Description
Evaluate criteria to determine age to start and age to stop, screening modality, and screening interval.
Mid-Level Flow Diagram
Semi-Structured Logic Statements
Inclusions
None.
Exclusions
| Name | Description |
|---|---|
Patient is not eligible for screening | |
See 'Screening Eligible' flow logic | |
Events
| Name | Description |
|---|---|
Age > 74? | Age > 74 years |
Patient age > 74 years | |
Indicators of reduced life expectancy? | Patient has conditions or meets criteria that indicate reduced life expectancy. |
Currently lactating? | Patient is currently lactating or breast feeding. |
OBSERVATIONS include `Lactating or Breastfeeding` | |
High risk exclusions or special population? | Patient meets criteria for patient population excluded from USPSTF recommendation statement or meets criteria for patient population identified as having higher than average risk in ACS guidelines. |
Actions
Discuss decision to continue screening Description The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older. Decision to continue screening mammography in average risk women should be based on shared decision-making. Pseudocode |
Discuss decision to continue screening if life expectancy < 10 years Description ACS advises that women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or more. Life expectancy is generally defined as having greater than a 50% probability of surviving 10 years. A validated tool such as www.eprognosis.com can help guide decision making. Decision to continue screening mammography in cases of limited life expectancy should be based on shared decision-making. Pseudocode |
High risk exclusion recommendations Description Evaluate for high risk exclusion criteria Pseudocode See 'High Risk Exclusions' flow logic |
Special population recommendations Description Evaluate for special population criteria Pseudocode See 'Special Populations' flow logic |
Consider delay if average risk Description There is no contraindication to screening mammography during lactation, however sensitivity and specificity are decreased. For average risk patients, consider a short delay in routine breast imaging until after lactation, particularly if they are not planning prolonged breastfeeding. Source: NCCN Pseudocode |
Average Risk recommendations Description Evaluate for average risk criteria Pseudocode See 'Average Risk' flow logic |