LinkId Text Cardinality Type Description & Constraints BreastQ Questionnaire https://connect.ichom.org/fhir/Questionnaire/BreastQ#0.0.1 BreastQ_Timing What is the timing of the response of this questionnaire? 1..1 choice Value Set: Timing of the response of the BreastQ BreastQ_Surgery Which type of surgery did you receive? 1..1 choice Value Set: Type of surgery for the Patient Reported Outcomes Instrument (BreastQ) Group-Mastectomy-baseline With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) BREASTQMAST_Q01 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQMAST_Q02 b. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQMAST_Q03 c. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQMAST_Q04 d. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group-BCT-Baseline-1 With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) BREASTQBCT_Q01.1 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCT_Q02.1 b. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCT_Q03.1 c. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCT_Q04.1 d. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group-BCT-Baseline-2 With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) BREASTQBCT_Q01.2 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCT_Q02.2 b. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCT_Q03.2 c. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCT_Q04.2 d. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group-Resection-Baseline-1 With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) BREASTQREC_Q01.1 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q02.1 b. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q03.1 c. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q04.1 d. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group-Resection-Baseline-2 With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) BREASTQREC_Q01.2 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q02.2 b. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q03.2 c. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q04.2 d. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group-Resection-Baseline-3 With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) BREASTQREC_Q01.3 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q02.3 b. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q03.3 c. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQREC_Q04.3 d. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing = Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group_mastectomy-posttreatment With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) BREASTQMASTP_Q01 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQMASTP_Q02 b. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQMASTP_Q03 c. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQMASTP_Q04 d. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy without immediate reconstruction (Type of surgery for BreastQ#2) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group-BCT0-posttreatment With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) BREASTQBCTP_Q01.1 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q02.1 b. The shape of your lumpectomy breast when you are wearing a bra? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q03.1 c. How normal you feel in your clothes? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q04.1 d. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q05.1 e. How your lumpectomy breast sits/hangs? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q06.1 f. How smoothly shaped your lumpectomy breast looks? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q07.1 g. The contour (outline) of your lumpectomy breast? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q08.1 h. How equal in size your breasts are to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q09.1 i. How normal your lumpectomy breast looks? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q10.1 j. How much your breast look the same? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q11.1 k. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery (Type of surgery for BreastQ#0) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group-BCT1-posttreatment With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) BREASTQBCTP_Q01.2 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q02.2 b. The shape of your lumpectomy breast when you are wearing a bra? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q03.2 c. How normal you feel in your clothes? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q04.2 d. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q05.2 e. How your lumpectomy breast sits/hangs? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q06.2 f. How smoothly shaped your lumpectomy breast looks? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q07.2 g. The contour (outline) of your lumpectomy breast? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q08.2 h. How equal in size your breasts are to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q09.2 i. How normal your lumpectomy breast looks? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q10.2 j. How much your breast look the same? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQBCTP_Q11.2 k. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Breast conserving surgery with mammoplasty (Type of surgery for BreastQ#1) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group_reconstruction3-posttreatment With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) BREASTQRECP_Q01.1 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q02.1 b. The shape of your reconstructed breast(s) when you are wearing a bra? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q03.1 c. How normal you feel in your clothes? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q04.1 d. The size of your reconstructed breast(s)? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q05.1 e. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q06.1 f. How your breasts are lined up in relation to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q07.1 g. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q08.1 h. The softness of your reconstructed breast(s)? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q09.1 i. How equal in size your breasts are to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q10.1 j. How natural your reconstructed breast(s) looks? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q11.1 k. How naturally your reconstructed breast(s) sits/hangs? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q12.1 l. How your reconstructed breast(s) feel to touch? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q13.1 m. How much your reconstructed breast(s) feels like a natural part of your body? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q14.1 n. How closely matched your breasts are to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q15.1 o. How your reconstructed breast(s) look now compared to before you had any breast surgery? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q16.1 p. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant) (Type of surgery for BreastQ#3) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group_reconstruction4-posttreatment With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) BREASTQRECP_Q01.2 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q02.2 b. The shape of your reconstructed breast(s) when you are wearing a bra? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q03.2 c. How normal you feel in your clothes? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q04.2 d. The size of your reconstructed breast(s)? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q05.2 e. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q06.2 f. How your breasts are lined up in relation to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q07.2 g. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q08.2 h. The softness of your reconstructed breast(s)? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q09.2 i. How equal in size your breasts are to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q10.2 j. How natural your reconstructed breast(s) looks? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q11.2 k. How naturally your reconstructed breast(s) sits/hangs? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q12.2 l. How your reconstructed breast(s) feel to touch? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q13.2 m. How much your reconstructed breast(s) feels like a natural part of your body? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q14.2 n. How closely matched your breasts are to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q15.2 o. How your reconstructed breast(s) look now compared to before you had any breast surgery? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q16.2 p. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (autologous) (Type of surgery for BreastQ#4) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Group_reconstruction5-posttreatment With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) BREASTQRECP_Q01.3 a. How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q02.3 b. The shape of your reconstructed breast(s) when you are wearing a bra? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q03.3 c. How normal you feel in your clothes? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q04.3 d. The size of your reconstructed breast(s)? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q05.3 e. Being able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q06.3 f. How your breasts are lined up in relation to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q07.3 g. How comfortable your bras fit? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q08.3 h. The softness of your reconstructed breast(s)? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q09.3 i. How equal in size your breasts are to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q10.3 j. How natural your reconstructed breast(s) looks? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q11.3 k. How naturally your reconstructed breast(s) sits/hangs? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q12.3 l. How your reconstructed breast(s) feel to touch? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q13.3 m. How much your reconstructed breast(s) feels like a natural part of your body? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q14.3 n. How closely matched your breasts are to each other? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q15.3 o. How your reconstructed breast(s) look now compared to before you had any breast surgery? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) BREASTQRECP_Q16.3 p. How you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Timing != Patient's first doctor's visit (baseline) (Timing of the response of the patient reported outcome measures#0) BreastQ_Surgery = Mastectomy with immediate reconstruction (direct/staged implant and autologous) (Type of surgery for BreastQ#5) Value Set: Patient Reported Outcomes Instrument response (BreastQ) Documentation for this format
BREAST-Q: Patient Reported Outcomes Instrument
What is the timing of the response of this questionnaire?
With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with:
Being able to wear clothing that is more fitted?
The shape of your lumpectomy breast when you are wearing a bra?
How smoothly shaped your lumpectomy breast looks?
The contour (outline) of your lumpectomy breast?
How equal in size your breasts are to each other?
How normal your lumpectomy breast looks?
The shape of your reconstructed breast(s) when you are wearing a bra?
The size of your reconstructed breast(s)?
How your breasts are lined up in relation to each other?
The softness of your reconstructed breast(s)?
How natural your reconstructed breast(s) looks?
How naturally your reconstructed breast(s) sits/hangs?
How your reconstructed breast(s) feel to touch?
How much your reconstructed breast(s) feels like a natural part of your body?
How closely matched your breasts are to each other?
How your reconstructed breast(s) look now compared to before you had any breast surgery?