description: Specialized screening Observation for breast histology and pathological TNM results.
package_name: uz.dhp.integrations
derivation: constraint
name: ScreeningBreastHistologyObservation
type: Observation
elements:
  code:
    pattern:
      type: CodeableConcept
      value:
        coding:
        - {code: '394597005', system: 'http://snomed.info/sct'}
    index: 0
  component:
    index: 1
    slicing:
      slices:
        totalLymphNodesExamined:
          match: {}
          schema:
            short: Total number of lymph nodes examined
            mustSupport: true
            index: 155
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00043, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 156
              value:
                minValueInteger: 0
                choices: [valueInteger]
                index: 158
              valueInteger: {type: integer, minValueInteger: 0, choiceOf: value, index: 159}
            required: [value, valueInteger]
        regionalLymphNodesProvided:
          match: {}
          schema:
            short: Regional lymph nodes were submitted for examination
            mustSupport: true
            index: 150
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00042, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 151
              value:
                choices: [valueBoolean]
                index: 153
              valueBoolean: {type: boolean, choiceOf: value, index: 154}
            required: [value, valueBoolean]
        lymphovascularInvasion:
          match: {}
          schema:
            short: Lymphovascular invasion
            mustSupport: true
            index: 60
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 59544-7, system: 'http://loinc.org', display: Lymph-vascular invasion Cancer specimen}
                index: 61
              value:
                choices: [valueCodeableConcept]
                index: 63
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 64}
            required: [value, valueCodeableConcept]
        nottinghamMitoticCount:
          match: {}
          schema:
            short: Nottingham mitotic rate score
            mustSupport: true
            index: 26
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 85300-2, system: 'http://loinc.org', display: 'Mitotic rate [Score] in Breast cancer specimen by Nottingham'}
                index: 27
              value:
                maxValueInteger: 3
                minValueInteger: 1
                choices: [valueInteger]
                index: 29
              valueInteger: {type: integer, maxValueInteger: 3, minValueInteger: 1, choiceOf: value, index: 30}
            required: [value, valueInteger]
        dcisResectionMarginStatus:
          match: {}
          schema:
            short: Resection margin status for DCIS
            mustSupport: true
            index: 135
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00039, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 136
              value:
                choices: [valueCodeableConcept]
                index: 138
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 139}
            required: [value, valueCodeableConcept]
        pathologicalT:
          match: {}
          schema:
            short: Pathological T category
            mustSupport: true
            index: 75
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00011, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 76
              value:
                choices: [valueCodeableConcept]
                index: 78
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 79}
            required: [value, valueCodeableConcept]
        imageQuality:
          match: {}
          schema: {index: 5}
          max: 0
        finalPathologicalStage:
          match: {}
          schema:
            short: Final pathological stage
            mustSupport: true
            index: 184
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00047, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 185
              value:
                choices: [valueCodeableConcept]
                index: 187
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 188}
            required: [value, valueCodeableConcept]
        overallGrade:
          match: {}
          schema:
            short: Overall histologic grade
            mustSupport: true
            index: 90
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00031, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 91
              value:
                choices: [valueCodeableConcept]
                index: 93
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 94}
            required: [value, valueCodeableConcept]
        primaryConclusion:
          match: {}
          schema:
            short: Primary conclusion marker
            mustSupport: true
            index: 189
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00048, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 190
              value:
                choices: [valueBoolean]
                index: 192
              valueBoolean: {type: boolean, choiceOf: value, index: 193}
            required: [value, valueBoolean]
        extranodalExtension:
          match: {}
          schema:
            short: Extranodal extension
            mustSupport: true
            index: 174
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00024, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 175
              value:
                choices: [valueBoolean]
                index: 177
              valueBoolean: {type: boolean, choiceOf: value, index: 178}
            required: [value, valueBoolean]
        microcalcifications:
          match: {}
          schema:
            short: Microcalcifications in the breast tumor
            mustSupport: true
            index: 65
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 44692-2, system: 'http://loinc.org', display: Microcalcifications in Breast tumor}
                index: 66
              value:
                choices: [valueCodeableConcept]
                index: 68
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 69}
            required: [value, valueCodeableConcept]
        positiveLymphNodes:
          match: {}
          schema:
            short: Number of positive lymph nodes
            mustSupport: true
            index: 160
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00044, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 161
              value:
                minValueInteger: 0
                choices: [valueInteger]
                index: 163
              valueInteger: {type: integer, minValueInteger: 0, choiceOf: value, index: 164}
            required: [value, valueInteger]
        dermalLymphovascularInvasion:
          match: {}
          schema:
            short: Dermal lymphovascular invasion
            mustSupport: true
            index: 120
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: '351551000210107', system: 'http://snomed.info/sct'}
                index: 121
              value:
                choices: [valueCodeableConcept]
                index: 123
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 124}
            required: [value, valueCodeableConcept]
        tumorFocality:
          match: {}
          schema:
            short: Tumor focality
            mustSupport: true
            index: 95
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: '396199003', system: 'http://snomed.info/sct'}
                index: 96
              value:
                choices: [valueCodeableConcept]
                index: 98
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 99}
            required: [value, valueCodeableConcept]
        dcisGrade:
          match: {}
          schema:
            short: DCIS nuclear malignancy grade
            mustSupport: true
            index: 50
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00009, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 51
              value:
                choices: [valueCodeableConcept]
                index: 53
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 54}
            required: [value, valueCodeableConcept]
        tumorSpread:
          match: {}
          schema:
            short: Tumor spread
            mustSupport: true
            array: true
            index: 100
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00033, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 101
              value:
                choices: [valueCodeableConcept]
                index: 103
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 104}
            required: [value, valueCodeableConcept]
        dcisNecrosis:
          match: {}
          schema:
            short: DCIS necrosis type
            mustSupport: true
            index: 55
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 85340-8, system: 'http://loinc.org', display: 'DCIS necrosis [Type] in Breast cancer specimen by Light microscopy'}
                index: 56
              value:
                choices: [valueCodeableConcept]
                index: 58
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 59}
            required: [value, valueCodeableConcept]
        pagetDiseasePresent:
          match: {}
          schema:
            short: Paget disease present
            mustSupport: true
            index: 115
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00036, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 116
              value:
                choices: [valueBoolean]
                index: 118
              valueBoolean: {type: boolean, choiceOf: value, index: 119}
            required: [value, valueBoolean]
        stageModifier:
          match: {}
          schema:
            short: Pathological stage modifier
            mustSupport: true
            index: 70
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00010, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 71
              value:
                choices: [valueCodeableConcept]
                index: 73
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 74}
            required: [value, valueCodeableConcept]
        pathologicalN:
          match: {}
          schema:
            short: Pathological N category
            mustSupport: true
            index: 80
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00012, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 81
              value:
                choices: [valueCodeableConcept]
                index: 83
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 84}
            required: [value, valueCodeableConcept]
        dcisResectionMarginLocation:
          match: {}
          schema:
            short: Location of a positive DCIS margin
            mustSupport: true
            array: true
            index: 145
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00041, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 146
              value:
                choices: [valueCodeableConcept]
                index: 148
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 149}
            required: [value, valueCodeableConcept]
        skinLesionFociPresent:
          match: {}
          schema:
            short: Skin lesion foci present
            mustSupport: true
            index: 110
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00035, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 111
              value:
                choices: [valueBoolean]
                index: 113
              valueBoolean: {type: boolean, choiceOf: value, index: 114}
            required: [value, valueBoolean]
        nottinghamTubularFormation:
          match: {}
          schema:
            short: Nottingham glandular differentiation (tubular formation) score
            mustSupport: true
            index: 16
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 85321-8, system: 'http://loinc.org', display: 'Glandular differentiation [Score] in Breast cancer specimen by Nottingham'}
                index: 17
              value:
                maxValueInteger: 3
                minValueInteger: 1
                choices: [valueInteger]
                index: 19
              valueInteger: {type: integer, maxValueInteger: 3, minValueInteger: 1, choiceOf: value, index: 20}
            required: [value, valueInteger]
        skinInvasion:
          match: {}
          schema:
            short: Type of skin invasion
            mustSupport: true
            array: true
            index: 105
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00034, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 106
              value:
                choices: [valueCodeableConcept]
                index: 108
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 109}
            required: [value, valueCodeableConcept]
        birads:
          match: {}
          schema: {index: 3}
          max: 0
        materialClass:
          match: {}
          schema:
            short: Class of material received for histology
            mustSupport: true
            _required: true
            index: 6
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: '371439000', system: 'http://snomed.info/sct'}
                index: 7
              value:
                choices: [valueCodeableConcept]
                index: 9
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 10}
            required: [value, valueCodeableConcept]
        transformationZone:
          match: {}
          schema: {index: 2}
          max: 0
        breastDensity:
          match: {}
          schema: {index: 4}
          max: 0
        nottinghamNuclearPleomorphism:
          match: {}
          schema:
            short: Nottingham nuclear pleomorphism score
            mustSupport: true
            index: 21
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 44645-0, system: 'http://loinc.org', display: Nuclear pleomorphism in Breast tumor by Nottingham}
                index: 22
              value:
                maxValueInteger: 3
                minValueInteger: 1
                choices: [valueInteger]
                index: 24
              valueInteger: {type: integer, maxValueInteger: 3, minValueInteger: 1, choiceOf: value, index: 25}
            required: [value, valueInteger]
        histologicType:
          match: {}
          schema:
            short: Breast histologic type
            mustSupport: true
            index: 11
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00006, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 12
              value:
                choices: [valueCodeableConcept]
                index: 14
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 15}
            required: [value, valueCodeableConcept]
        invasiveResectionMarginStatus:
          match: {}
          schema:
            short: Resection margin status for invasive carcinoma
            mustSupport: true
            index: 130
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00038, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 131
              value:
                choices: [valueCodeableConcept]
                index: 133
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 134}
            required: [value, valueCodeableConcept]
        dcisArchitecturalPattern:
          match: {}
          schema:
            short: DCIS architectural growth pattern
            mustSupport: true
            array: true
            index: 45
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 85302-8, system: 'http://loinc.org', display: 'Growth pattern of DCIS [Type] in Breast cancer specimen by Light microscopy'}
                index: 46
              value:
                choices: [valueCodeableConcept]
                index: 48
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 49}
            required: [value, valueCodeableConcept]
        residualCancerBurdenClass:
          match: {}
          schema:
            short: Residual Cancer Burden class
            mustSupport: true
            index: 125
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: '444987009', system: 'http://snomed.info/sct'}
                index: 126
              value:
                choices: [valueCodeableConcept]
                index: 128
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 129}
            required: [value, valueCodeableConcept]
        largestInvasiveFocus:
          match: {}
          schema:
            short: Maximum dimension of the invasive component
            mustSupport: true
            index: 31
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 44635-1, system: 'http://loinc.org', display: 'Invasive component size.maximum dimension [Length] in Breast tumor'}
                index: 32
              value:
                pattern:
                  type: Quantity
                  value: {code: mm, unit: mm, system: 'http://unitsofmeasure.org'}
                choices: [valueQuantity]
                index: 34
              valueQuantity:
                type: Quantity
                pattern:
                  type: Quantity
                  value: {code: mm, unit: mm, system: 'http://unitsofmeasure.org'}
                choiceOf: value
                index: 35
              value[x]:
                elements:
                  value: {minValueDecimal: 0, index: 36}
                  unit: {index: 37}
                  system: {index: 38}
                  code: {index: 39}
                required: [value, unit, system, code]
            required: [value, valueQuantity]
        dcisPresent:
          match: {}
          schema:
            short: Presence of ductal carcinoma in situ (DCIS)
            mustSupport: true
            index: 40
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00008, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 41
              value:
                choices: [valueBoolean]
                index: 43
              valueBoolean: {type: boolean, choiceOf: value, index: 44}
            required: [value, valueBoolean]
        distantMetastasis:
          match: {}
          schema:
            short: Distant metastasis site
            mustSupport: true
            array: true
            index: 179
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: '385421009', system: 'http://snomed.info/sct'}
                index: 180
              value:
                choices: [valueCodeableConcept]
                index: 182
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 183}
            required: [value, valueCodeableConcept]
        largestLymphNodeMetastasis:
          match: {}
          schema:
            short: Largest lymph node metastasis
            mustSupport: true
            index: 165
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00045, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 166
              value:
                pattern:
                  type: Quantity
                  value: {code: mm, unit: mm, system: 'http://unitsofmeasure.org'}
                choices: [valueQuantity]
                index: 168
              valueQuantity:
                type: Quantity
                pattern:
                  type: Quantity
                  value: {code: mm, unit: mm, system: 'http://unitsofmeasure.org'}
                choiceOf: value
                index: 169
              value[x]:
                elements:
                  value: {minValueDecimal: 0, index: 170}
                  unit: {index: 171}
                  system: {index: 172}
                  code: {index: 173}
                required: [value, unit, system, code]
            required: [value, valueQuantity]
        invasiveResectionMarginLocation:
          match: {}
          schema:
            short: Location of a positive invasive carcinoma margin
            mustSupport: true
            array: true
            index: 140
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00040, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 141
              value:
                choices: [valueCodeableConcept]
                index: 143
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 144}
            required: [value, valueCodeableConcept]
        pathologicalM:
          match: {}
          schema:
            short: Pathological M category
            mustSupport: true
            index: 85
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: scrn-0073-00013, system: 'https://terminology.dhp.uz/fhir/integrations/CodeSystem/screening-specialized-observation-parameter-cs'}
                index: 86
              value:
                choices: [valueCodeableConcept]
                index: 88
              valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 89}
            required: [value, valueCodeableConcept]
package_version: 0.8.0
class: profile
kind: resource
url: https://dhp.uz/fhir/integrations/StructureDefinition/screening-breast-histology-observation
base: https://dhp.uz/fhir/integrations/StructureDefinition/screening-observation|0.8.0
version: 0.8.0
required: [component]