OncoLog, Volume 46, Number 11/12, November/December 2001 Page: Clinical Discussion
12 p. : ill.View a full description of this periodical.
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Breast Screening/Diagnostic Guidelines (6)
ABNORMAL FINDINGS ON CLINICAL BREAST EXAM:
SKIN CHANGES
- Peau d'orange Yes Repeat biopsy
Reassess
- Erythema Consider skin biopsy
- Nipple excoriation ACR category and/or core biopsy Benign? Refer to Breast
- Scaling 1, 2, or 3 of breast parenchyma No Cancer Practice
-Eczema Bilateral
mammogram Guideline (available
ultrasound on the Internet)
ACR category Tissue diagnosis of mammographic abnormality by
4 or 5 iiiiye-yuided FNA uil winbiupsy* ui
excisional biopsy after needle localization*Specimen radiograph to confirm presence
of suspicious calcification seen on mammogram.
Specimen radiograph if microcalcifications
or other nonpalpable abnormality to confirm
that suspicious lesion has been sampled.
***This chart is available on the Internet and was
published in the Fall 2001 issue of Compass.
ACR = BI-RADS, Breast Imaging Reporting and
Data System of the American College of Radiology
FNA = fine-needle aspirationFNA
or core Excisional biopsy
biYepsy Return to appropriate
Yes screening (Panel 1)***
Benign?
No Refer to Breast
Bng? No___________ Cancer Practice
Benign? N- Guideline (available
on the Internet)
Yes
One or more of the following: repeat imaging,
repeat biopsy, or do skin biopsy
Refer to Breast
Cancer Practice
Benign? No Guideline (available
on the Internet)
Yes
No
Reassess clinical and
radiographic findings and Benign?
consider excisional biopsy Return to appropriate
Yes screening (Panel 1)***Ver:Compass/3/4/#6
M. D. Anderson s Practice Guidelines were developed by multidisciplinary teams of physicians and nurses and are intended to represent evidence-based cancer careawith
consensus of opinion used secondarily. The core development team for this guideline included Dr Therese Bartholomew Bevers and Dr Carol B. Selling.(Continued from previous page)
anxiety and avoiding repeat
tests and other delays in the
process.
" Attentiveness to reported symptoms.
Listen to the patient's reports
of symptoms and respond with
a thorough evaluation of any
abnormality." Continue investigating until all
findings are concordant. Clinical
findings, imaging studies, and
cytological or histopathological
interpretations should all support
any conclusion reached. Continue
until they do, repeating studies if
necessary.
* Provide thorough follow-up care.References & Suggested Reading
American College of Radiology (ACR)
Standards for Performance of Ultrasound-
Guided Percutaneous Breast Interventional
Procedures, 1996
American College of Radiology (ACR).
Standards for Performance of Breast
Ultrasound Examination, 1/1/99
Hunt KK, Robb GL, Strom EA, Ueno NT, Eds.
Breast Cancer The M. D. Anderson Cancer
Care Series. New York: Springer, 2001
NCCN Practice Guidelines: BI-RADS Category
Definitions, Version 1. 2001Quarterly Supplement to OncoLog
Produced by the Department of Scientific Publications
for the Practice Outcomes Program
Ronald S. Wallets, M.D.
Medical Director; Care Management Program,
M. D. Anderson Cancer Center and
Medical Director, Managed Care Programs,
M. D. Anderson Physicians NetworkT"
Academic Programs
Margaret Kripke, Ph.D.
Executive Vice President and Chief Academic Officer
Stephen P. Tomasovic, Ph.D.
Vice President for Educational Programs
Managing Editor
Julia M. Starr, B.A.
Department of Scientific Publications
Contributing Editor
Sunni Hosemann, R.N., B.S.N.
Educational Programs
Design
Mataya Design
Chart Illustrations
Malaya Design
2001 The University of Texas M. D. Anderson
Cancer Center
Individuals should not rely exclusively on information
contained in these clinical guidelines. Health care
providers must use their own professional judgment in
treating patients. Individuals should not substitute
these guidelines for professional medical advice,
diagnosis, or treatment and should consult a qualified
physician if they have medical questions or concerns.
The University of Texas M. D. Anderson Cancer
Center makes no warranties or representations,
expressed or implied, as to the accuracy, complete-
ness, or usefulness of the information contained or
referenced in the clinical guidelines and disclaims
any and all liability for injury and/or other damages
to any third party resultingfrom any individual's
following these guidelines.
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University of Texas M.D. Anderson Cancer Center. OncoLog, Volume 46, Number 11/12, November/December 2001, periodical, November 2001; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth903627/m1/6/: accessed July 18, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.