASION
|
|---|
| 267 | EXTRAMURAL VENOUS INVASION
|
|---|
| 268 | PROMINENT LYMPHOID INFILTRATE
|
|---|
| 269 | 29SIZE OF TUMOR (mm).............
|
|---|
| 270 | 38 AJCC STAGE...................
|
|---|
| 271 | 19 CLINICAL STAGED BY...........
|
|---|
| 272 | 88 AJCC STAGE...................
|
|---|
| 273 | 89 PATHOLOGIC STAGED BY.........
|
|---|
| 274 | MARGIN OF RESECTION:
|
|---|
| 275 | 754 PROXIMAL MARGIN..............
|
|---|
| 276 | 755 DISTAL MARGIN................
|
|---|
| 277 | 756 RADIAL MARGIN................
|
|---|
| 278 | 757DISTANCE TO MUCOSAL MARGIN.....
|
|---|
| 279 | 758DISTANCE TO RADIAL MARGIN......
|
|---|
| 280 | 759BLOOD VESSEL/LYMPHATIC INVASION
|
|---|
| 281 | 760EXTRAMURAL VENOUS INVASION.....
|
|---|
| 282 | 761PROMINENT LYMPHOID INFILTRATE..
|
|---|
| 283 | PHYSICIAN PROVIDING TREATMENT
|
|---|
| 284 | DATE OF FIRST COURSE TREATMENT
|
|---|
| 285 | DATE OF INPATIENT ADMISSION
|
|---|
| 286 | DATE OF INPATIENT DISCHARGE
|
|---|
| 287 | 762PHYSICIAN PROVIDING TREATMENT.....
|
|---|
| 288 | DATE OF FIRST COURSE TREATMENT....:
|
|---|
| 289 | 1DATE OF INPATIENT ADMISSION.......
|
|---|
| 290 | 1.1DATE OF INPATIENT DISCHARGE.......
|
|---|
| 291 | NON CANCER-DIRECTED SURGERY DATE:
|
|---|
| 292 | NON CANCER-DIRECTED SURGERY.....:
|
|---|
| 293 | SURGERY OF PRIMARY SITE DATE....:
|
|---|
| 294 | SURGERY OF PRIMARY SITE.........:
|
|---|
| 295 | ADDITIONAL SURGICAL PROCEDURES..: NA, none performed
|
|---|
| 296 | LAPAROSCOPY USED DURING SURGERY.: NA
|
|---|
| 297 | METHOD OF ANASTOMOSIS...........: Not done
|
|---|
| 298 | DIST OF ANASTOMOSIS FROM DENTATE: 0
|
|---|
| 299 | RESIDUAL PRIMARY TUMOR..........: NA
|
|---|
| 300 | OTHER SURGERY:
|
|---|
| 301 | PATHOLOGICAL STATUS...........: NA
|
|---|
| 302 | COMPLICATIONS AFTER FIRST COURSE OF TREATMENT:
|
|---|
| 303 | #################### #################### ####################
|
|---|
| 304 | #################### #################### ####################
|
|---|
| 305 | #################### #################### ####################
|
|---|
| 306 | #################### #################### ####################
|
|---|
| 307 | #################### #################### ####################
|
|---|
