English French Notes Complete/Exclude 59. WAS ENTIRE SPECIMEN SUBMITTED TO PATHOLOGY..................: NA 60. IF MARGINS ARE FREE, WHAT IS THE DISTANCE..................: NA TO PATHOLOGY..................: Unknown THE DISTANCE..................: Unknown 948 59. WAS ENTIRE SPECIMEN SUBMITTED TO PATHOLOGY.................. 949 60. IF MARGINS ARE FREE, WHAT IS THE DISTANCE.................. 61. SCOPE OF REGIONAL LYMPH NODE 62. NUMBER OF REGIONAL LYMPH NODES 63. SURGERY OF OTHER REGIONAL SITE(S), DISTANT SITE(S), OR DISTANT LYMPH NODE(S)......: 66. MICROSCOPIC STATUS OF FINAL MARGIN AFTER RESECTION........: NA MARGIN AFTER RESECTION........: Unknown MARGIN AFTER RE-EXCISION......: NA MARGIN AFTER RE-EXCISION......: Unknown 951 66. MICROSCOPIC STATUS OF FINAL MARGIN AFTER RE-EXCISION...... GO TO ITEM: RADIATION THERAPY 67. RADIATION THERAPY.............: 68. PRE-RADIATION THERAPY MAMMOGRAM OF PATIENT..........: Not done MAMMOGRAM OF PATIENT..........: Unknown if done 952 68. PRE-RADIATION THERAPY MAMMOGRAM OF PATIENT.......... 69. DATE RADIATION STARTED........: 70. DATE RADIATION ENDED..........: 71. SITES IRRADIATED..............: 72. (F) cGy DOSE TO WHOLE BREAST OR CHEST WALL.................: 73. (F) BOOST RADIATION...........: 361 70. DATE RADIATION ENDED.......... 953 71. SITES IRRADIATED.............. OR CHEST WALL.................: (Data Item for Females Only) 73. (F) BOOST RADIATION...........: (Data Item for Females Only) 954 72. (F) cGy DOSE TO WHOLE BREAST OR CHEST WALL................. 443 73. (F) BOOST RADIATION........... 74. REASON FOR NO RADIATION ......: HORMONE THERAPY 75. HORMONE THERAPY...............: 76. DATE HORMONE THERAPY STARTED..: 77. (M) SPECIFIC HORMONE THERAPY..: (Data Item for Males Only) 77. (M) SPECIFIC HORMONE THERAPY...: None 77. (M) SPECIFIC HORMONE THERAPY...: Unknown 955 77. (M) SPECIFIC HORMONE THERAPY.. 79. DATE CHEMOTHERAPY STARTED.....: 80. CHEMOTHERAPEUTIC REGIME CONTAINING DOXORUBICIN.......: NA, no chemotherapy CONTAINING DOXORUBICIN.......: Unknown 956 80. CHEMOTHERAPEUTIC REGIME CONTAINING DOXORUBICIN........ 81. DATE OF FIRST RECURRENCE 82. TYPE OF FIRST RECURRENCE 81. TYPE OF FIRST RECURRENCE 82. DATE OF FIRST RECURRENCE TABLE VI - FIRST RECURRENCE 70 81. DATE OF FIRST RECURRENCE 71 82. TYPE OF FIRST RECURRENCE 83. DATE OF LAST CONTACT OR DEATH 84. VITAL STATUS 85. CANCER STATUS 86. COMPLETED BY 87. REVIEWED BY CANCER COMMITTEE TABLE VII - STATUS AT LAST CONTACT 83. DATE OF LAST CONTACT OR DEATH..: 15 84. VITAL STATUS................... 85. CANCER STATUS..................: 81 86. COMPLETED BY................... 82 87. REVIEWED BY CANCER COMMITTEE... 1. INSTITUTION ID NUMBER............: H6 2. ACCESSION NUMBER.................: 3. SEQUENCE NUMBER..................: 4. POSTAL CODE AT DIAGNOSIS.........: 5. DATE OF BIRTH....................: 7. SPANISH ORIGIN...................: 9. PRIMARY PAYER AT DIAGNOSIS.......: 10. FAMILY HISTORY OF BREAST CANCER: MATERNAL AUNT...................: MATERNAL GRANDMOTHER............: ONE SISTER ONLY.................: MORE THAN ONE SISTER............: POSTIVE FAMILY HISTORY, NOS.....: 11. (F) PERSONAL HISTORY OF BREAST 12. SYNCHRONOUS BREAST CANCER........: 13. PERSONAL HISTORY OF OTHER CANCER: 14. (F) HORMONE REPLACEMENT THERAPY..: 15. (F) HOW MANY YEARS OF HORMONE REPLACEMENT THERAPY..............: TABLE II - INITIAL DIAGNOSIS 16. CLASS OF CASE....................: 17. DIAGNOSTIC EVALUATION: 18. (F) TYPE OF MAMMOGRAM: A. MAMMOGRAM GIVEN, TYPE UNKNOWN: B. SCREENING MAMMOGRAM..........: C. DIAGNOSTIC MAMMOGRAM.........: D. MAGNIFICAITON MAMMOGRAM......: 19. (F) PRESENTATION OF MOST DEFINITIVE MAMMOGRAM.............: 20. DATE OF INITIAL DIAGNOSIS........: 21. DATE OF PATHOLOGIC DIAGNOSIS.....: 22. PRIMARY SITE (ICD-O-2)...........: 24. BEHAVIOR CODE (ICD-O-2)..........: 25. IF INVASIVE DUCTUAL CARCINOMA REPORTED, IS DCIS ALSO PRESENT...: 27. ARCHITECTURE PATTERN IF DCIS IS PRESENT.......................: 28. NUCLEAR GRADE IF DCIS IS 29. DIAGNOSTIC CONFIRMATION..........: 30. (M) LEVEL OF INVOLVEMENT: CHEST WALL......................: PECTORAL MUSCLES................: DIAGNOSTIC AND STAGING PROCEDURES 31. BIOPSY PROCEDURE.................: 33. PALPABILITY OF PRIMARY...........: 34. FIRST DETECTED BY................: TABLE III - TUMOR MARKERS AND PROGNOSTIC TESTS 35. (M) DNA INDEX/PLOIDY.............: 36. ESTROGEN RECEPTOR PROTEIN........: 37. PROGESTERONE RECEPTOR PROTEIN....: 38. (M) ANDROGEN RECEPTOR PROTEIN....: 39. TYPE OF TEST.....................: Print Breast Cancer PCE (Data Item for Females Only) (Data Item for Males Only) TABLE IV - EXTENT OF DISEASE AND AJCC STAGE 40. SIZE OF TUMOR (mm)...............: 41. SIZE OF DCIS TUMOR (mm)..........: 42. REGIONAL NODES EXAMINED..........: 43. REGIONAL NODES POSITIVE..........: SENTINEL NODES 44. SENTINEL NODES BIOPSY............: 45. NUMBER OF SENTINEL NODES 46. NUMBER OF SENTINEL NODES 47. SENTINEL NODE DETECTED BY........: 48. AJCC CLINICAL STAGE (cTNM): AJCC STAGE......................: 49. AJCC PATHOLOGIC STAGE (pTNM): 50. STAGED BY: CLINICAL STAGE..................: PATHOLOGIC STAGE................: TABLE V - FIRST COURSE OF TREATMENT 51. DATE OF FIRST COURSE TREATMENT...: 52. DATE OF NON CANCER-DIRECTED 53. NON CANCER-DIRECTED SURGERY......: 54. DATE OF (FIRST) CANCER- DIRECTED SURGERY.................: 55. SURGICAL APPROACH................: 56. SURGERY OF PRIMARY SITE..........: 57. SPECIMEN RADIOGRAPH..............: 58. SURGICAL MARGINS.................: 59. WAS ENTIRE SPECIMEN SUBMITTED TO PATHOLOGY.....................: 60. IF MARGINS ARE FREE, WHAT IS THE DISTANCE.....................: 61. SCOPE OF REGIONAL LYMPH NODE 62. NUMBER OF REGIONAL LYMPH NODES 63. SURGERY OF OTHER REGIONAL SITE(S), DISTANT SITE(S), OR DISTANT LYMPH NODE(S).........: 66. MICROSCOPIC STATUS OF FINAL MARGIN AFTER RE-EXCISION.........: 67. RADIATION THERAPY................: 68. PRE-RADIATION THERAPY MAMMOGRAM OF PATIENT.............: 69. DATE RADIATION STARTED...........: 70. DATE RADIATION ENDED.............: 71. SITES IRRADIATED.................: 72. (F) cCy DOSE TO WHOLE BREAST OR CHEST WALL....................: 73. BOOST RADIATION..................: 74. REASON FOR NOT RADIATION.........: HORMONE THERAPY 75. HORMONE THERAPY..................: 76. DATE HORMONE THERAPY STARTED.....: 77. (M) SPECIFIC HORMONE THERAPY.....: 79. DATE CHEMOTHERAPY STARTED........: 80. CHEMOTHERAPEUTIC REGIME CONTAINING DOXORUBICIN...........: TABLE VI - FIRST RECURRENCE 81. DATE OF FIRST RECURRENCE.........: 82. TYPE OF FIRST RECURRENCE.........: TABLE VII - STATUS AT LAST CONTACT 83. DATE OF LAST CONTACT OR DEATH....: 84. VITAL STATUS.....................: 85. CANCER STATUS....................: 86. COMPLETED BY.....................: 87. REVIEWED BY CANCER COMMITTEE.....: The Accession Year is not 1997. The Diagnostic Confirmation code is not 1, 2 or 4. There is no HISTOLOGY for this primary. The BEHAVIOR code is not 2 (in situ) or 3 (malignant). The Histology of is not eligible. 9:Print Colorectal Cancer PCE Patient Care Evaluation Study of Colorectal Cancer ACCESSION NUMBER SEQUENCE NUMBER POSTAL CODE AT DIAGNOSIS FAMILY HISTORY OF COLORECTAL CANCER PERSONAL HISTORY OF COLORECTAL CANCER MULTIPLE COLON/RECTUM PRIMARIES 1997 PERSONAL HISTORY OF NON-COLORECTAL CANCER PREVIOUS TAH/BSO OTHER PRIOR CONDITIONS ACCESSION NUMBER.....................: SEQUENCE NUMBER......................: 9POSTAL CODE AT DIAGNOSIS............. DATE OF BIRTH........................: 9SPANISH ORIGIN....................... 18PRIMARY PAYER AT DIAGNOSIS........... 700FAMILY HISTORY OF COLORECTAL CANCER.. 701PERSONAL HISTORY OF COLORECTAL CANCER 702MULTIPLE COLON/RECTUM PRIMARIES 1997. PERSONAL HISTORY OF NON-COLORECTAL CANCER: 706 OVARIAN CARCINOMA, PERITONEAL SITE. 710PREVIOUS TAH/BSO..................... OTHER PRIOR CONDITIONS: 714 PRIOR POLYPS....................... DURATION OF SIGNS/SYMPTOMS PRESENT AT INITIAL DIAGNOSIS (months) INITIAL METHODS OF DIAGNOSIS REASON LEADING TO EVENTUAL DX DIAGNOSTIC EVALUATION LEVEL OF TUMOR BY ENDOSCOPIC EXAM LEVEL OF RECTAL TUMOR PRIMARY SITE HISTOLOGY/BEHAVIOR CODE DIAGNOSTIC CONFIRMATION TABLE II- INITIAL DIAGNOSIS CLASS OF CLASS...................: 717 BOWEL OBSTRUCTION.............. 718 CHANGE IN BOWEL HABIT.......... 719 EMER PRESENTATION-OBSTRUCTION.. 722 OCCULT BLOOD ONLY IN STOOL..... 725 RECTAL BLEEDING (MELENA)....... INITIAL METHODS OF DIAGNOSIS: 729 SCREENING DIGITAL RECTAL EXAM.. 730 SCREENING PHYSICAL EXAM........ 732REASON LEADING TO EVENTUAL DX.... DIAGNOSTIC EVALUATION: 733 BARIUM ENEMA, DOUBLE CONTRAST.. 734 BARIUM ENEMA, SINGLE CONTRAST.. 735 BARIUM ENEMA, NOS.............. 736 BIOPSY OF PRIMARY SITE......... 737 BIOPSY OF METASTATIC SITE...... 421 CT SCAN OF CHEST............... 738 CT SCAN OF LIVER............... 739 CT SCAN OF PRIMARY SITE........ 741 CHEST ROENTGENOGRAM............ 743 DIGITAL RECTAL EXAM............ 744 FLEXIBLE SIGMOIDOSCOPY......... 745 INTRAVENOUS PYELOGRAM (IVP).... 746 SERUM-LIVER FUNCTION TEST...... 749 STOOL GUAIAC (OCCULT BLOOD).... 752LEVEL OF TUMOR BY ENDOSCOPIC EXAM 753LEVEL OF RECTAL TUMOR............ PRIMARY SITE.....................: HISTOLOGY/BEHAVIOR CODE..........: 26DIAGNOSTIC CONFIRMATION.......... SIZE OF TUMOR (mm) CLINICAL STAGED BY PATHOLOGIC STAGED BY MARGIN OF RESECTION DISTANCE TO CLOSEST MUCOSAL MARGIN DISTANCE TO CLOSEST RADIAL MARGIN BLOOD VESSEL OR LYMPHATIC INVASION EXTRAMURAL VENOUS INVASION PROMINENT LYMPHOID INFILTRATE 29SIZE OF TUMOR (mm)............. 38 AJCC STAGE................... 19 CLINICAL STAGED BY........... 88 AJCC STAGE................... 89 PATHOLOGIC STAGED BY......... MARGIN OF RESECTION: 754 PROXIMAL MARGIN.............. 755 DISTAL MARGIN................ 756 RADIAL MARGIN................ 757DISTANCE TO MUCOSAL MARGIN..... 758DISTANCE TO RADIAL MARGIN...... 759BLOOD VESSEL/LYMPHATIC INVASION 760EXTRAMURAL VENOUS INVASION..... 761PROMINENT LYMPHOID INFILTRATE.. PHYSICIAN PROVIDING TREATMENT DATE OF FIRST COURSE TREATMENT DATE OF INPATIENT ADMISSION DATE OF INPATIENT DISCHARGE 762PHYSICIAN PROVIDING TREATMENT..... DATE OF FIRST COURSE TREATMENT....: 1DATE OF INPATIENT ADMISSION....... 1.1DATE OF INPATIENT DISCHARGE....... NON CANCER-DIRECTED SURGERY DATE: NON CANCER-DIRECTED SURGERY.....: SURGERY OF PRIMARY SITE DATE....: SURGERY OF PRIMARY SITE.........: ADDITIONAL SURGICAL PROCEDURES..: NA, none performed LAPAROSCOPY USED DURING SURGERY.: NA METHOD OF ANASTOMOSIS...........: Not done DIST OF ANASTOMOSIS FROM DENTATE: 0 RESIDUAL PRIMARY TUMOR..........: NA OTHER SURGERY: PATHOLOGICAL STATUS...........: NA COMPLICATIONS AFTER FIRST COURSE OF TREATMENT: #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################