FHIR IG analytics| Package | lt.hl7.fhir.breast |
| Resource Type | Questionnaire |
| Id | Questionnaire-questionnaire-mammogram-lt-breast.json |
| FHIR Version | R5 |
| Source | https://build.fhir.org/ig/HL7LT/ig-lt-breast/Questionnaire-questionnaire-mammogram-lt-breast.html |
| URL | https://hl7.lt/fhir/breast/Questionnaire/questionnaire-mammogram-lt-breast |
| Version | 0.0.1 |
| Status | active |
| Date | 2026-03-29T12:06:43+00:00 |
| Name | MammogramQuestionnaireLtBreast |
| Title | Questionnaire: Mammogram ESPBI Form (LT Breast) |
| Description | Structured data-capture form for mammogram reporting based on ADP Table 7.1. |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
English
Generated Narrative: Questionnaire questionnaire-mammogram-lt-breast
Language: en
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  MammogramQuestionnaireLtBreast | Structured data-capture form for mammogram reporting based on ADP Table 7.1. | Questionnaire | https://hl7.lt/fhir/breast/Questionnaire/questionnaire-mammogram-lt-breast#0.0.1 | |
  grp-exam-context | Examination context | 0..1 | group | |
  exam-date | Date of test | 0..1 | dateTime | |
 radiation-dose | Radiation dose (mGy) | 0..1 | quantity | |
 technologist-name | Radiology technologist | 0..1 | string | |
| equipment-name | Equipment name | 0..1 | string | |
 facility-name | Facility name | 0..1 | string | |
| grp-palpable-changes | Palpable / visible changes | 0..1 | group | |
 skin-formations | Skin formations | 0..1 | coding | Options: 2 options |
| scars | Scars | 0..1 | coding | Options: 2 options |
| nipple-inversion | Nipple inversion | 0..1 | coding | Options: 2 options |
| prior-breast-surgery | Prior breast surgery | 0..1 | coding | Options: 2 options |
| breast-injuries | Breast injuries | 0..1 | coding | Options: 2 options |
| breast-diseases | Breast diseases | 0..1 | coding | Options: 2 options |
 other-information | Other information | 0..1 | text | |
| grp-gland-density | Gland density | 0..1 | group | |
| acr-density | ACR breast density category | 0..1 | coding | Options: 4 options |
| grp-findings-right | Findings – right breast | 0..1 | group | |
| right-changes-present | Changes present | 0..1 | coding | Options: 2 options |
| right-formations | Formations | 0..1 | coding | Options: 2 options |
| right-formations-quadrant | Quadrant location | 0..1 | coding | Options: 4 options |
| right-calcifications | Calcifications | 0..1 | coding | Options: 2 options |
| right-deformation | Deformation | 0..1 | coding | Options: 2 options |
| right-asymmetric-tissue | Asymmetric tissue | 0..1 | coding | Options: 2 options |
| right-dataset-size | Dataset size (mm) | 0..1 | quantity | |
| grp-findings-left | Findings – left breast | 0..1 | group | |
| left-changes-present | Changes present | 0..1 | coding | Options: 2 options |
| left-formations | Formations | 0..1 | coding | Options: 2 options |
| left-formations-quadrant | Quadrant location | 0..1 | coding | Options: 4 options |
| left-calcifications | Calcifications | 0..1 | coding | Options: 2 options |
| left-deformation | Deformation | 0..1 | coding | Options: 2 options |
| left-asymmetric-tissue | Asymmetric tissue | 0..1 | coding | Options: 2 options |
| left-dataset-size | Dataset size (mm) | 0..1 | quantity | |
| grp-dynamics | Dynamic changes compared to previous examination | 0..1 | group | |
| dynamics | Dynamic changes | 0..1 | coding | Options: 2 options |
| grp-related-changes | Related changes | 0..1 | group | |
| skin-changes | Skin changes | 0..1 | coding | Options: 2 options |
| nipple-changes | Nipple changes | 0..1 | coding | Options: 2 options |
| lymph-node-changes | Lymph node changes | 0..1 | coding | Options: 2 options |
| grp-conclusion | Conclusion | 0..1 | group | |
 birads-conclusion | BI-RADS conclusion | 0..1 | coding | Options: 6 options |
| recommendations | Recommendations | 0..* | coding | Options: 6 options |
| conclusion-notes | Notes | 0..1 | text | |
| Documentation for this format | ||||
Options Sets
Answer options for skin-formations
Answer options for scars
Answer options for nipple-inversion
Answer options for prior-breast-surgery
Answer options for breast-injuries
Answer options for breast-diseases
Answer options for acr-density
Answer options for right-changes-present
Answer options for right-formations
Answer options for right-formations-quadrant
Answer options for right-calcifications
Answer options for right-deformation
Answer options for right-asymmetric-tissue
Answer options for left-changes-present
Answer options for left-formations
Answer options for left-formations-quadrant
Answer options for left-calcifications
Answer options for left-deformation
Answer options for left-asymmetric-tissue
Answer options for dynamics
Answer options for skin-changes
Answer options for nipple-changes
Answer options for lymph-node-changes
Answer options for birads-conclusion
Answer options for recommendations
Lithuanian
Generated Narrative: Questionnaire questionnaire-mammogram-lt-breast
Language: en
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
| MammogramQuestionnaireLtBreast | Structured data-capture form for mammogram reporting based on ADP Table 7.1. | Questionnaire | https://hl7.lt/fhir/breast/Questionnaire/questionnaire-mammogram-lt-breast#0.0.1 | |
| grp-exam-context | Examination context | 0..1 | group | |
| exam-date | Date of test | 0..1 | dateTime | |
| radiation-dose | Radiation dose (mGy) | 0..1 | quantity | |
| technologist-name | Radiology technologist | 0..1 | string | |
| equipment-name | Equipment name | 0..1 | string | |
| facility-name | Facility name | 0..1 | string | |
| grp-palpable-changes | Palpable / visible changes | 0..1 | group | |
| skin-formations | Skin formations | 0..1 | coding | Options: 2 options |
| scars | Scars | 0..1 | coding | Options: 2 options |
| nipple-inversion | Nipple inversion | 0..1 | coding | Options: 2 options |
| prior-breast-surgery | Prior breast surgery | 0..1 | coding | Options: 2 options |
| breast-injuries | Breast injuries | 0..1 | coding | Options: 2 options |
| breast-diseases | Breast diseases | 0..1 | coding | Options: 2 options |
| other-information | Other information | 0..1 | text | |
| grp-gland-density | Gland density | 0..1 | group | |
| acr-density | ACR breast density category | 0..1 | coding | Options: 4 options |
| grp-findings-right | Findings – right breast | 0..1 | group | |
| right-changes-present | Changes present | 0..1 | coding | Options: 2 options |
| right-formations | Formations | 0..1 | coding | Options: 2 options |
| right-formations-quadrant | Quadrant location | 0..1 | coding | Options: 4 options |
| right-calcifications | Calcifications | 0..1 | coding | Options: 2 options |
| right-deformation | Deformation | 0..1 | coding | Options: 2 options |
| right-asymmetric-tissue | Asymmetric tissue | 0..1 | coding | Options: 2 options |
| right-dataset-size | Dataset size (mm) | 0..1 | quantity | |
| grp-findings-left | Findings – left breast | 0..1 | group | |
| left-changes-present | Changes present | 0..1 | coding | Options: 2 options |
| left-formations | Formations | 0..1 | coding | Options: 2 options |
| left-formations-quadrant | Quadrant location | 0..1 | coding | Options: 4 options |
| left-calcifications | Calcifications | 0..1 | coding | Options: 2 options |
| left-deformation | Deformation | 0..1 | coding | Options: 2 options |
| left-asymmetric-tissue | Asymmetric tissue | 0..1 | coding | Options: 2 options |
| left-dataset-size | Dataset size (mm) | 0..1 | quantity | |
| grp-dynamics | Dynamic changes compared to previous examination | 0..1 | group | |
| dynamics | Dynamic changes | 0..1 | coding | Options: 2 options |
| grp-related-changes | Related changes | 0..1 | group | |
| skin-changes | Skin changes | 0..1 | coding | Options: 2 options |
| nipple-changes | Nipple changes | 0..1 | coding | Options: 2 options |
| lymph-node-changes | Lymph node changes | 0..1 | coding | Options: 2 options |
| grp-conclusion | Conclusion | 0..1 | group | |
| birads-conclusion | BI-RADS conclusion | 0..1 | coding | Options: 6 options |
| recommendations | Recommendations | 0..* | coding | Options: 6 options |
| conclusion-notes | Notes | 0..1 | text | |
| Documentation for this format | ||||
Options Sets
Answer options for skin-formations
Answer options for scars
Answer options for nipple-inversion
Answer options for prior-breast-surgery
Answer options for breast-injuries
Answer options for breast-diseases
Answer options for acr-density
Answer options for right-changes-present
Answer options for right-formations
Answer options for right-formations-quadrant
Answer options for right-calcifications
Answer options for right-deformation
Answer options for right-asymmetric-tissue
Answer options for left-changes-present
Answer options for left-formations
Answer options for left-formations-quadrant
Answer options for left-calcifications
Answer options for left-deformation
Answer options for left-asymmetric-tissue
Answer options for dynamics
Answer options for skin-changes
Answer options for nipple-changes
Answer options for lymph-node-changes
Answer options for birads-conclusion
Answer options for recommendations
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "questionnaire-mammogram-lt-breast",
"language": "en",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"url": "https://hl7.lt/fhir/breast/Questionnaire/questionnaire-mammogram-lt-breast",
"version": "0.0.1",
"name": "MammogramQuestionnaireLtBreast",
"title": "Questionnaire: Mammogram ESPBI Form (LT Breast)",
"status": "active",
"date": "2026-03-29T12:06:43+00:00",
"publisher": "Lithuanian Medical Library",
"contact": [
{
"name": "Lithuanian Medical Library",
"telecom": [
{
"system": "url",
"value": "https://medicinosnk.lt"
},
{
"system": "email",
"value": "info@medicinosnk.lt"
}
]
}
],
"description": "Structured data-capture form for mammogram reporting based on ADP Table 7.1.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "LT"
}
]
}
],
"item": [
{
"linkId": "grp-exam-context",
"text": "Examination context",
"type": "group",
"item": [
{
"linkId": "exam-date",
"text": "Date of test",
"type": "dateTime"
},
{
"linkId": "radiation-dose",
"text": "Radiation dose (mGy)",
"type": "quantity"
},
{
"linkId": "technologist-name",
"text": "Radiology technologist",
"type": "string"
},
{
"linkId": "equipment-name",
"text": "Equipment name",
"type": "string"
},
{
"linkId": "facility-name",
"text": "Facility name",
"type": "string"
}
]
},
{
"linkId": "grp-palpable-changes",
"text": "Palpable / visible changes",
"type": "group",
"item": [
{
"linkId": "skin-formations",
"text": "Skin formations",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "scars",
"text": "Scars",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "nipple-inversion",
"text": "Nipple inversion",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "prior-breast-surgery",
"text": "Prior breast surgery",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "breast-injuries",
"text": "Breast injuries",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "breast-diseases",
"text": "Breast diseases",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "other-information",
"text": "Other information",
"type": "text"
}
]
},
{
"linkId": "grp-gland-density",
"text": "Gland density",
"type": "group",
"item": [
{
"linkId": "acr-density",
"text": "ACR breast density category",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "acr-a",
"display": "ACR A – Almost entirely fatty"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "acr-b",
"display": "ACR B – Scattered areas of fibroglandular density"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "acr-c",
"display": "ACR C – Heterogeneously dense"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "acr-d",
"display": "ACR D – Extremely dense"
}
}
]
}
]
},
{
"linkId": "grp-findings-right",
"text": "Findings – right breast",
"type": "group",
"item": [
{
"linkId": "right-changes-present",
"text": "Changes present",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "right-formations",
"text": "Formations",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
],
"item": [
{
"linkId": "right-formations-quadrant",
"text": "Quadrant location",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "uoq",
"display": "Upper outer quadrant"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "uiq",
"display": "Upper inner quadrant"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "loq",
"display": "Lower outer quadrant"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "liq",
"display": "Lower inner quadrant"
}
}
]
}
]
},
{
"linkId": "right-calcifications",
"text": "Calcifications",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "right-deformation",
"text": "Deformation",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "right-asymmetric-tissue",
"text": "Asymmetric tissue",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "right-dataset-size",
"text": "Dataset size (mm)",
"type": "quantity"
}
]
},
{
"linkId": "grp-findings-left",
"text": "Findings – left breast",
"type": "group",
"item": [
{
"linkId": "left-changes-present",
"text": "Changes present",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "left-formations",
"text": "Formations",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
],
"item": [
{
"linkId": "left-formations-quadrant",
"text": "Quadrant location",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "uoq",
"display": "Upper outer quadrant"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "uiq",
"display": "Upper inner quadrant"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "loq",
"display": "Lower outer quadrant"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "liq",
"display": "Lower inner quadrant"
}
}
]
}
]
},
{
"linkId": "left-calcifications",
"text": "Calcifications",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "left-deformation",
"text": "Deformation",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "left-asymmetric-tissue",
"text": "Asymmetric tissue",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "left-dataset-size",
"text": "Dataset size (mm)",
"type": "quantity"
}
]
},
{
"linkId": "grp-dynamics",
"text": "Dynamic changes compared to previous examination",
"type": "group",
"item": [
{
"linkId": "dynamics",
"text": "Dynamic changes",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "dynamics-none",
"display": "Image without negative dynamics"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "dynamics-negative",
"display": "Negative dynamics observed"
}
}
]
}
]
},
{
"linkId": "grp-related-changes",
"text": "Related changes",
"type": "group",
"item": [
{
"linkId": "skin-changes",
"text": "Skin changes",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "nipple-changes",
"text": "Nipple changes",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "lymph-node-changes",
"text": "Lymph node changes",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
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}
]
}
]
},
{
"linkId": "grp-conclusion",
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{
"valueCoding": {
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{
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},
{
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},
{
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},
{
"valueCoding": {
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},
{
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]
},
{
"linkId": "recommendations",
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"repeats": true,
"answerOption": [
{
"valueCoding": {
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"code": "rec-mammographic-control",
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},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "rec-additional-mammography",
"display": "Additional mammography"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/breast-questionnaire-options",
"code": "rec-ultrasound",
"display": "Ultrasound examination"
}
},
{
"valueCoding": {
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"code": "rec-mri",
"display": "MRI examination"
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},
{
"valueCoding": {
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"code": "rec-biopsy",
"display": "Biopsy indicated"
}
},
{
"valueCoding": {
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"code": "rec-consultation",
"display": "Consultation with breast specialist"
}
}
]
},
{
"linkId": "conclusion-notes",
"text": "Notes",
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}
]
}
]
}