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

BreastCancerPresenceStatementProfile


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="oncology-BreastCancerPresenceStatement"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>BC BreastCancerPresenceStatement Profile</b></p>
  <p>Diagnosis of cancer originating in the tissues of the breast, and potentially spread to other organs of the body.</p>
  <p><b>BC Mapping Summary</b></p>
  <p><pre>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
</pre></p>
</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerPresenceStatement"/>
  <identifier>
    <system value="http://hl7.org/fhir/us/breastcancer"/>
    <value value="oncology.BreastCancerPresenceStatement"/>
  </identifier>
  <version value="0.2.0"/>
  <name value="BreastCancerPresenceStatementProfile"/>
  <title value="BC BreastCancerPresenceStatement Profile"/>
  <status value="draft"/>
  <date value="2018-08-17T00:00:00+10:00"/>
  <publisher
             value="The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cic/index.cfm"/>
    </telecom>
  </contact>
  <description
               value="Diagnosis of cancer originating in the tissues of the breast, and potentially spread to other organs of the body."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="argonaut-dq-dstu2"/>
    <uri value="http://unknown.org/Argonaut%20DQ%20DSTU2"/>
    <name value="Argonaut DQ DSTU2"/>
  </mapping>
  <mapping>
    <identity value="sct-concept"/>
    <uri value="http://snomed.info/conceptdomain"/>
    <name value="SNOMED CT Concept Domain Binding"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="sct-attr"/>
    <uri value="http://snomed.info/sct"/>
    <name value="SNOMED CT Attribute Binding"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Condition"/>
  <baseDefinition
                  value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Condition:oncology-BreastCancerPresenceStatement">
      <path value="Condition"/>
      <short value="BC BreastCancerPresenceStatement Profile"/>
      <definition
                  value="Diagnosis of cancer originating in the tissues of the breast, and potentially spread to other organs of the body."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="con-4"/>
        <severity value="error"/>
        <human
               value="If condition is abated, then clinicalStatus must be either inactive, resolved, or remission"/>
        <expression
                    value="abatement.empty() or (abatement as boolean).not()  or clinicalStatus=&#39;resolved&#39; or clinicalStatus=&#39;remission&#39; or clinicalStatus=&#39;inactive&#39;"/>
        <xpath
               value="not(f:abatementBoolean/@value=true() or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), &#39;abatement&#39;)])) or f:clinicalStatus/@value=(&#39;resolved&#39;, &#39;remission&#39;, &#39;inactive&#39;))"/>
        <source value="Condition"/>
      </constraint>
      <constraint>
        <key value="con-3"/>
        <severity value="error"/>
        <human
               value="Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error"/>
        <expression
                    value="verificationStatus=&#39;entered-in-error&#39; or clinicalStatus.exists()"/>
        <xpath
               value="f:verificationStatus/@value=&#39;entered-in-error&#39; or exists(f:clinicalStatus)"/>
        <source value="Condition"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <key value="us-core-1"/>
        <severity value="warning"/>
        <human
               value="A code in Condition.category SHOULD be from US Core Condition Category Codes value set."/>
        <expression
                    value="where(category in &#39;http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category&#39;).exists()"/>
        <xpath value="(no xpath equivalent)"/>
      </constraint>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="sct-concept"/>
        <map
             value="&lt; 243796009 |Situation with explicit context|:
246090004 |Associated finding| =
((&lt; 404684003 |Clinical finding| MINUS
&lt;&lt; 420134006 |Propensity to adverse reactions| MINUS 
&lt;&lt; 473010000 |Hypersensitivity condition| MINUS 
&lt;&lt; 79899007 |Drug interaction| MINUS
&lt;&lt; 69449002 |Drug action| MINUS 
&lt;&lt; 441742003 |Evaluation finding| MINUS 
&lt;&lt; 307824009 |Administrative status| MINUS 
&lt;&lt; 385356007 |Tumor stage finding|) OR
&lt; 272379006 |Event|)"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PPR message"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value&lt;Diagnosis]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.general"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.id">
      <path value="Condition.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.meta">
      <path value="Condition.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.implicitRules">
      <path value="Condition.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.language">
      <path value="Condition.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.text">
      <path value="Condition.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.contained">
      <path value="Condition.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.extension">
      <path value="Condition.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:breastsite">
      <path value="Condition.extension"/>
      <sliceName value="breastsite"/>
      <definition value="A body site specific to the breast structure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/condition-targetBodySite"/>
      </type>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:morphologybehavior">
      <path value="Condition.extension"/>
      <sliceName value="morphologybehavior"/>
      <definition
                  value="A description of the morphology and behavioral characteristics of the cancer."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension"/>
      </type>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:morphologybehavior.id">
      <path value="Condition.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:morphologybehavior.extension:extension">
      <path value="Condition.extension.extension"/>
      <sliceName value="extension"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:morphologybehavior.url">
      <path value="Condition.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri
                value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:morphologybehavior.valueCodeableConcept">
      <path value="Condition.extension.valueCodeableConcept"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-MorphologyBehaviorVS"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.modifierExtension">
      <path value="Condition.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.identifier">
      <path value="Condition.identifier"/>
      <short value="External Ids for this condition"/>
      <definition
                  value="This records identifiers associated with this condition that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation)."/>
      <requirements value="Need to allow connection to a wider workflow."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.clinicalStatus">
      <path value="Condition.clinicalStatus"/>
      <short value="active | recurrence | inactive | remission | resolved"/>
      <definition value="The clinical status of the condition."/>
      <comment
               value="This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.clinicalStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <condition value="con-3"/>
      <condition value="con-4"/>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-clinical"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 303105007 |Disease phases|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-14 / DG1-6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Observation ACT
.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=&quot;clinicalStatus&quot;, moodCode=EVN].value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.clinicalStatus"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.verificationStatus">
      <path value="Condition.verificationStatus"/>
      <short
             value="provisional | differential | confirmed | refuted | entered-in-error | unknown"/>
      <definition
                  value="The verification status to support the clinical status of the condition."/>
      <comment
               value="verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.

This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.verificationStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="unknown"/>
      <condition value="con-3"/>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-ver-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 410514004 |Finding context value|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-13"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Observation ACT
.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=&quot;verificationStatus&quot;, moodCode=EVN].value"/>
      </mapping>
      <mapping>
        <identity value="sct-attr"/>
        <map value="408729009"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.verificationStatus"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.category">
      <path value="Condition.category"/>
      <short value="problem-list-item | encounter-diagnosis"/>
      <definition value="A category assigned to the condition."/>
      <comment
               value="The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Condition.category"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <strength value="preferred"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 404684003 |Clinical finding|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="&#39;problem&#39; if from PRB-3. &#39;diagnosis&#39; if from DG1 segment in PV1 message"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.category"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.severity">
      <path value="Condition.severity"/>
      <short value="Subjective severity of condition"/>
      <definition
                  value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
      <comment
               value="Coding of the severity with a terminology is preferred, where possible."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Condition.severity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConditionSeverity"/>
        </extension>
        <strength value="required"/>
        <description
                     value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-severity"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 272141005 |Severities|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-26 / ABS-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Can be pre/post-coordinated into value.  Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;severity&quot;].value"/>
      </mapping>
      <mapping>
        <identity value="sct-attr"/>
        <map value="246112005"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="grade"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.code">
      <path value="Condition.code"/>
      <short value="Identification of the condition, problem or diagnosis"/>
      <definition value="Identification of the condition, problem or diagnosis."/>
      <requirements
                    value="0..1 to account for primarily narrative only resources."/>
      <alias value="type"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastCarcinomaHistologicTypeVS"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map
             value="code 246090004 |Associated finding| (&lt; 404684003 |Clinical finding| MINUS
&lt;&lt; 420134006 |Propensity to adverse reactions| MINUS 
&lt;&lt; 473010000 |Hypersensitivity condition| MINUS 
&lt;&lt; 79899007 |Drug interaction| MINUS
&lt;&lt; 69449002 |Drug action| MINUS 
&lt;&lt; 441742003 |Evaluation finding| MINUS 
&lt;&lt; 307824009 |Administrative status| MINUS 
&lt;&lt; 385356007 |Tumor stage finding|) 
OR &lt; 413350009 |Finding with explicit context|
OR &lt; 272379006 |Event|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
      <mapping>
        <identity value="sct-attr"/>
        <map value="246090004"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.code"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.bodySite">
      <path value="Condition.bodySite"/>
      <short value="Anatomical location, if relevant"/>
      <definition
                  value="The anatomical location where this condition manifests itself."/>
      <comment
               value="Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Condition.bodySite"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing anatomical locations. May include laterality."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/body-site"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 442083009  |Anatomical or acquired body structure|"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".targetBodySiteCode"/>
      </mapping>
      <mapping>
        <identity value="sct-attr"/>
        <map value="363698007"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.subject">
      <path value="Condition.subject"/>
      <short value="Who has the condition?"/>
      <definition
                  value="Indicates the patient or group who the condition record is associated with."/>
      <requirements
                    value="Group is typically used for veterinary or public health use cases."/>
      <alias value="patient"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.patient"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.context">
      <path value="Condition.context"/>
      <short value="Encounter or episode when condition first asserted"/>
      <definition
                  value="Encounter during which the condition was first asserted."/>
      <comment
               value="This record indicates the encounter this particular record is associated with.  In the case of a &quot;new&quot; diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first &quot;known&quot;."/>
      <alias value="encounter"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.context"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-encounter-Encounter"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19 (+PV1-54)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.onset[x]">
      <path value="Condition.onset[x]"/>
      <short value="Estimated or actual date,  date-time, or age"/>
      <definition
                  value="Estimated or actual date or date-time  the condition began, in the opinion of the clinician."/>
      <comment
               value="Age is generally used when the patient reports an age at which the Condition began to occur."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.onset[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-16"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;age at onset&quot;].value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.init"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.abatement[x]">
      <path value="Condition.abatement[x]"/>
      <short value="If/when in resolution/remission"/>
      <definition
                  value="The date or estimated date that the condition resolved or went into remission. This is called &quot;abatement&quot; because of the many overloaded connotations associated with &quot;remission&quot; or &quot;resolution&quot; - Conditions are never really resolved, but they can abate."/>
      <comment
               value="There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.abatement[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <condition value="con-4"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;age at remission&quot;].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.done"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.assertedDate">
      <path value="Condition.assertedDate"/>
      <short value="Date record was believed accurate"/>
      <definition
                  value="The date on which the existance of the Condition was first asserted or acknowledged."/>
      <comment
               value="The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.assertedDate"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="REL-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.asserter">
      <path value="Condition.asserter"/>
      <short value="Person who asserts this condition"/>
      <definition value="Individual who is making the condition statement."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.asserter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="REL-7.1 identifier + REL-7.12 type code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.author"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.stage">
      <path value="Condition.stage"/>
      <short value="Stage/grade, usually assessed formally"/>
      <definition
                  value="Clinical stage or grade of a condition. May include formal severity assessments."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="con-1"/>
        <severity value="error"/>
        <human value="Stage SHALL have summary or assessment"/>
        <expression value="summary.exists() or assessment.exists()"/>
        <xpath value="exists(f:summary) or exists(f:assessment)"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map
             value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;stage/grade&quot;]"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.stage.id">
      <path value="Condition.stage.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.stage.extension">
      <path value="Condition.stage.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.stage.modifierExtension">
      <path value="Condition.stage.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.stage.summary">
      <path value="Condition.stage.summary"/>
      <short value="Simple summary (disease specific)"/>
      <definition
                  value="A simple summary of the stage such as &quot;Stage 3&quot;. The determination of the stage is disease-specific."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage.summary"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-1"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConditionStage"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing condition stages (e.g. Cancer stages)."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-stage"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 254291000 |Staging and scales|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.stage.assessment">
      <path value="Condition.stage.assessment"/>
      <short value="Formal record of assessment"/>
      <definition
                  value="Reference to a formal record of the evidence on which the staging assessment is based."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage.assessment"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerStage"/>
      </type>
      <condition value="con-1"/>
      <mapping>
        <identity value="rim"/>
        <map value=".self"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.evidence">
      <path value="Condition.evidence"/>
      <short value="Supporting evidence"/>
      <definition
                  value="Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed."/>
      <comment
               value="The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="con-2"/>
        <severity value="error"/>
        <human value="evidence SHALL have code or details"/>
        <expression value="code.exists() or detail.exists()"/>
        <xpath value="exists(f:code) or exists(f:detail)"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.evidence.id">
      <path value="Condition.evidence.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.evidence.extension">
      <path value="Condition.evidence.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.evidence.modifierExtension">
      <path value="Condition.evidence.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.evidence.code">
      <path value="Condition.evidence.code"/>
      <short value="Manifestation/symptom"/>
      <definition
                  value="A manifestation or symptom that led to the recording of this condition."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence.code"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-2"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ManifestationOrSymptom"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes that describe the manifestation or symptoms of a condition."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/manifestation-or-symptom"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 404684003 |Clinical finding|"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="[code=&quot;diagnosis&quot;].value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="why"/>
      </mapping>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.evidence.detail">
      <path value="Condition.evidence.detail"/>
      <short value="Supporting information found elsewhere"/>
      <definition
                  value="Links to other relevant information, including pathology reports."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence.detail"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <condition value="con-2"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".self"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="why"/>
      </mapping>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.note">
      <path value="Condition.note"/>
      <short value="Additional information about the Condition"/>
      <definition
                  value="Additional information about the Condition. This is a general notes/comments entry  for description of the Condition, its diagnosis and prognosis."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="NTE child of PRB"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Condition:oncology-BreastCancerPresenceStatement">
      <path value="Condition"/>
      <short value="BC BreastCancerPresenceStatement Profile"/>
      <definition
                  value="Diagnosis of cancer originating in the tissues of the breast, and potentially spread to other organs of the body."/>
      <mustSupport value="false"/>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:breastsite">
      <path value="Condition.extension"/>
      <sliceName value="breastsite"/>
      <definition value="A body site specific to the breast structure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/condition-targetBodySite"/>
      </type>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:morphologybehavior">
      <path value="Condition.extension"/>
      <sliceName value="morphologybehavior"/>
      <definition
                  value="A description of the morphology and behavioral characteristics of the cancer."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension"/>
      </type>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.extension:morphologybehavior.valueCodeableConcept">
      <path value="Condition.extension.valueCodeableConcept"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-MorphologyBehaviorVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.clinicalStatus">
      <path value="Condition.clinicalStatus"/>
      <min value="1"/>
      <max value="1"/>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.severity">
      <path value="Condition.severity"/>
      <min value="0"/>
      <max value="0"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConditionSeverity"/>
        </extension>
        <strength value="required"/>
        <description
                     value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-severity"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.code">
      <path value="Condition.code"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastCarcinomaHistologicTypeVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.bodySite">
      <path value="Condition.bodySite"/>
      <min value="0"/>
      <max value="0"/>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.context">
      <path value="Condition.context"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-encounter-Encounter"/>
      </type>
    </element>
    <element id="Condition:oncology-BreastCancerPresenceStatement.stage">
      <path value="Condition.stage"/>
    </element>
    <element
             id="Condition:oncology-BreastCancerPresenceStatement.stage.assessment">
      <path value="Condition.stage.assessment"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerStage"/>
      </type>
    </element>
  </differential>
</StructureDefinition>