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 
{
"resourceType" : "StructureDefinition",
"id" : "oncology-BreastSite",
"text" : {
"status" : "generated",
"div" : "<div xmlns="http://www.w3.org/1999/xhtml">
<p><b>BC BreastSite Profile</b></p>
<p>A body site specific to the breast structure.</p>
<p><b>BC Mapping Summary</b></p>
<p><pre>oncology.BreastSite maps to BodySite:
CodeableConcept maps to code
Laterality maps to qualifier (slice on = coding.code)
AnatomicalDirection maps to qualifier
</pre></p>
</div>"
},
"url" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSite",
"identifier" : [
{
"system" : "http://hl7.org/fhir/us/breastcancer",
"value" : "oncology.BreastSite"
}
],
"version" : "0.2.0",
"name" : "BreastSiteProfile",
"title" : "BC BreastSite Profile",
"status" : "draft",
"date" : "2018-08-17T00:00:00+10:00",
"publisher" : "The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC)",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/cic/index.cfm"
}
]
}
],
"description" : "A body site specific to the breast structure.",
"fhirVersion" : "3.0.1",
"mapping" : [
{
"identity" : "rim",
"uri" : "http://hl7.org/v3",
"name" : "RIM Mapping"
},
{
"identity" : "openehr",
"uri" : "http://openehr.org",
"name" : "Open EHR Archetype Mapping"
},
{
"identity" : "w5",
"uri" : "http://hl7.org/fhir/w5",
"name" : "W5 Mapping"
},
{
"identity" : "v2",
"uri" : "http://hl7.org/v2",
"name" : "HL7 v2 Mapping"
}
],
"kind" : "resource",
"abstract" : false,
"type" : "BodySite",
"baseDefinition" : "http://hl7.org/fhir/StructureDefinition/BodySite",
"derivation" : "constraint",
"snapshot" : {
"element" : [
{
"id" : "BodySite:oncology-BreastSite",
"path" : "BodySite",
"short" : "BC BreastSite Profile",
"definition" : "A body site specific to the breast structure.",
"alias" : [
"anatomical location"
],
"min" : 0,
"max" : "*",
"constraint" : [
{
"key" : "dom-2",
"severity" : "error",
"human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression" : "contained.contained.empty()",
"xpath" : "not(parent::f:contained and f:contained)",
"source" : "DomainResource"
},
{
"key" : "dom-1",
"severity" : "error",
"human" : "If the resource is contained in another resource, it SHALL NOT contain any narrative",
"expression" : "contained.text.empty()",
"xpath" : "not(parent::f:contained and f:text)",
"source" : "DomainResource"
},
{
"key" : "dom-4",
"severity" : "error",
"human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source" : "DomainResource"
},
{
"key" : "dom-3",
"severity" : "error",
"human" : "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
"expression" : "contained.where(('#'+id in %resource.descendants().reference).not()).empty()",
"xpath" : "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
"source" : "DomainResource"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "Entity. Role, or Act"
},
{
"identity" : "rim",
"map" : "ActSIte"
},
{
"identity" : "openehr",
"map" : "Archetype ID openEHR-EHR-CLUSTER.anatomical_location.v1 Concept name Anatomical Location Concept description Record details about an anatomical location. Keywords location, site, anatomical Copyright © openEHR Foundation Purpose To record details about anatomical location. Misuse Not for specifiying unilateral/bilateral occurrence - this is related to an evaluation which perhaps includes multiple locations. Author Author name: Heather Leslie Organization: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10 Translator Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh Other contributors Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK References Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail."
},
{
"identity" : "w5",
"map" : "clinical.diagnostics"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.id",
"path" : "BodySite.id",
"short" : "Logical id of this artifact",
"definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment" : "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" : 0,
"max" : "1",
"base" : {
"path" : "Resource.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "id"
}
],
"isSummary" : true
},
{
"id" : "BodySite:oncology-BreastSite.meta",
"path" : "BodySite.meta",
"short" : "Metadata about the resource",
"definition" : "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" : 0,
"max" : "1",
"base" : {
"path" : "Resource.meta",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Meta"
}
],
"isSummary" : true
},
{
"id" : "BodySite:oncology-BreastSite.implicitRules",
"path" : "BodySite.implicitRules",
"short" : "A set of rules under which this content was created",
"definition" : "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" : "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's meaning or interpretation.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.implicitRules",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "uri"
}
],
"isModifier" : true,
"isSummary" : true
},
{
"id" : "BodySite:oncology-BreastSite.language",
"path" : "BodySite.language",
"short" : "Language of the resource content",
"definition" : "The base language in which the resource is written.",
"comment" : "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" : 0,
"max" : "1",
"base" : {
"path" : "Resource.language",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "code"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference" : {
"reference" : "http://hl7.org/fhir/ValueSet/all-languages"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "Language"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean" : true
}
],
"strength" : "extensible",
"description" : "A human language.",
"valueSetReference" : {
"reference" : "http://hl7.org/fhir/ValueSet/languages"
}
}
},
{
"id" : "BodySite:oncology-BreastSite.text",
"path" : "BodySite.text",
"short" : "Text summary of the resource, for human interpretation",
"definition" : "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 "clinically safe" 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" : "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 "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.",
"alias" : [
"narrative",
"html",
"xhtml",
"display"
],
"min" : 0,
"max" : "1",
"base" : {
"path" : "DomainResource.text",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Narrative"
}
],
"condition" : [
"dom-1"
],
"mapping" : [
{
"identity" : "rim",
"map" : "Act.text?"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.contained",
"path" : "BodySite.contained",
"short" : "Contained, inline Resources",
"definition" : "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" : "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" : [
"inline resources",
"anonymous resources",
"contained resources"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.contained",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Resource"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.extension",
"path" : "BodySite.extension",
"slicing" : {
"id" : "2",
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"ordered" : false,
"rules" : "open"
},
"short" : "Additional Content defined by implementations",
"definition" : "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" : "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" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.extension:clockdirection",
"path" : "BodySite.extension",
"sliceName" : "clockdirection",
"definition" : "A direction indicated by an angle relative to 12 o'clock.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-ClockDirection-extension"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.extension:distancefrombreastsitetonipple",
"path" : "BodySite.extension",
"sliceName" : "distancefrombreastsitetonipple",
"definition" : "Distance between the feature of interest (e.g., the tumor) and the nipple.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-DistanceFromBreastSiteToNipple-extension"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.modifierExtension",
"path" : "BodySite.modifierExtension",
"short" : "Extensions that cannot be ignored",
"definition" : "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" : "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" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"isModifier" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.identifier",
"path" : "BodySite.identifier",
"short" : "Bodysite identifier",
"definition" : "Identifier for this instance of the anatomical location.",
"min" : 0,
"max" : "*",
"type" : [
{
"code" : "Identifier"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : ".id"
},
{
"identity" : "openehr",
"map" : "Specific location Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)"
},
{
"identity" : "w5",
"map" : "id"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.active",
"path" : "BodySite.active",
"short" : "Whether this body site record is in active use",
"definition" : "Whether this body site is in active use.",
"comment" : "This element is labeled as a modifier because it may be used to mark that the resource was created in error.",
"requirements" : "Need to be able to mark a body site entry as not to be used because it was created in error.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
],
"defaultValueBoolean" : true,
"isModifier" : true,
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "statusCode"
},
{
"identity" : "w5",
"map" : "status"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.code",
"path" : "BodySite.code",
"short" : "Named anatomical location",
"definition" : "Code representing a body site specific to the breast structure.",
"min" : 1,
"max" : "1",
"type" : [
{
"code" : "CodeableConcept"
}
],
"isSummary" : true,
"binding" : {
"strength" : "required",
"valueSetReference" : {
"reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSiteVS"
}
},
"mapping" : [
{
"identity" : "v2",
"map" : "OBX-20"
},
{
"identity" : "rim",
"map" : ".targetSiteCode"
},
{
"identity" : "openehr",
"map" : "Name of location"
},
{
"identity" : "w5",
"map" : "what"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.qualifier",
"path" : "BodySite.qualifier",
"slicing" : {
"id" : "1",
"discriminator" : [
{
"type" : "value",
"path" : "coding.code"
}
],
"ordered" : false,
"rules" : "open"
},
"short" : "Modification to location code",
"definition" : "Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.",
"min" : 0,
"max" : "*",
"type" : [
{
"code" : "CodeableConcept"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "BodySiteQualifier"
}
],
"strength" : "example",
"description" : "Concepts modifying the anatomic location",
"valueSetReference" : {
"reference" : "http://hl7.org/fhir/ValueSet/bodysite-relative-location"
}
},
"mapping" : [
{
"identity" : "v2",
"map" : "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
},
{
"identity" : "rim",
"map" : ".targetSiteCode"
},
{
"identity" : "openehr",
"map" : "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
},
{
"identity" : "w5",
"map" : "what"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.qualifier:cimi-element-Laterality",
"path" : "BodySite.qualifier",
"sliceName" : "cimi-element-Laterality",
"short" : "Laterality",
"definition" : "Anatomical location or specimen further detailing the side(s) of interest.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "CodeableConcept"
}
],
"binding" : {
"strength" : "required",
"valueSetReference" : {
"reference" : "http://hl7.org/fhir/ValueSet/bodysite-laterality"
}
},
"mapping" : [
{
"identity" : "v2",
"map" : "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
},
{
"identity" : "rim",
"map" : ".targetSiteCode"
},
{
"identity" : "openehr",
"map" : "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
},
{
"identity" : "w5",
"map" : "what"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.qualifier:cimi-element-AnatomicalDirection",
"path" : "BodySite.qualifier",
"sliceName" : "cimi-element-AnatomicalDirection",
"short" : "AnatomicalDirection",
"definition" : "Anatomical location or specimen further detailing directionality.",
"min" : 0,
"max" : "0",
"type" : [
{
"code" : "CodeableConcept"
}
],
"binding" : {
"strength" : "required",
"valueSetReference" : {
"reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/cimi-element-AnatomicalDirectionVS"
}
},
"mapping" : [
{
"identity" : "v2",
"map" : "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
},
{
"identity" : "rim",
"map" : ".targetSiteCode"
},
{
"identity" : "openehr",
"map" : "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
},
{
"identity" : "w5",
"map" : "what"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.description",
"path" : "BodySite.description",
"short" : "Anatomical location description",
"definition" : "A summary, charactarization or explanation of the anatomic location.",
"comment" : "This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "string"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : ".text"
},
{
"identity" : "openehr",
"map" : "Description of anatomical location/Visual markings/orientation"
},
{
"identity" : "w5",
"map" : "what"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.image",
"path" : "BodySite.image",
"short" : "Attached images",
"definition" : "Image or images used to identify a location.",
"min" : 0,
"max" : "*",
"type" : [
{
"code" : "Attachment"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "outboundRelationship[typeCode=COMP].target"
},
{
"identity" : "openehr",
"map" : "Image"
},
{
"identity" : "w5",
"map" : "what"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.patient",
"path" : "BodySite.patient",
"short" : "Who this is about",
"definition" : "The person to which the body site belongs.",
"min" : 1,
"max" : "1",
"type" : [
{
"code" : "Reference",
"targetProfile" : "http://hl7.org/fhir/StructureDefinition/Patient"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : ".scoper or .scoper.playsRole"
},
{
"identity" : "w5",
"map" : "who.focus"
}
]
}
]
},
"differential" : {
"element" : [
{
"id" : "BodySite:oncology-BreastSite",
"path" : "BodySite",
"short" : "BC BreastSite Profile",
"definition" : "A body site specific to the breast structure."
},
{
"id" : "BodySite:oncology-BreastSite.extension:clockdirection",
"path" : "BodySite.extension",
"sliceName" : "clockdirection",
"definition" : "A direction indicated by an angle relative to 12 o'clock.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-ClockDirection-extension"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.extension:distancefrombreastsitetonipple",
"path" : "BodySite.extension",
"sliceName" : "distancefrombreastsitetonipple",
"definition" : "Distance between the feature of interest (e.g., the tumor) and the nipple.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : "http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-DistanceFromBreastSiteToNipple-extension"
}
]
},
{
"id" : "BodySite:oncology-BreastSite.code",
"path" : "BodySite.code",
"definition" : "Code representing a body site specific to the breast structure.",
"min" : 1,
"max" : "1",
"binding" : {
"strength" : "required",
"valueSetReference" : {
"reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastSiteVS"
}
}
},
{
"id" : "BodySite:oncology-BreastSite.qualifier",
"path" : "BodySite.qualifier",
"slicing" : {
"id" : "1",
"discriminator" : [
{
"type" : "value",
"path" : "coding.code"
}
],
"ordered" : false,
"rules" : "open"
}
},
{
"id" : "BodySite:oncology-BreastSite.qualifier:cimi-element-Laterality",
"path" : "BodySite.qualifier",
"sliceName" : "cimi-element-Laterality",
"short" : "Laterality",
"definition" : "Anatomical location or specimen further detailing the side(s) of interest.",
"min" : 0,
"max" : "1",
"binding" : {
"strength" : "required",
"valueSetReference" : {
"reference" : "http://hl7.org/fhir/ValueSet/bodysite-laterality"
}
}
},
{
"id" : "BodySite:oncology-BreastSite.qualifier:cimi-element-AnatomicalDirection",
"path" : "BodySite.qualifier",
"sliceName" : "cimi-element-AnatomicalDirection",
"short" : "AnatomicalDirection",
"definition" : "Anatomical location or specimen further detailing directionality.",
"min" : 0,
"max" : "0",
"binding" : {
"strength" : "required",
"valueSetReference" : {
"reference" : "http://hl7.org/fhir/us/breastcancer/ValueSet/cimi-element-AnatomicalDirectionVS"
}
}
}
]
}
}