bcr-breast-tumour-supplement
type: StructureDefinition
node role: treeRoot
id:
  v: bcr-breast-tumour-supplement
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition bcr-breast-tumour-supplement Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> <a href="StructureDefinition-bcr-breast-tumour-supplement-definitions.html#bcr-breast-tumour-supplement" title="Logical model of the breast-tumour-specific supplement to the standard cancer#xA;registration form (Bijlage 55, *vervolg 1*). Contains menopausal status,#xA;molecular markers (with separate values for tumour 1 and, when multifocal,#xA;tumour 2), and surgical / lymph node data.#xA;#xA;Source: Bijlage 55 (vervolg 1) of the RIZIV Verordening of 28 July 2003,#xA;amended 15 December 2025.">bcr-breast-tumour-supplement 0..* Base BCR Breast Tumour Supplement — Bijlage 55 vervolg 1 (Logical Model) #xD; menopausalStatus 0..1 code Menopausal status at diagnosis Binding: BCR Menopausal Status (required) #xD; molecularMarker 0..* BackboneElement Molecular marker result #xD; <a href="StructureDefinition-bcr-breast-tumour-supplement-definitions.html#bcr-breast-tumour-supplement.molecularMarker.marker" title="Molecular marker. Form-listed markers:#xA;ER (oestrogen receptor), PR (progesterone receptor),#xA;HER2-IHC (HER2 IHC score), HER2-IHC-ISH (combined HER2 status),#xA;BRCA1-2, CHEK2, PALB2, ATM, PIK3CA (PIKCA3 on the form),#xA;KI67 (Ki-67 before systemic therapy), OTHER (free-text marker name).">marker 1..1 code Marker Binding: BCR Molecular Marker (required) #xD; otherMarkerName 0..1 string Other marker name #xD; tumourIndex 1..1 unsignedInt Tumour index #xD; testDate 0..1 date Test date #xD; <a href="StructureDefinition-bcr-breast-tumour-supplement-definitions.html#bcr-breast-tumour-supplement.molecularMarker.result" title="Result of the marker. Permitted codings depend on the marker:#xA;- ER, PR: positief / gering positief / negatief.#xA;- HER2-IHC: 0 / 1+ / 2+ / 3+.#xA;- HER2-IHC-ISH: positief / HER2 low (provisional) / negatief.#xA;- BRCA1-2, CHEK2, PALB2, ATM, PIK3CA: niet getest /…
url:
  v: https://www.ehealth.fgov.be/standards/fhir/registries/bcr/StructureDefinition/bcr-breast-tumour-supplement
  l: bcr-breast-tumour-supplement
version:
  v: 0.1.0
name:
  v: BCRBreastTumourSupplement
title:
  v: BCR Breast Tumour Supplement — Bijlage 55 vervolg 1 (Logical Model)
status:
  v: draft
experimental:
  v: true
date:
  v: 2026-05-04T06:30:16+00:00
publisher:
  v: eHealth Platform Belgium
contact:
  name:
    v: eHealth Platform Belgium
  telecom:
    system:
      v: url
    value:
      v: https://www.ehealth.fgov.be
  telecom:
    system:
      v: email
description:
  v: Logical model of the breast-tumour-specific supplement to the standard cancer registration form (Bijlage 55, *vervolg 1*). Contains menopausal status, molecular markers (with separate values for tumour 1 and, when multifocal, tumour 2), and surgical / lymph node data. Source: Bijlage 55 (vervolg 1) of the RIZIV Verordening of 28 July 2003, amended 15 December 2025.
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
      l: 3166
    code:
      v: BE
    display:
      v: Belgium
fhir version:
  v: 4.0.1
kind:
  v: logical
abstract:
  v: false
type:
  v: https://www.ehealth.fgov.be/standards/fhir/registries/bcr/StructureDefinition/bcr-breast-tumour-supplement
  l: bcr-breast-tumour-supplement
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Base
  l: Base
derivation:
  v: specialization
snapshot:
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    url:
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      l: snapshot-base-version
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      v: 4.0.1
  element:
    id:
      v: bcr-breast-tumour-supplement
    path:
      v: bcr-breast-tumour-supplement
    short:
      v: BCR Breast Tumour Supplement — Bijlage 55 vervolg 1 (Logical Model)
    definition:
      v: Logical model of the breast-tumour-specific supplement to the standard cancer registration form (Bijlage 55, *vervolg 1*). Contains menopausal status, molecular markers (with separate values for tumour 1 and, when multifocal, tumour 2), and surgical / lymph node data. Source: Bijlage 55 (vervolg 1) of the RIZIV Verordening of 28 July 2003, amended 15 December 2025.
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    id:
      v: bcr-breast-tumour-supplement.menopausalStatus
    path:
      v: bcr-breast-tumour-supplement.menopausalStatus
    short:
      v: Menopausal status at diagnosis
    definition:
      v: Menopausal status. Codes: ja / nee / onduidelijk / niet gekend / niet van toepassing (mannelijke patiënt).
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        l: code
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      value set:
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        l: bcr-menopausal-status-vs
  element:
    id:
      v: bcr-breast-tumour-supplement.molecularMarker
    path:
      v: bcr-breast-tumour-supplement.molecularMarker
    short:
      v: Molecular marker result
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Url
v: string
l: string

v: value

v: url

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v: 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.

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id:
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definition:
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comment:
  v: 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.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
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id:
  v: bcr-breast-tumour-supplement.molecularMarker.marker
path:
  v: bcr-breast-tumour-supplement.molecularMarker.marker
short:
  v: Marker
definition:
  v: Molecular marker. Form-listed markers: ER (oestrogen receptor), PR (progesterone receptor), HER2-IHC (HER2 IHC score), HER2-IHC-ISH (combined HER2 status), BRCA1-2, CHEK2, PALB2, ATM, PIK3CA (PIKCA3 on the form), KI67 (Ki-67 before systemic therapy), OTHER (free-text marker name).
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type:
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    l: code
binding:
  strength:
    v: required
  value set:
    v: https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-molecular-marker-vs
    l: bcr-molecular-marker-vs

id:
  v: bcr-breast-tumour-supplement.molecularMarker.otherMarkerName
path:
  v: bcr-breast-tumour-supplement.molecularMarker.otherMarkerName
short:
  v: Other marker name
definition:
  v: Free-text marker name when `marker = OTHER`.
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id:
  v: bcr-breast-tumour-supplement.molecularMarker.tumourIndex
path:
  v: bcr-breast-tumour-supplement.molecularMarker.tumourIndex
short:
  v: Tumour index
definition:
  v: Tumour to which the result applies: 1 (primary tumour) or 2 (second tumour, only in multifocal disease).
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type:
  code:
    v: unsignedInt
    l: unsignedInt

id:
  v: bcr-breast-tumour-supplement.molecularMarker.testDate
path:
  v: bcr-breast-tumour-supplement.molecularMarker.testDate
short:
  v: Test date
definition:
  v: Date the marker was measured.
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id:
  v: bcr-breast-tumour-supplement.molecularMarker.result
path:
  v: bcr-breast-tumour-supplement.molecularMarker.result
short:
  v: Result
definition:
  v: Result of the marker. Permitted codings depend on the marker: - ER, PR: positief / gering positief / negatief. - HER2-IHC: 0 / 1+ / 2+ / 3+. - HER2-IHC-ISH: positief / HER2 low (provisional) / negatief. - BRCA1-2, CHEK2, PALB2, ATM, PIK3CA: niet getest / geen mutatie / somatische mutatie / kiembaanmutatie. - KI67: see `resultPercentage` (or `niet getest`).
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  strength:
    v: extensible
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    l: bcr-molecular-marker-result-vs

id:
  v: bcr-breast-tumour-supplement.molecularMarker.resultPercentage
path:
  v: bcr-breast-tumour-supplement.molecularMarker.resultPercentage
short:
  v: Result percentage
definition:
  v: Numeric percentage result. Used for Ki-67 (`marker = KI67`).
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type:
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    l: decimal

id:
  v: bcr-breast-tumour-supplement.surgeryPerformed
path:
  v: bcr-breast-tumour-supplement.surgeryPerformed
short:
  v: Surgery performed
definition:
  v: Indicates whether section 3 (surgical data) is in scope. When false or absent, the surgery fields below are not applicable.
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type:
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    l: boolean

id:
  v: bcr-breast-tumour-supplement.maxPathDiameterInvasiveMm
path:
  v: bcr-breast-tumour-supplement.maxPathDiameterInvasiveMm
short:
  v: Max pathological diameter, invasive component, before systemic therapy (mm)
definition:
  v: Maximale pathologische doormeter invasieve component vóór systemische therapie.
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id:
  v: bcr-breast-tumour-supplement.maxPathDiameterInSituMm
path:
  v: bcr-breast-tumour-supplement.maxPathDiameterInSituMm
short:
  v: Max pathological diameter, in situ component, before systemic therapy (mm)
definition:
  v: Maximale pathologische doormeter in situ component vóór systemische therapie.
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type:
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id:
  v: bcr-breast-tumour-supplement.minMarginDistanceInvasiveMm
path:
  v: bcr-breast-tumour-supplement.minMarginDistanceInvasiveMm
short:
  v: Min distance, invasive component to surgical margin (mm)
definition:
  v: Minimale afstand van de invasieve component tot de snijrand.
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id:
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short:
  v: Min distance, in situ component to surgical margin (mm)
definition:
  v: Minimale afstand van de in situ component tot snijrand.
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id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment
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  v: bcr-breast-tumour-supplement.lymphNodeAssessment
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  v: Lymph node assessment
definition:
  v: One row of the sentinel / axillary / other-nodes table.
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definition:
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comment:
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short:
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definition:
  v: 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: 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.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
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  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.location
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.location
short:
  v: Node location
definition:
  v: Lymph node group. Codes: SENTINEL (Sentinelklieren), AXILLARY (Axillaire klieren), OTHER (Andere klieren).
min:
  v: 1
max:
  v: 1
base:
  path:
    v: bcr-breast-tumour-supplement.lymphNodeAssessment.location
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
binding:
  strength:
    v: required
  value set:
    v: https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-lymph-node-location-vs
    l: bcr-lymph-node-location-vs

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.examined
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.examined
short:
  v: Number examined
definition:
  v: Aantal onderzocht.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: bcr-breast-tumour-supplement.lymphNodeAssessment.examined
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: unsignedInt
    l: unsignedInt

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.positive
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.positive
short:
  v: Number positive
definition:
  v: Aantal positief.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: bcr-breast-tumour-supplement.lymphNodeAssessment.positive
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: unsignedInt
    l: unsignedInt

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.assessmentDate
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.assessmentDate
short:
  v: Assessment date
definition:
  v: Date of the lymph node assessment.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: bcr-breast-tumour-supplement.lymphNodeAssessment.assessmentDate
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date

element:
  id:
    v: bcr-breast-tumour-supplement
  path:
    v: bcr-breast-tumour-supplement
  short:
    v: BCR Breast Tumour Supplement — Bijlage 55 vervolg 1 (Logical Model)
  definition:
    v: Logical model of the breast-tumour-specific supplement to the standard cancer registration form (Bijlage 55, *vervolg 1*). Contains menopausal status, molecular markers (with separate values for tumour 1 and, when multifocal, tumour 2), and surgical / lymph node data. Source: Bijlage 55 (vervolg 1) of the RIZIV Verordening of 28 July 2003, amended 15 December 2025.
element:
  id:
    v: bcr-breast-tumour-supplement.menopausalStatus
  path:
    v: bcr-breast-tumour-supplement.menopausalStatus
  short:
    v: Menopausal status at diagnosis
  definition:
    v: Menopausal status. Codes: ja / nee / onduidelijk / niet gekend / niet van toepassing (mannelijke patiënt).
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: code
      l: code
  binding:
    strength:
      v: required
    value set:
      v: https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-menopausal-status-vs
      l: bcr-menopausal-status-vs
element:
  id:
    v: bcr-breast-tumour-supplement.molecularMarker
  path:
    v: bcr-breast-tumour-supplement.molecularMarker
  short:
    v: Molecular marker result
  definition:
    v: One molecular-marker measurement on tumour 1, or on tumour 2 in the case of multifocal disease.
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: BackboneElement
      l: BackboneElement
element:
  id:
    v: bcr-breast-tumour-supplement.molecularMarker.marker
  path:
    v: bcr-breast-tumour-supplement.molecularMarker.marker
  short:
    v: Marker
  definition:
    v: Molecular marker. Form-listed markers: ER (oestrogen receptor), PR (progesterone receptor), HER2-IHC (HER2 IHC score), HER2-IHC-ISH (combined HER2 status), BRCA1-2, CHEK2, PALB2, ATM, PIK3CA (PIKCA3 on the form), KI67 (Ki-67 before systemic therapy), OTHER (free-text marker name).
  min:
    v: 1
  max:
    v: 1
  type:
    code:
      v: code
      l: code
  binding:
    strength:
      v: required
    value set:
      v: https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-molecular-marker-vs
      l: bcr-molecular-marker-vs
element:
  id:
    v: bcr-breast-tumour-supplement.molecularMarker.otherMarkerName
  path:
    v: bcr-breast-tumour-supplement.molecularMarker.otherMarkerName
  short:
    v: Other marker name
  definition:
    v: Free-text marker name when `marker = OTHER`.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: string
      l: string
element:
  id:
    v: bcr-breast-tumour-supplement.molecularMarker.tumourIndex
  path:
    v: bcr-breast-tumour-supplement.molecularMarker.tumourIndex
  short:
    v: Tumour index
  definition:
    v: Tumour to which the result applies: 1 (primary tumour) or 2 (second tumour, only in multifocal disease).
  min:
    v: 1
  max:
    v: 1
  type:
    code:
      v: unsignedInt
      l: unsignedInt
element:
  id:
    v: bcr-breast-tumour-supplement.molecularMarker.testDate
  path:
    v: bcr-breast-tumour-supplement.molecularMarker.testDate
  short:
    v: Test date
  definition:
    v: Date the marker was measured.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: date
      l: date
element:
  id:
    v: bcr-breast-tumour-supplement.molecularMarker.result
  path:
    v: bcr-breast-tumour-supplement.molecularMarker.result
  short:
    v: Result
  definition:
    v: Result of the marker. Permitted codings depend on the marker: - ER, PR: positief / gering positief / negatief. - HER2-IHC: 0 / 1+ / 2+ / 3+. - HER2-IHC-ISH: positief / HER2 low (provisional) / negatief. - BRCA1-2, CHEK2, PALB2, ATM, PIK3CA: niet getest / geen mutatie / somatische mutatie / kiembaanmutatie. - KI67: see `resultPercentage` (or `niet getest`).
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: CodeableConcept
      l: CodeableConcept
  binding:
    strength:
      v: extensible
    value set:
      v: https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-molecular-marker-result-vs
      l: bcr-molecular-marker-result-vs
element:
  id:
    v: bcr-breast-tumour-supplement.molecularMarker.resultPercentage
  path:
    v: bcr-breast-tumour-supplement.molecularMarker.resultPercentage
  short:
    v: Result percentage
  definition:
    v: Numeric percentage result. Used for Ki-67 (`marker = KI67`).
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: decimal
      l: decimal
element:
  id:
    v: bcr-breast-tumour-supplement.surgeryPerformed
  path:
    v: bcr-breast-tumour-supplement.surgeryPerformed
  short:
    v: Surgery performed
  definition:
    v: Indicates whether section 3 (surgical data) is in scope. When false or absent, the surgery fields below are not applicable.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: boolean
      l: boolean
element:
  id:
    v: bcr-breast-tumour-supplement.maxPathDiameterInvasiveMm
  path:
    v: bcr-breast-tumour-supplement.maxPathDiameterInvasiveMm
  short:
    v: Max pathological diameter, invasive component, before systemic therapy (mm)
  definition:
    v: Maximale pathologische doormeter invasieve component vóór systemische therapie.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: decimal
      l: decimal
element:
  id:
    v: bcr-breast-tumour-supplement.maxPathDiameterInSituMm
  path:
    v: bcr-breast-tumour-supplement.maxPathDiameterInSituMm

v: Max pathological diameter, in situ component, before systemic therapy (mm)

v: Maximale pathologische doormeter in situ component vóór systemische therapie.

v: 0

v: 1

code:
  v: decimal
  l: decimal

id:
  v: bcr-breast-tumour-supplement.minMarginDistanceInvasiveMm
path:
  v: bcr-breast-tumour-supplement.minMarginDistanceInvasiveMm
short:
  v: Min distance, invasive component to surgical margin (mm)
definition:
  v: Minimale afstand van de invasieve component tot de snijrand.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: decimal
    l: decimal

id:
  v: bcr-breast-tumour-supplement.minMarginDistanceInSituMm
path:
  v: bcr-breast-tumour-supplement.minMarginDistanceInSituMm
short:
  v: Min distance, in situ component to surgical margin (mm)
definition:
  v: Minimale afstand van de in situ component tot snijrand.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: decimal
    l: decimal

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment
short:
  v: Lymph node assessment
definition:
  v: One row of the sentinel / axillary / other-nodes table.
min:
  v: 0
max:
  v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.location
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.location
short:
  v: Node location
definition:
  v: Lymph node group. Codes: SENTINEL (Sentinelklieren), AXILLARY (Axillaire klieren), OTHER (Andere klieren).
min:
  v: 1
max:
  v: 1
type:
  code:
    v: code
    l: code
binding:
  strength:
    v: required
  value set:
    v: https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-lymph-node-location-vs
    l: bcr-lymph-node-location-vs

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.examined
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.examined
short:
  v: Number examined
definition:
  v: Aantal onderzocht.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: unsignedInt
    l: unsignedInt

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.positive
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.positive
short:
  v: Number positive
definition:
  v: Aantal positief.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: unsignedInt
    l: unsignedInt

id:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.assessmentDate
path:
  v: bcr-breast-tumour-supplement.lymphNodeAssessment.assessmentDate
short:
  v: Assessment date
definition:
  v: Date of the lymph node assessment.
min:
  v: 0
max:
  v: 1
type:
  code:
    v: date
    l: date