TY - JOUR
T1 - Select Choices in Benign Breast Disease
T2 - An Initiative of the American Society of Breast Surgeons for the American Board of Internal Medicine Choosing Wisely® Campaign
AU - Rao, Roshni
AU - Ludwig, Kandace
AU - Bailey, Lisa
AU - Berry, Tiffany S.
AU - Buras, Robert
AU - Degnim, Amy
AU - Fayanju, Oluwadamilola M.
AU - Froman, Joshua
AU - Golesorkhi, Negar
AU - Greenburg, Caprice
AU - Ma, Ayemoe Thu
AU - Mautner, Starr Koslow
AU - Krontiras, Helen
AU - Sowden, Michelle
AU - Wexelman, Barbara
AU - Landercasper, Jeffrey
N1 - Publisher Copyright:
© 2018, Society of Surgical Oncology.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background: Up to 50% of all women encounter benign breast problems. In contrast to breast cancer, high-level evidence is not available to guide treatment. Management is therefore largely based on individual physician experience/training. The American board of internal medicine (ABIM) initiated its Choosing Wisely® campaign to promote conversations between patients and physicians about challenging the use of tests or procedures which may not be necessary. The American society of breast surgeons (ASBrS) Patient safety and quality committee (PSQC) chose to participate in this campaign in regard to the management of benign breast disease. Methods: The PSQC solicited initial candidate measures. PSQC surgeons represent a wide variety of practices. The resulting measures were ranked by modified Delphi appropriateness methodology in two rounds. The final list was approved by ASBrS and endorsed by the ABIM. Results: The final five measures are as follows. (1) Don’t routinely excise areas of pseuodoangiomatous stromal hyperplasia (PASH) of the breast in patients who are not having symptoms from it. (2) Don’t routinely surgically excise biopsy-proven fibroadenomas that are < 2 cm. (3) Don’t routinely operate for a breast abscess without an initial attempt to percutaneously aspirate. (4) Don’t perform screening mammography in asymptomatic patients with normal exams who have less than a 5-years life expectancy. (5) Don’t routinely drain nonpainful, fluid-filled cysts. Conclusions: The ASBrS Choosing Wisely® measures that address benign breast disease management are easily accessible to patients via the internet. Consensus was reached by PSQC regarding these recommendations. These measures provide guidance for shared decision-making.
AB - Background: Up to 50% of all women encounter benign breast problems. In contrast to breast cancer, high-level evidence is not available to guide treatment. Management is therefore largely based on individual physician experience/training. The American board of internal medicine (ABIM) initiated its Choosing Wisely® campaign to promote conversations between patients and physicians about challenging the use of tests or procedures which may not be necessary. The American society of breast surgeons (ASBrS) Patient safety and quality committee (PSQC) chose to participate in this campaign in regard to the management of benign breast disease. Methods: The PSQC solicited initial candidate measures. PSQC surgeons represent a wide variety of practices. The resulting measures were ranked by modified Delphi appropriateness methodology in two rounds. The final list was approved by ASBrS and endorsed by the ABIM. Results: The final five measures are as follows. (1) Don’t routinely excise areas of pseuodoangiomatous stromal hyperplasia (PASH) of the breast in patients who are not having symptoms from it. (2) Don’t routinely surgically excise biopsy-proven fibroadenomas that are < 2 cm. (3) Don’t routinely operate for a breast abscess without an initial attempt to percutaneously aspirate. (4) Don’t perform screening mammography in asymptomatic patients with normal exams who have less than a 5-years life expectancy. (5) Don’t routinely drain nonpainful, fluid-filled cysts. Conclusions: The ASBrS Choosing Wisely® measures that address benign breast disease management are easily accessible to patients via the internet. Consensus was reached by PSQC regarding these recommendations. These measures provide guidance for shared decision-making.
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U2 - 10.1245/s10434-018-6584-5
DO - 10.1245/s10434-018-6584-5
M3 - Article
C2 - 29968026
AN - SCOPUS:85049569921
SN - 1068-9265
VL - 25
SP - 2795
EP - 2800
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 10
ER -