Implementierungsleitfaden Therapieziele Onkologie
1.0.0-ballot - Ballot
Germany
Implementierungsleitfaden Therapieziele Onkologie - Local Development build (v1.0.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
<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: <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: <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>