 Guidelines, order sets, protocols and more.
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Breast Disease, Diagnosis of (Guideline)
Released 01/2010
Scope and Target Population:This guideline applies to all patients who have a breast concern or abnormality. Clinical Highlights and Recommendations:- It is imperative that communications between the radiologic and surgical consultants and the primary care provider are thorough and consistent.
- A bloody tap or a persistent mass following aspiration of a palpable dominant mass should be referred to a surgeon or radiologist for additional workup regardless of negative imaging.
- Patients with a spontaneous bloody or watery discharge should be referred to a radiologist for imaging studies and a surgeon if appropriate.
- The risk of cancer with a negative evaluation for breast pain is less than 1%.
- Any questionable abnormal pathologic findings from image-directed biopsy requires a surgical consultation and possible open biopsy.
Priority Aims:- Reduce the length of time between first knowledge of a breast abnormality and diagnostic resolution.
- Ensure that a bloody tap or a persistent mass following aspiration of a palpable dominant mass is referred to a surgeon regardless of negative imaging.
- Ensure that patients with spontaneous bloody or watery discharge have a mammogram (with or without an ultrasound) and are referred to a surgeon or radiologist.
- Ensure that needle biopsies demonstrating abnormal (any questionable or pathologic findings that do not correlate with imaging) pathologic findings are followed by performance of an open biopsy.
- Ensure that all women with a breast concern that is indeterminate will have a follow-up clinical assessment within two to three months.
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