|
Date of Diagnosis
|
Diagnosis
• • •
|
|
Surgery
• • •
|
Surg Date
|
|
Initial Pathologic Stage
|
Pathologic Prognostic Stage
|
|
Pathology:
• • •
|
|
|
Tumor Size
|
TNM:
• • •
|
|
ER
|
PR
|
|
ER Percent
|
PR Percent
|
|
Her2neu
• • •
|
|
|
p53
• • •
|
Ki 67
• • •
|
|
LVI
|
Neoadjuvant
|
|
Margins
• • •
|
Closest Margin
|
|
Nodes pos / nodes removed
/
|
Size of nodal mets
|
|
ECE
|
|
|
Mammaprint
|
MPI
|
|
Oncotype:
/
|
|
|
DCISionRT
|
DCIS Score
|
|
DCISionRT Risks DCIS + Invasive
|
DCISionRT Risks DCIS + Invasive
|
|
DCISionRT Risks Invasive Only
|
DCISionRT Risks Invasive Only
|
|
Genetic testing
• • •
|
Breast Cancer Before 50 years
|
|
Medical Oncology
• • •
|
Chemotherapy
• • •
|
|
Endocrine therapy:
• • •
|
|
|
Radiation Oncology
• • •
|
Radation
|
|
Plastic Surgery
|
|
|
Clinical Trial
|
|
|
Last Mammogram
|
Mamm Result
• • •
|
|
Date future mammogram needed:
• • •
|
|
|
Last Breast MRI
|
MRI Result
• • •
|
|
Date future MRI needed:
• • •
|
|
|
Review Past Hx
|
|
|
Additional notes:
|
|
|
Follow-up
• • •
|
We discussed the following:
• • •
|
