SubmittedbyBarbaraFenton,MD,MedicalDirectorofAugustaCarePartners
Did you know that at Augusta, we have an ongoing quality initiative to improve our breast cancer screening rates? This was selected by ACP’s Quality Committee as one of two key initiatives for 2018 and 2019.
A Task Force, composed of clinicians from women’s imaging in radiology, family medicine, internal medicine, breast surgery, and occupational health, began meeting last fall. Data was presented by Dr. Goodnight in Radiology demonstrating that women in our community are not receiving mammograms as early and as regularly as they should. The Task Force recognized the need to promote a consistent message to minimize practice variation with regard to screening guidelines and recommendations. After much review, the National Comprehensive Cancer Network (NCCN) guideline was selected as the ACP network standard.
For women of average risk, beginning at age 40 years, the following are recommended:
- Annual clinical encounter
- Annual screening mammogram (consider tomosynthesis)
- Breast awareness
This is the same guideline that in fact is already being used by our Cancer Center and Women’s Imaging in Radiology. It was most recently updated in May of 2018 and the full guideline can be accessed on the NCCN website, access requires registration but is free to providers.
Many women know that there is roughly a one in eight chance of being diagnosed with breast cancer, and that breast cancer is the second leading cause of cancer death in women, second only to lung cancer. However many women don’t recognize that, while having a first degree relative with breast cancer almost doubles a woman’s risk, most women (8 out of 10) who get breast cancer do not have a family history of the disease.
Every day at Augusta Health, 20% of the women receiving a mammogram have not had a mammogram within 2 years’ time.
Data shown below, also demonstrates the significant opportunity for earlier, more frequent mammograms for the women in this community. (all of the RED in the graph)
Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women, with the benefit increasing with advancing age. Since screening also exposes women to potential harms, such as callbacks, and associated anxiety related to that, remember 3D tomography not only increases breast cancer detection rates but also decreases call back rates. This is covered by Medicare, although many patients do not recognize it. At Augusta, 3D tomography is available at Stuart’s Draft Primary & Urgent Care and at Women’s Imaging at Augusta Hospital.
References:
https://www.nccn.org/professionals/physician_gls/d