HL7 FHIR Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment 2)
This page is part of the Breast Cancer Data Logical Models and FHIR Profiles (v0.2.0: STU 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions 
The official URL for this profile is:
http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerPresenceStatement
Diagnosis of cancer originating in the tissues of the breast, and potentially spread to other organs of the body.
This profile builds on US Core Condition (a.k.a Problem) Profile.
This profile was published on Fri Aug 17 00:00:00 AEST 2018 as a draft by The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC).
View the corresponding BreastCancerPresenceStatementModel logical model.
Summary
Mandatory: 0 element (1 nested mandatory element)
Prohibited: 2 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
BC Mapping Source
This structure represents the following BC mapping definition:
oncology.BreastCancerPresenceStatement maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition: PersonOfRecord maps to subject ConditionAssertionTopic.Category maps to category ConditionAssertionTopic.TopicCode maps to code constrain bodySite to 0..0 ConditionAssertionTopic.AnatomicalLocation maps to http://hl7.org/fhir/StructureDefinition/condition-targetBodySite ConditionPresenceContext.Encounter maps to context ConditionPresenceContext.ClinicalStatus maps to clinicalStatus ConditionPresenceContext.VerificationStatus maps to verificationStatus ConditionPresenceContext.Onset maps to onset[x] ConditionPresenceContext.Abatement maps to abatement[x] ConditionPresenceContext.Severity maps to severity ConditionPresenceContext.Stage maps to stage ConditionPresenceContext.Stage.CodeableConcept maps to stage.summary ConditionPresenceContext.Stage.StageDetail maps to stage.assessment
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Condition | BC BreastCancerPresenceStatement Profile | |||
  condition-targetBodySite | 0..* | Reference(BodySite) | Extension URL: http://hl7.org/fhir/StructureDefinition/condition-targetBodySite | |
| oncology-MorphologyBehavior-extension | 0..1 | CodeableConcept | BC MorphologyBehavior Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension | |
  valueCodeableConcept | Binding: BC MorphologyBehaviorVS ValueSet (required) | |||
| clinicalStatus | 1..1 | |||
| severity | 0..0 | |||
| code | Binding: BC BreastCarcinomaHistologicTypeVS ValueSet (required) | |||
| bodySite | 0..0 | |||
 context | Reference(BC Encounter Profile) | |||
 stage | ||||
 assessment | 0..1 | Reference(BC BreastCancerStage Profile) | ||
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition | I | 0..* | BC BreastCancerPresenceStatement Profile us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. | |
 id | Σ | 0..1 | id | Logical id of this artifact |
 meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: Common Languages (extensible) | |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
 contained | 0..* | Resource | Contained, inline Resources | |
| extension | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url | |
| condition-targetBodySite | 0..* | Reference(BodySite) | Extension URL: http://hl7.org/fhir/StructureDefinition/condition-targetBodySite | |
| oncology-MorphologyBehavior-extension | 0..1 | CodeableConcept | BC MorphologyBehavior Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension | |
 id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension" | |
| valueCodeableConcept | 1..1 | CodeableConcept | Value of extension Binding: BC MorphologyBehaviorVS ValueSet (required) | |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | External Ids for this condition |
| clinicalStatus | ?!SΣI | 1..1 | code | active | recurrence | inactive | remission | resolved Binding: Condition Clinical Status Codes (required) |
| verificationStatus | ?!SΣI | 1..1 | code | provisional | differential | confirmed | refuted | entered-in-error | unknown Binding: ConditionVerificationStatus (required) |
| category | S | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: US Core Condition Category Codes (preferred) |
| code | SΣ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: BC BreastCarcinomaHistologicTypeVS ValueSet (required) |
| subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Who has the condition? |
| context | Σ | 0..1 | Reference(BC Encounter Profile) | Encounter or episode when condition first asserted |
 onset[x] | Σ | 0..1 | dateTime, Age, Period, Range, string | Estimated or actual date, date-time, or age |
| abatement[x] | I | 0..1 | dateTime, Age, boolean, Period, Range, string | If/when in resolution/remission |
| assertedDate | Σ | 0..1 | dateTime | Date record was believed accurate |
| asserter | Σ | 0..1 | Reference(Practitioner | Patient | RelatedPerson) | Person who asserts this condition |
| stage | I | 0..1 | BackboneElement | Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| summary | I | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: Condition Stage (example) |
| assessment | I | 0..1 | Reference(BC BreastCancerStage Profile) | Formal record of assessment |
| evidence | I | 0..* | BackboneElement | Supporting evidence con-2: evidence SHALL have code or details |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| code | ΣI | 0..* | CodeableConcept | Manifestation/symptom Binding: Manifestation and Symptom Codes (example) |
| detail | ΣI | 0..* | Reference(Resource) | Supporting information found elsewhere |
| note | 0..* | Annotation | Additional information about the Condition | |
| Documentation for this format | ||||
Summary
Mandatory: 0 element (1 nested mandatory element)
Prohibited: 2 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
BC Mapping Source
This structure represents the following BC mapping definition:
oncology.BreastCancerPresenceStatement maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition: PersonOfRecord maps to subject ConditionAssertionTopic.Category maps to category ConditionAssertionTopic.TopicCode maps to code constrain bodySite to 0..0 ConditionAssertionTopic.AnatomicalLocation maps to http://hl7.org/fhir/StructureDefinition/condition-targetBodySite ConditionPresenceContext.Encounter maps to context ConditionPresenceContext.ClinicalStatus maps to clinicalStatus ConditionPresenceContext.VerificationStatus maps to verificationStatus ConditionPresenceContext.Onset maps to onset[x] ConditionPresenceContext.Abatement maps to abatement[x] ConditionPresenceContext.Severity maps to severity ConditionPresenceContext.Stage maps to stage ConditionPresenceContext.Stage.CodeableConcept maps to stage.summary ConditionPresenceContext.Stage.StageDetail maps to stage.assessment
Differential View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition | BC BreastCancerPresenceStatement Profile | |||
| condition-targetBodySite | 0..* | Reference(BodySite) | Extension URL: http://hl7.org/fhir/StructureDefinition/condition-targetBodySite | |
| oncology-MorphologyBehavior-extension | 0..1 | CodeableConcept | BC MorphologyBehavior Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension | |
| valueCodeableConcept | Binding: BC MorphologyBehaviorVS ValueSet (required) | |||
| clinicalStatus | 1..1 | |||
| severity | 0..0 | |||
| code | Binding: BC BreastCarcinomaHistologicTypeVS ValueSet (required) | |||
| bodySite | 0..0 | |||
| context | Reference(BC Encounter Profile) | |||
| stage | ||||
| assessment | 0..1 | Reference(BC BreastCancerStage Profile) | ||
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition | I | 0..* | BC BreastCancerPresenceStatement Profile us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set. | |
| id | Σ | 0..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: Common Languages (extensible) | |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
| contained | 0..* | Resource | Contained, inline Resources | |
| extension | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url | |
| condition-targetBodySite | 0..* | Reference(BodySite) | Extension URL: http://hl7.org/fhir/StructureDefinition/condition-targetBodySite | |
| oncology-MorphologyBehavior-extension | 0..1 | CodeableConcept | BC MorphologyBehavior Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension" | |
| valueCodeableConcept | 1..1 | CodeableConcept | Value of extension Binding: BC MorphologyBehaviorVS ValueSet (required) | |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | External Ids for this condition |
| clinicalStatus | ?!SΣI | 1..1 | code | active | recurrence | inactive | remission | resolved Binding: Condition Clinical Status Codes (required) |
| verificationStatus | ?!SΣI | 1..1 | code | provisional | differential | confirmed | refuted | entered-in-error | unknown Binding: ConditionVerificationStatus (required) |
| category | S | 1..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: US Core Condition Category Codes (preferred) |
| code | SΣ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: BC BreastCarcinomaHistologicTypeVS ValueSet (required) |
| subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Who has the condition? |
| context | Σ | 0..1 | Reference(BC Encounter Profile) | Encounter or episode when condition first asserted |
| onset[x] | Σ | 0..1 | dateTime, Age, Period, Range, string | Estimated or actual date, date-time, or age |
| abatement[x] | I | 0..1 | dateTime, Age, boolean, Period, Range, string | If/when in resolution/remission |
| assertedDate | Σ | 0..1 | dateTime | Date record was believed accurate |
| asserter | Σ | 0..1 | Reference(Practitioner | Patient | RelatedPerson) | Person who asserts this condition |
| stage | I | 0..1 | BackboneElement | Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| summary | I | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: Condition Stage (example) |
| assessment | I | 0..1 | Reference(BC BreastCancerStage Profile) | Formal record of assessment |
| evidence | I | 0..* | BackboneElement | Supporting evidence con-2: evidence SHALL have code or details |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| code | ΣI | 0..* | CodeableConcept | Manifestation/symptom Binding: Manifestation and Symptom Codes (example) |
| detail | ΣI | 0..* | Reference(Resource) | Supporting information found elsewhere |
| note | 0..* | Annotation | Additional information about the Condition | |
| Documentation for this format | ||||
Downloads: StructureDefinition: (XML, JSON, TTL), Schema: XML Schematron
| Path | Name | Conformance | ValueSet |
| Condition.language | Common Languages | extensible | Common Languages |
| Condition.extension.valueCodeableConcept | BC MorphologyBehaviorVS ValueSet | required | MorphologyBehaviorVS |
| Condition.clinicalStatus | Condition Clinical Status Codes | required | Condition Clinical Status Codes |
| Condition.verificationStatus | ConditionVerificationStatus | required | ConditionVerificationStatus |
| Condition.category | US Core Condition Category Codes | preferred | US Core Condition Category Codes |
| Condition.code | BC BreastCarcinomaHistologicTypeVS ValueSet | required | BreastCarcinomaHistologicTypeVS |
| Condition.stage.summary | Condition Stage | example | Condition Stage |
| Condition.evidence.code | Manifestation and Symptom Codes | example | Manifestation and Symptom Codes |
| Id | Path | Details | Requirements |
| dom-2 | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-1 | Condition | If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty() | |
| dom-4 | Condition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-3 | Condition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty() | |
| con-4 | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive' | |
| con-3 | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error : verificationStatus='entered-in-error' or clinicalStatus.exists() | |
| us-core-1 | Condition | A code in Condition.category SHOULD be from US Core Condition Category Codes value set. : where(category in 'http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category').exists() | |
| ele-1 | Condition.stage | All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count()) | |
| con-1 | Condition.stage | Stage SHALL have summary or assessment : summary.exists() or assessment.exists() | |
| ele-1 | Condition.evidence | All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count()) | |
| con-2 | Condition.evidence | evidence SHALL have code or details : code.exists() or detail.exists() |