ICSI has made a significant format enhancement in our scientific documents. All scientific documents (excluding Order Sets) now have “interactive” capability that allows a user to click on various links in the document and easily navigate from one area to another. For example, you can click on an algorithm box (those denoted with an “A” and those that refer to other algorithm boxes) and link directly to supporting annotation.

A tip for quickly going back and forth within the document:
Go to View, Toolbars, More Tools, Page Navigation, Previous View.
This should give you a back arrow tool that will allow you to go back and forth between views easily.

Note: The interactive links within ICSI PDF guidelines may not work on some mobile devices. However, the GoodReader App (and possibly some other "reader" applications) will allow anyone to open ICSI interactive PDF Guidelines on their mobile device and utilize most of the interactive capabilities.

Scope and Target Population:
This guideline applies to all patients who have a breast concern or abnormality.

Aims:

1. Reduce the length of time between first knowledge of a breast abnormality and diagnostic resolution.
   
2. Ensure that patients with bloody or clear discharge have a mammogram (with or without an ultrasound) and are referred to a surgeon or radiologist.
   
3. Ensure that needle biopsies demonstrating abnormal findings are followed by performance of an excisional biopsy.
   
4. Ensure that all women with a breast concern that is indeterminate will have a follow-up clinical assessment within 6 to 12 months.

Clinical Highlights:

• It is imperative that communications between the radiologic and surgical consultants and the primary care clinician are thorough and consistent.
  
• Patients with a bloody or clear discharge should be referred to a radiologist and/or surgeon for further evaluation.
  
• A persistent mass with negative imaging does not rule out malignancy and requires a referral to a surgeon.
  
• Abnormal pathologic findings from image-directed biopsy requires a surgical consultation and possible excisional biopsy.