This page is part of the ICHOM FHIR Implementation Guide: Breast Cancer (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: Cancer Stage Group ( Experimental )

A staging system to describe the amount and spread of breast cancer in a patient’s body, using TNM staging (per AJCC 8th Ed.). This profile is in alignment with the mCODE TNM Stage Group Profile.

Usage:

• Examples for this Resource Profile: Observation/ClinicalTNMStagePatient147, Observation/PathologicalTNMStagePatient147

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
code	S	1..1	CodeableConcept	Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject	S	0..1	Reference(Breast cancer patient)	Who and/or what the observation is about
Slices for hasMember	S	0..*	Reference(Observation)	Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage	S	0..1	Reference(TNM Primary Tumor Stage)	TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage	S	0..1	Reference(TNM Regional Nodal Stage)	TNM Regional Nodal Stage
hasMember:TNMDistantMetastases	S	0..1	Reference(TNM Distant Metastases)	TNM Distant Metastases
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	required	TNMStageGroupVS

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject	SΣ	0..1	Reference(Breast cancer patient)	Who and/or what the observation is about
Slices for hasMember	SΣ	0..*	Reference(Observation)	Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage	SΣ	0..1	Reference(TNM Primary Tumor Stage)	TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage	SΣ	0..1	Reference(TNM Regional Nodal Stage)	TNM Regional Nodal Stage
hasMember:TNMDistantMetastases	SΣ	0..1	Reference(TNM Distant Metastases)	TNM Distant Metastases
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.code	required	TNMStageGroupVS

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions
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: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject	SΣ	0..1	Reference(Breast cancer patient)	Who and/or what the observation is about
focus	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	ΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
Slices for hasMember	SΣ	0..*	Reference(Observation)	Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage	SΣ	0..1	Reference(TNM Primary Tumor Stage)	TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage	SΣ	0..1	Reference(TNM Regional Nodal Stage)	TNM Regional Nodal Stage
hasMember:TNMDistantMetastases	SΣ	0..1	Reference(TNM Distant Metastases)	TNM Distant Metastases
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.code	required	TNMStageGroupVS
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

This structure is derived from Observation

Summary

Must-Support: 6 elements

Structures

This structure refers to these other structures:

• Breast cancer patient (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/patient)
• TNM Primary Tumor Stage (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-primary-tumor-stage)
• TNM Regional Nodal Stage (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-regional-nodes-stage)
• TNM Distant Metastases (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-distant-metastases)

Slices

This structure defines the following Slices:

• The element Observation.hasMember is sliced based on the value of pattern:$this.resolve().code

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
code	S	1..1	CodeableConcept	Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject	S	0..1	Reference(Breast cancer patient)	Who and/or what the observation is about
Slices for hasMember	S	0..*	Reference(Observation)	Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage	S	0..1	Reference(TNM Primary Tumor Stage)	TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage	S	0..1	Reference(TNM Regional Nodal Stage)	TNM Regional Nodal Stage
hasMember:TNMDistantMetastases	S	0..1	Reference(TNM Distant Metastases)	TNM Distant Metastases
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	required	TNMStageGroupVS

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject	SΣ	0..1	Reference(Breast cancer patient)	Who and/or what the observation is about
Slices for hasMember	SΣ	0..*	Reference(Observation)	Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage	SΣ	0..1	Reference(TNM Primary Tumor Stage)	TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage	SΣ	0..1	Reference(TNM Regional Nodal Stage)	TNM Regional Nodal Stage
hasMember:TNMDistantMetastases	SΣ	0..1	Reference(TNM Distant Metastases)	TNM Distant Metastases
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.code	required	TNMStageGroupVS

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions
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: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject	SΣ	0..1	Reference(Breast cancer patient)	Who and/or what the observation is about
focus	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	ΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
Slices for hasMember	SΣ	0..*	Reference(Observation)	Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage	SΣ	0..1	Reference(TNM Primary Tumor Stage)	TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage	SΣ	0..1	Reference(TNM Regional Nodal Stage)	TNM Regional Nodal Stage
hasMember:TNMDistantMetastases	SΣ	0..1	Reference(TNM Distant Metastases)	TNM Distant Metastases
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.code	required	TNMStageGroupVS
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

This structure is derived from Observation

Summary

Must-Support: 6 elements

Structures

This structure refers to these other structures:

• Breast cancer patient (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/patient)
• TNM Primary Tumor Stage (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-primary-tumor-stage)
• TNM Regional Nodal Stage (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-regional-nodes-stage)
• TNM Distant Metastases (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-distant-metastases)

Slices

This structure defines the following Slices:

• The element Observation.hasMember is sliced based on the value of pattern:$this.resolve().code

Other representations of profile: CSV, Excel, Schematron