<?xml version="1.0" encoding="UTF-8"?>

<Bundle xmlns="http://hl7.org/fhir">
  <id value="BundleMammaNeoadjuvant"/>
  <language value="en"/>
  <type value="transaction"/>
  <entry>
    <fullUrl value="http://example.org/fhir/Patient/PatientinMamma"/>
    <resource>
      <Patient>
        <id value="PatientinMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <name>
          <family value="Baumann"/>
          <given value="Sabine"/>
        </name>
        <gender value="female"/>
        <birthDate value="1977-06-24"/>
      </Patient>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Patient"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Practitioner/OnkologinMamma"/>
    <resource>
      <Practitioner>
        <id value="OnkologinMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <name>
          <family value="Musterarzt"/>
          <given value="Katrin"/>
        </name>
      </Practitioner>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Practitioner"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Organization/TumorzentrumMamma"/>
    <resource>
      <Organization>
        <id value="TumorzentrumMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <name value="Zertifiziertes Brustzentrum Musterklinik"/>
      </Organization>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Organization"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Organization/Tumorboard"/>
    <resource>
      <Organization>
        <id value="Tumorboard"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <identifier>
          <system value="https://www.musterklinik.de/fhir/sid/organisationen"/>
          <value value="tumorboard-brust-001"/>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="team"/>
            <display value="Organizational team"/>
          </coding>
        </type>
        <name value="Zertifiziertes Brustzentrum Musterklinik"/>
      </Organization>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Organization"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/ServiceRequest/ServiceRequestBiopsieMamma"/>
    <resource>
      <ServiceRequest>
        <id value="ServiceRequestBiopsieMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <intent value="order"/>
        <code>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="44578009"/>
            <display value="Core needle biopsy of breast (procedure)"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <authoredOn value="2025-09-12"/>
        <requester>
          <reference value="Practitioner/OnkologinMamma"/>
        </requester>
      </ServiceRequest>
    </resource>
    <request>
      <method value="POST"/>
      <url value="ServiceRequest"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/ServiceRequest/ServiceRequestPathologieMamma"/>
    <resource>
      <ServiceRequest>
        <id value="ServiceRequestPathologieMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <intent value="order"/>
        <code>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="788124003"/>
            <display value="Histopathology service (qualifier value)"/>
          </coding>
          <text value="Histopathologische Untersuchung inkl. Rezeptor-/HER2-Status und Ki-67"/>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <authoredOn value="2025-09-15"/>
        <requester>
          <reference value="Practitioner/OnkologinMamma"/>
        </requester>
        <specimen>
          <reference value="Specimen/SpecimenBiopsieMamma"/>
        </specimen>
      </ServiceRequest>
    </resource>
    <request>
      <method value="POST"/>
      <url value="ServiceRequest"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/ServiceRequest/ServiceRequestStagingMamma"/>
    <resource>
      <ServiceRequest>
        <id value="ServiceRequestStagingMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <intent value="order"/>
        <code>
          <text value="Klinische Ausbreitungsdiagnostik / TNM-Staging"/>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <authoredOn value="2025-09-15"/>
        <requester>
          <reference value="Practitioner/OnkologinMamma"/>
        </requester>
      </ServiceRequest>
    </resource>
    <request>
      <method value="POST"/>
      <url value="ServiceRequest"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/ServiceRequest/ServiceRequestGBRCAMamma"/>
    <resource>
      <ServiceRequest>
        <id value="ServiceRequestGBRCAMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <intent value="order"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="21639-0"/>
            <display value="BRCA1 gene mutations tested for in Blood or Tissue by Molecular genetics method Nominal"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <authoredOn value="2025-09-18"/>
        <requester>
          <reference value="Practitioner/OnkologinMamma"/>
        </requester>
      </ServiceRequest>
    </resource>
    <request>
      <method value="POST"/>
      <url value="ServiceRequest"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/CarePlan/CarePlanMammaDiagnostik"/>
    <resource>
      <CarePlan>
        <id value="CarePlanMammaDiagnostik"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-diagnostic-care-plan"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="active"/>
        <intent value="plan"/>
        <category>
          <text value="Tumordiagnostik"/>
        </category>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <author>
          <reference value="Practitioner/OnkologinMamma"/>
        </author>
        <addresses>
          <reference value="Condition/ConditionMamma"/>
        </addresses>
        <goal>
          <reference value="Goal/DiagnosticGoal"/>
        </goal>
        <activity>
          <outcomeReference>
            <reference value="Procedure/ProcedureBiopsieMamma"/>
          </outcomeReference>
          <reference>
            <reference value="ServiceRequest/ServiceRequestBiopsieMamma"/>
          </reference>
        </activity>
        <activity>
          <outcomeReference>
            <reference value="Observation/ObsHistologieMamma"/>
          </outcomeReference>
          <outcomeReference>
            <reference value="Observation/ObsGradingMamma"/>
          </outcomeReference>
          <outcomeReference>
            <reference value="Observation/ObsEstrogenrezeptorMamma"/>
          </outcomeReference>
          <outcomeReference>
            <reference value="Observation/ObsProgesteronrezeptorMamma"/>
          </outcomeReference>
          <outcomeReference>
            <reference value="Observation/ObsHER2Mamma"/>
          </outcomeReference>
          <outcomeReference>
            <reference value="Observation/ObsKi67Mamma"/>
          </outcomeReference>
          <reference>
            <reference value="ServiceRequest/ServiceRequestPathologieMamma"/>
          </reference>
        </activity>
        <activity>
          <outcomeReference>
            <reference value="Observation/ObsTNMklinischMamma"/>
          </outcomeReference>
          <reference>
            <reference value="ServiceRequest/ServiceRequestStagingMamma"/>
          </reference>
        </activity>
        <activity>
          <outcomeReference>
            <reference value="Observation/ObsGBRCAMamma"/>
          </outcomeReference>
          <reference>
            <reference value="ServiceRequest/ServiceRequestGBRCAMamma"/>
          </reference>
        </activity>
      </CarePlan>
    </resource>
    <request>
      <method value="POST"/>
      <url value="CarePlan"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Goal/DiagnosticGoal"/>
    <resource>
      <Goal>
        <id value="DiagnosticGoal"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-goal"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="http://hl7.org/fhir/StructureDefinition/goal-acceptance">
          <extension url="individual">
            <valueReference>
              <reference value="Patient/PatientinMamma"/>
            </valueReference>
          </extension>
          <extension url="status">
            <valueCode value="agree"/>
          </extension>
          <extension url="priority">
            <valueCodeableConcept>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/goal-priority"/>
                <code value="high-priority"/>
                <display value="High Priority"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <lifecycleStatus value="active"/>
        <achievementStatus>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/goal-achievement"/>
            <code value="in-progress"/>
            <display value="In Progress"/>
          </coding>
        </achievementStatus>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="261004008"/>
            <display value="Diagnostic intent"/>
          </coding>
        </category>
        <priority>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/goal-priority"/>
            <code value="high-priority"/>
            <display value="High Priority"/>
          </coding>
        </priority>
        <description>
          <text value="Diagnosesicherung für die Verdachtsdiagnose"/>
        </description>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <startDate value="2025-09-12"/>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="21905-5"/>
              <display value="Primary tumor.clinical [Class] Cancer"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="21906-3"/>
              <display value="Regional lymph nodes.clinical [Class] Cancer"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="21907-1"/>
              <display value="Distant metastases.clinical [Class] Cancer"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="21908-9"/>
              <display value="Stage group.clinical Cancer"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="40556-3"/>
              <display value="Estrogen receptor Ag [Presence] in Tissue by Immune stain"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="85339-0"/>
              <display value="Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48676-1"/>
              <display value="HER2 Ag [Interpretation] in Tissue"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="21855-2"/>
              <display value="Primary site Cancer"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="44648-4"/>
              <display value="Histologic grade [Score] in Breast cancer specimen by Nottingham"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="33732-9"/>
              <display value="Histology grade [Identifier] in Cancer specimen"/>
            </coding>
          </measure>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="85347-3"/>
              <display value="Sentinel lymph nodes examined [#] in Cancer specimen by Light microscopy"/>
            </coding>
          </measure>
        </target>
        <expressedBy>
          <reference value="Practitioner/OnkologinMamma"/>
        </expressedBy>
        <addresses>
          <reference value="Condition/ConditionMamma"/>
        </addresses>
        <outcomeReference>
          <reference value="Observation/ObsDiseaseStatusMamma"/>
        </outcomeReference>
      </Goal>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Goal"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Condition/ConditionMamma"/>
    <resource>
      <Condition>
        <id value="ConditionMamma"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-condition"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="http://hl7.org/fhir/StructureDefinition/condition-assertedDate">
          <valueDateTime value="2025-09-15"/>
        </extension>
        <clinicalStatus>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
            <code value="active"/>
          </coding>
        </clinicalStatus>
        <verificationStatus>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
            <code value="confirmed"/>
          </coding>
        </verificationStatus>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/condition-category"/>
            <code value="encounter-diagnosis"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://fhir.de/CodeSystem/bfarm/icd-10-gm"/>
            <version value="2026"/>
            <code value="C50.4"/>
            <display value="Bösartige Neubildung: Oberer äußerer Quadrant der Brustdrüse"/>
          </coding>
          <text value="Invasives Mammakarzinom links, oberer äußerer Quadrant (NST), triple-negativ"/>
        </code>
        <bodySite>
          <text value="Mamma links, oberer äußerer Quadrant"/>
        </bodySite>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <onsetDateTime value="2025-09-15"/>
        <recordedDate value="2025-09-15"/>
      </Condition>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Condition"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Procedure/ProcedureBiopsieMamma"/>
    <resource>
      <Procedure>
        <id value="ProcedureBiopsieMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="103693007"/>
            <display value="Diagnostic procedure (procedure)"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="44578009"/>
            <display value="Core needle biopsy of breast (procedure)"/>
          </coding>
          <text value="Sonografisch gesteuerte Stanzbiopsie der Mamma links"/>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <performedDateTime value="2025-09-15"/>
        <reasonReference>
          <reference value="Condition/ConditionMamma"/>
        </reasonReference>
        <bodySite>
          <text value="Mamma links, oberer äußerer Quadrant"/>
        </bodySite>
      </Procedure>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Procedure"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Specimen/SpecimenBiopsieMamma"/>
    <resource>
      <Specimen>
        <id value="SpecimenBiopsieMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="available"/>
        <type>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="122737001"/>
            <display value="Specimen from breast obtained by core needle biopsy"/>
          </coding>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="119376003"/>
            <display value="Tissue specimen (specimen)"/>
          </coding>
          <text value="Stanzbiopsat (Gewebeprobe) Mamma links"/>
        </type>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <collection>
          <collectedDateTime value="2025-09-15"/>
          <method>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="9911007"/>
              <display value="Core needle biopsy"/>
            </coding>
          </method>
          <bodySite>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="76365002"/>
              <display value="Structure of upper outer quadrant of breast"/>
            </coding>
            <text value="Mamma links, oberer äußerer Quadrant"/>
          </bodySite>
        </collection>
      </Specimen>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Specimen"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsHistologieMamma"/>
    <resource>
      <Observation>
        <id value="ObsHistologieMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="59847-4"/>
            <display value="Histology and Behavior ICD-O-3 Cancer"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-09-15"/>
        <valueCodeableConcept>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="82711006"/>
            <display value="Infiltrating duct carcinoma"/>
          </coding>
          <coding>
            <system value="urn:oid:2.16.840.1.113883.6.43.1"/>
            <code value="8500/3"/>
            <display value="Invasives duktales Karzinom / Karzinom ohne speziellen Typ (NST)"/>
          </coding>
          <text value="Invasives Mammakarzinom, NST (ICD-O-3 8500/3)"/>
        </valueCodeableConcept>
        <specimen>
          <reference value="Specimen/SpecimenBiopsieMamma"/>
        </specimen>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsGradingMamma"/>
    <resource>
      <Observation>
        <id value="ObsGradingMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="44648-4"/>
            <display value="Histologic grade [Score] in Breast cancer specimen by Nottingham"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-09-15"/>
        <valueCodeableConcept>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="1155704001"/>
            <display value="G3: Poorly differentiated"/>
          </coding>
          <coding>
            <system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-grading"/>
            <code value="3"/>
            <display value="schlecht differenziert"/>
          </coding>
          <text value="G3 – schlecht differenziert (Elston-Ellis)"/>
        </valueCodeableConcept>
        <specimen>
          <reference value="Specimen/SpecimenBiopsieMamma"/>
        </specimen>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsTNMklinischMamma"/>
    <resource>
      <Observation>
        <id value="ObsTNMklinischMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="21908-9"/>
            <display value="Stage group.clinical Cancer"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-09-16"/>
        <valueCodeableConcept>
          <text value="cT2 cN1 cM0 – UICC IIB"/>
        </valueCodeableConcept>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsEstrogenrezeptorMamma"/>
    <resource>
      <Observation>
        <id value="ObsEstrogenrezeptorMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="85337-4"/>
            <display value="Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain"/>
          </coding>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="1234806008"/>
            <display value="Observation using immunohistochemistry (observable entity)"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-09-17"/>
        <valueCodeableConcept>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA6577-6"/>
            <display value="Negative"/>
          </coding>
        </valueCodeableConcept>
        <note>
          <text value="Immunhistochemie: &lt;1 % positive Kerne → ER-negativ."/>
        </note>
        <specimen>
          <reference value="Specimen/SpecimenBiopsieMamma"/>
        </specimen>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsProgesteronrezeptorMamma"/>
    <resource>
      <Observation>
        <id value="ObsProgesteronrezeptorMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="85339-0"/>
            <display value="Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain"/>
          </coding>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="1234806008"/>
            <display value="Observation using immunohistochemistry (observable entity)"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-09-17"/>
        <valueCodeableConcept>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA6577-6"/>
            <display value="Negative"/>
          </coding>
        </valueCodeableConcept>
        <note>
          <text value="Immunhistochemie: &lt;1 % positive Kerne → PR-negativ."/>
        </note>
        <specimen>
          <reference value="Specimen/SpecimenBiopsieMamma"/>
        </specimen>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsHER2Mamma"/>
    <resource>
      <Observation>
        <id value="ObsHER2Mamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="48676-1"/>
            <display value="HER2 Ag [Interpretation] in Tissue"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-09-17"/>
        <valueCodeableConcept>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA6577-6"/>
            <display value="Negative"/>
          </coding>
          <coding>
            <system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-mamma-her2neu-status-obds"/>
            <code value="N"/>
            <display value="negativ"/>
          </coding>
          <coding>
            <system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-mamma-her2neu-status-leitlinie"/>
            <code value="negativ"/>
            <display value="HER2-negativ"/>
          </coding>
        </valueCodeableConcept>
        <note>
          <text value="Immunhistochemie 1+ → HER2-negativ; keine In-situ-Hybridisierung erforderlich."/>
        </note>
        <specimen>
          <reference value="Specimen/SpecimenBiopsieMamma"/>
        </specimen>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsKi67Mamma"/>
    <resource>
      <Observation>
        <id value="ObsKi67Mamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="85330-9"/>
            <display value="Cells.Ki-67 nuclear Ag/cells in Breast cancer specimen by Immune stain"/>
          </coding>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="1234806008"/>
            <display value="Observation using immunohistochemistry (observable entity)"/>
          </coding>
          <text value="Ki-67 Proliferationsindex (MIB-1)"/>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-09-17"/>
        <valueQuantity>
          <value value="70"/>
          <unit value="%"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="%"/>
        </valueQuantity>
        <specimen>
          <reference value="Specimen/SpecimenBiopsieMamma"/>
        </specimen>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsGBRCAMamma"/>
    <resource>
      <Observation>
        <id value="ObsGBRCAMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="21639-0"/>
            <display value="BRCA1 gene mutations tested for in Blood or Tissue by Molecular genetics method Nominal"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-09-25"/>
        <valueCodeableConcept>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="260385009"/>
            <display value="Negative"/>
          </coding>
        </valueCodeableConcept>
        <note>
          <text value="gBRCA1/2: keine (wahrscheinlich) pathogene Variante (Klasse 4/5) nachgewiesen."/>
        </note>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/EpisodeOfCare/TherapielinieChemo"/>
    <resource>
      <EpisodeOfCare>
        <id value="TherapielinieChemo"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-line"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent">
          <extension url="hauptintention">
            <valueCodeableConcept>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="373847000"/>
                <display value="Neoadjuvant intent"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="phase">
            <valueCodeableConcept>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="373808002"/>
                <display value="Curative - procedure intent"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/enlist-lot">
          <extension url="setting">
            <valueCodeableConcept>
              <coding>
                <system value="https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/enlist-lot-setting"/>
                <code value="eLoT"/>
                <display value="eLoT — frühes Setting"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="line">
            <valuePositiveInt value="1"/>
          </extension>
          <extension url="modification">
            <valueUnsignedInt value="0"/>
          </extension>
          <extension url="notation">
            <valueString value="eLoT 1.0"/>
          </extension>
          <extension url="lineId">
            <valueIdentifier>
              <system value="https://bih-cei.de/fhir/therapieziele-onkologie/sid/enlist-line"/>
              <value value="mamma-baumann-elot-1"/>
            </valueIdentifier>
          </extension>
        </extension>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/enlist-countable">
          <valueCodeableConcept>
            <coding>
              <system value="https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/enlist-countable"/>
              <code value="counted"/>
              <display value="Zählt in der LoT-Zählung"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-line-medication-request">
          <valueReference>
            <reference value="MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"/>
          </valueReference>
        </extension>
        <status value="finished"/>
        <type>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="385786002"/>
            <display value="Chemotherapy care"/>
          </coding>
        </type>
        <diagnosis>
          <condition>
            <reference value="Condition/ConditionMamma"/>
          </condition>
          <role>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
              <code value="CC"/>
              <display value="Chief complaint"/>
            </coding>
          </role>
          <rank value="1"/>
        </diagnosis>
        <patient>
          <reference value="Patient/PatientinMamma"/>
        </patient>
        <managingOrganization>
          <reference value="Organization/Tumorboard"/>
        </managingOrganization>
        <period>
          <start value="2025-10-01"/>
          <end value="2026-03-15"/>
        </period>
        <careManager>
          <reference value="Practitioner/OnkologinMamma"/>
        </careManager>
      </EpisodeOfCare>
    </resource>
    <request>
      <method value="POST"/>
      <url value="EpisodeOfCare"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/EpisodeOfCare/TherapielinieOperation"/>
    <resource>
      <EpisodeOfCare>
        <id value="TherapielinieOperation"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-line"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent">
          <extension url="hauptintention">
            <valueCodeableConcept>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="373808002"/>
                <display value="Curative - procedure intent"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/enlist-countable">
          <valueCodeableConcept>
            <coding>
              <system value="https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/enlist-countable"/>
              <code value="not-counted"/>
              <display value="Zählt nicht"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <status value="finished"/>
        <type>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="387713003"/>
            <display value="Surgical procedure"/>
          </coding>
        </type>
        <diagnosis>
          <condition>
            <reference value="Condition/ConditionMamma"/>
          </condition>
          <role>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"/>
              <code value="CC"/>
              <display value="Chief complaint"/>
            </coding>
          </role>
          <rank value="1"/>
        </diagnosis>
        <patient>
          <reference value="Patient/PatientinMamma"/>
        </patient>
        <managingOrganization>
          <reference value="Organization/Tumorboard"/>
        </managingOrganization>
        <period>
          <start value="2026-03-20"/>
          <end value="2026-04-06"/>
        </period>
        <referralRequest>
          <reference value="ServiceRequest/ServiceRequestProcedure"/>
        </referralRequest>
        <careManager>
          <reference value="Practitioner/OnkologinMamma"/>
        </careManager>
      </EpisodeOfCare>
    </resource>
    <request>
      <method value="POST"/>
      <url value="EpisodeOfCare"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Goal/TherapiezielMammaHeilung"/>
    <resource>
      <Goal>
        <id value="TherapiezielMammaHeilung"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-goal"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent">
          <extension url="hauptintention">
            <valueCodeableConcept>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="373808002"/>
                <display value="Curative - procedure intent"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/goal-acceptance">
          <extension url="individual">
            <valueReference>
              <reference value="Patient/PatientinMamma"/>
            </valueReference>
          </extension>
          <extension url="status">
            <valueCode value="agree"/>
          </extension>
          <extension url="priority">
            <valueCodeableConcept>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/goal-priority"/>
                <code value="high-priority"/>
                <display value="High Priority"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/goal-relationship">
          <extension url="type">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/goal-relationship-type"/>
                <code value="predecessor"/>
                <display value="Predecessor"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="target">
            <valueReference>
              <reference value="Goal/DiagnosticGoal"/>
            </valueReference>
          </extension>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/goal-relationship">
          <extension url="type">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/goal-relationship-type"/>
                <code value="successor"/>
                <display value="Successor"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="target">
            <valueReference>
              <reference value="Goal/FollowUpGoal"/>
            </valueReference>
          </extension>
        </extension>
        <lifecycleStatus value="active"/>
        <achievementStatus>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/goal-achievement"/>
            <code value="achieved"/>
            <display value="Achieved"/>
          </coding>
        </achievementStatus>
        <category>
          <coding>
            <system value="https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type"/>
            <code value="heilung"/>
            <display value="Heilung"/>
          </coding>
        </category>
        <category>
          <coding>
            <system value="https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type"/>
            <code value="funktionserhalt"/>
            <display value="Funktionserhalt"/>
          </coding>
        </category>
        <priority>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/goal-priority"/>
            <code value="high-priority"/>
            <display value="High Priority"/>
          </coding>
        </priority>
        <description>
          <text value="Kurative Behandlung des frühen triple-negativen Mammakarzinoms mittels neoadjuvanter Systemtherapie und brusterhaltender Operation; Erreichen einer pathologischen Komplettremission (pCR)."/>
        </description>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <startDate value="2025-09-22"/>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="21908-9"/>
              <display value="Stage group.clinical Cancer"/>
            </coding>
          </measure>
          <dueDate value="2026-04-15"/>
        </target>
        <expressedBy>
          <reference value="Practitioner/OnkologinMamma"/>
        </expressedBy>
        <addresses>
          <reference value="Condition/ConditionMamma"/>
        </addresses>
        <outcomeReference>
          <reference value="Observation/ObsDiseaseStatusMamma"/>
        </outcomeReference>
      </Goal>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Goal"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/ServiceRequest/ServiceRequestProcedure"/>
    <resource>
      <ServiceRequest>
        <id value="ServiceRequestProcedure"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-tumorboard-service-request"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="active"/>
        <intent value="proposal"/>
        <category>
          <coding>
            <system value="http://loinc.org"/>
            <code value="85232-7"/>
            <display value="Tumor board Consult note"/>
          </coding>
        </category>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="387713003"/>
            <display value="Surgical procedure"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="392021009"/>
            <display value="Lumpectomy of breast (procedure)"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
      </ServiceRequest>
    </resource>
    <request>
      <method value="POST"/>
      <url value="ServiceRequest"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"/>
    <resource>
      <MedicationRequest>
        <id value="MedicationRequestPembroChemoNeoadjuvantMamma"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-tumorboard-medication-request"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/enlist-change">
          <valueCodeableConcept>
            <coding>
              <system value="https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/enlist-change-type"/>
              <code value="new"/>
              <display value="New LoT"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <status value="completed"/>
        <intent value="plan"/>
        <category>
          <coding>
            <system value="http://loinc.org"/>
            <code value="85232-7"/>
            <display value="Tumor board Consult note"/>
          </coding>
        </category>
        <medicationCodeableConcept>
          <text value="Pembrolizumab + Carboplatin/Paclitaxel, gefolgt von Pembrolizumab + Epirubicin/Cyclophosphamid (KEYNOTE-522)"/>
        </medicationCodeableConcept>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
      </MedicationRequest>
    </resource>
    <request>
      <method value="POST"/>
      <url value="MedicationRequest"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma1"/>
    <resource>
      <MedicationAdministration>
        <id value="MedicationAdministrationPembroChemoNeoadjuvantMamma1"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <medicationCodeableConcept>
          <text value="Pembrolizumab + Carboplatin (q3w), Paclitaxel wöchentlich begleitend (KEYNOTE-522, Phase 1)"/>
        </medicationCodeableConcept>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-10-01"/>
        <request>
          <reference value="MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"/>
        </request>
        <note>
          <text value="Zyklus 1 von 4 (Pembro/Carbo q3w); begleitend wöchentliche Paclitaxel-Gaben, hier nicht einzeln erfasst"/>
        </note>
      </MedicationAdministration>
    </resource>
    <request>
      <method value="POST"/>
      <url value="MedicationAdministration"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma2"/>
    <resource>
      <MedicationAdministration>
        <id value="MedicationAdministrationPembroChemoNeoadjuvantMamma2"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <medicationCodeableConcept>
          <text value="Pembrolizumab + Carboplatin (q3w), Paclitaxel wöchentlich begleitend (KEYNOTE-522, Phase 1)"/>
        </medicationCodeableConcept>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2025-11-01"/>
        <request>
          <reference value="MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"/>
        </request>
        <note>
          <text value="Zyklus 2 von 4 (Pembro/Carbo q3w); begleitend wöchentliche Paclitaxel-Gaben, hier nicht einzeln erfasst"/>
        </note>
      </MedicationAdministration>
    </resource>
    <request>
      <method value="POST"/>
      <url value="MedicationAdministration"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma3"/>
    <resource>
      <MedicationAdministration>
        <id value="MedicationAdministrationPembroChemoNeoadjuvantMamma3"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <medicationCodeableConcept>
          <text value="Pembrolizumab + Carboplatin (q3w), Paclitaxel wöchentlich begleitend (KEYNOTE-522, Phase 1)"/>
        </medicationCodeableConcept>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2026-02-10"/>
        <request>
          <reference value="MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"/>
        </request>
        <note>
          <text value="Zyklus 3 von 4 (Pembro/Carbo q3w); begleitend wöchentliche Paclitaxel-Gaben, hier nicht einzeln erfasst"/>
        </note>
      </MedicationAdministration>
    </resource>
    <request>
      <method value="POST"/>
      <url value="MedicationAdministration"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma4"/>
    <resource>
      <MedicationAdministration>
        <id value="MedicationAdministrationPembroChemoNeoadjuvantMamma4"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <medicationCodeableConcept>
          <text value="Pembrolizumab + Carboplatin (q3w), Paclitaxel wöchentlich begleitend (KEYNOTE-522, Phase 1)"/>
        </medicationCodeableConcept>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2026-03-15"/>
        <request>
          <reference value="MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"/>
        </request>
        <note>
          <text value="Zyklus 4 von 4 (Pembro/Carbo q3w); begleitend wöchentliche Paclitaxel-Gaben, hier nicht einzeln erfasst"/>
        </note>
      </MedicationAdministration>
    </resource>
    <request>
      <method value="POST"/>
      <url value="MedicationAdministration"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Procedure/ProcedureOperationMamma"/>
    <resource>
      <Procedure>
        <id value="ProcedureOperationMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="completed"/>
        <code>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="392021009"/>
            <display value="Lumpectomy of breast (procedure)"/>
          </coding>
          <text value="Brusterhaltende Operation (BET) links + Sentinel-Lymphknoten-Biopsie"/>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <performedDateTime value="2026-04-02"/>
      </Procedure>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Procedure"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsTNMpathologischMamma"/>
    <resource>
      <Observation>
        <id value="ObsTNMpathologischMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="21902-2"/>
            <display value="Stage group.pathology Cancer"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2026-04-07"/>
        <valueCodeableConcept>
          <text value="ypT0 ypN0 – pathologische Komplettremission (pCR)"/>
        </valueCodeableConcept>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Observation/ObsDiseaseStatusMamma"/>
    <resource>
      <Observation>
        <id value="ObsDiseaseStatusMamma"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="97509-4"/>
            <display value="Cancer disease progression"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <effectiveDateTime value="2026-04-07"/>
        <valueCodeableConcept>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="260415000"/>
            <display value="Not detected"/>
          </coding>
        </valueCodeableConcept>
        <note>
          <text value="Pathologische Komplettremission (pCR, ypT0 ypN0) nach neoadjuvanter Systemtherapie."/>
        </note>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/CarePlan/CarePlanMammaNeoadjuvant"/>
    <resource>
      <CarePlan>
        <id value="CarePlanMammaNeoadjuvant"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-care-plan"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-careplan-custodian">
          <valueReference>
            <reference value="Organization/TumorzentrumMamma"/>
          </valueReference>
        </extension>
        <status value="active"/>
        <intent value="plan"/>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="736252007"/>
            <display value="Cancer care plan"/>
          </coding>
        </category>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <period>
          <start value="2025-09-22"/>
        </period>
        <author>
          <reference value="Practitioner/OnkologinMamma"/>
        </author>
        <addresses>
          <reference value="Condition/ConditionMamma"/>
        </addresses>
        <goal>
          <reference value="Goal/TherapiezielMammaHeilung"/>
        </goal>
        <activity>
          <outcomeReference>
            <reference value="MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma1"/>
          </outcomeReference>
          <outcomeReference>
            <reference value="MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma2"/>
          </outcomeReference>
          <outcomeReference>
            <reference value="MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma3"/>
          </outcomeReference>
          <outcomeReference>
            <reference value="MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma4"/>
          </outcomeReference>
          <reference>
            <reference value="MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"/>
          </reference>
        </activity>
        <activity>
          <outcomeReference>
            <reference value="Procedure/ProcedureOperationMamma"/>
          </outcomeReference>
          <reference>
            <reference value="ServiceRequest/ServiceRequestProcedure"/>
          </reference>
        </activity>
        <activity>
          <reference>
            <reference value="MedicationRequest/MedicationRequestPembroAdjuvantMamma"/>
          </reference>
        </activity>
        <activity>
          <outcomeReference>
            <reference value="Observation/ObsDiseaseStatusMamma"/>
          </outcomeReference>
        </activity>
      </CarePlan>
    </resource>
    <request>
      <method value="POST"/>
      <url value="CarePlan"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Goal/FollowUpGoal"/>
    <resource>
      <Goal>
        <id value="FollowUpGoal"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-goal"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="http://hl7.org/fhir/StructureDefinition/goal-acceptance">
          <extension url="individual">
            <valueReference>
              <reference value="Patient/PatientinMamma"/>
            </valueReference>
          </extension>
          <extension url="status">
            <valueCode value="agree"/>
          </extension>
          <extension url="priority">
            <valueCodeableConcept>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/goal-priority"/>
                <code value="high-priority"/>
                <display value="High Priority"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/goal-relationship">
          <extension url="type">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/goal-relationship-type"/>
                <code value="predecessor"/>
                <display value="Predecessor"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="target">
            <valueReference>
              <reference value="Goal/DiagnosticGoal"/>
            </valueReference>
          </extension>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/goal-relationship">
          <extension url="type">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/goal-relationship-type"/>
                <code value="predecessor"/>
                <display value="Predecessor"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="target">
            <valueReference>
              <reference value="Goal/TherapiezielMammaHeilung"/>
            </valueReference>
          </extension>
        </extension>
        <lifecycleStatus value="planned"/>
        <achievementStatus>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/goal-achievement"/>
            <code value="in-progress"/>
            <display value="In Progress"/>
          </coding>
        </achievementStatus>
        <category>
          <coding>
            <system value="https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type"/>
            <code value="lebensqualitaet"/>
            <display value="Lebensqualität"/>
          </coding>
        </category>
        <priority>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/goal-priority"/>
            <code value="high-priority"/>
            <display value="High Priority"/>
          </coding>
        </priority>
        <description>
          <text value="Monitoring der Lebensqualität und des Krankheitsstatus nach der onkologischen Erkrankung und Therapie"/>
        </description>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <startDate value="2026-08-15"/>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="21976-6"/>
              <display value="Cancer outcome status"/>
            </coding>
          </measure>
          <detailCodeableConcept>
            <text value="Kein Hinweis auf Lokalrezidiv oder Fernmetastasen"/>
          </detailCodeableConcept>
          <dueDate value="2026-11-15"/>
        </target>
        <target>
          <measure>
            <coding>
              <system value="http://loinc.org"/>
              <code value="24606-6"/>
              <display value="Mammografie"/>
            </coding>
          </measure>
          <detailCodeableConcept>
            <text value="Unauffällige Nachsorge-Mammographie (jährlich), kein Rezidivnachweis"/>
          </detailCodeableConcept>
          <dueDate value="2027-04-15"/>
        </target>
        <target>
          <measure>
            <text value="Arm-/Schulterfunktion und Lymphödem-Status nach axillärem Eingriff"/>
          </measure>
          <detailCodeableConcept>
            <text value="Kein manifestes Lymphödem, erhaltene Schulterbeweglichkeit"/>
          </detailCodeableConcept>
        </target>
        <target>
          <measure>
            <text value="Gesundheitsbezogene Lebensqualität (PROM, EORTC QLQ-C30 / BR23) – MII PRO-Modul"/>
          </measure>
          <detailCodeableConcept>
            <text value="Stabile bis verbesserte Lebensqualität im Verlauf"/>
          </detailCodeableConcept>
        </target>
        <expressedBy>
          <reference value="Practitioner/OnkologinMamma"/>
        </expressedBy>
        <addresses>
          <reference value="Condition/ConditionMamma"/>
        </addresses>
        <outcomeReference>
          <reference value="Observation/ObsDiseaseStatusMamma"/>
        </outcomeReference>
      </Goal>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Goal"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/ServiceRequest/ServiceRequestMammographieNachsorge"/>
    <resource>
      <ServiceRequest>
        <id value="ServiceRequestMammographieNachsorge"/>
        <language value="en"/>
        <text>
          <status value="generated"/>
        </text>
        <status value="active"/>
        <intent value="plan"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="24606-6"/>
            <display value="Mammografie"/>
          </coding>
          <text value="Nachsorge-Mammographie beidseits (jährlich)"/>
        </code>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <occurrenceDateTime value="2027-04-15"/>
        <requester>
          <reference value="Practitioner/OnkologinMamma"/>
        </requester>
        <reasonReference>
          <reference value="Condition/ConditionMamma"/>
        </reasonReference>
      </ServiceRequest>
    </resource>
    <request>
      <method value="POST"/>
      <url value="ServiceRequest"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/CarePlan/CarePlanMammaNachsorge"/>
    <resource>
      <CarePlan>
        <id value="CarePlanMammaNachsorge"/>
        <meta>
          <profile value="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-care-plan"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/>
        </text>
        <extension url="https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-careplan-custodian">
          <valueReference>
            <reference value="Organization/TumorzentrumMamma"/>
          </valueReference>
        </extension>
        <status value="active"/>
        <intent value="plan"/>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="736252007"/>
            <display value="Cancer care plan"/>
          </coding>
        </category>
        <subject>
          <reference value="Patient/PatientinMamma"/>
        </subject>
        <period>
          <start value="2026-08-15"/>
        </period>
        <author>
          <reference value="Practitioner/OnkologinMamma"/>
        </author>
        <addresses>
          <reference value="Condition/ConditionMamma"/>
        </addresses>
        <goal>
          <reference value="Goal/FollowUpGoal"/>
        </goal>
        <activity>
          <reference>
            <reference value="ServiceRequest/ServiceRequestMammographieNachsorge"/>
          </reference>
        </activity>
      </CarePlan>
    </resource>
    <request>
      <method value="POST"/>
      <url value="CarePlan"/>
    </request>
  </entry>
</Bundle>