{ "resourceType" : "Bundle", "id" : "PrimaryScreeningDecision_JosephineGreene-past-breast-pain-adh-biopsy", "type" : "collection", "entry" : [{ "fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/14", "resource" : { "resourceType" : "CarePlan", "id" : "14", "text" : { "status" : "generated", "div" : "

Generated Narrative: CarePlan 14

instantiatesCanonical: Primary Screening Decision

status: Draft

intent: Proposal

subject: Josephine38 Greene57

created: 2024-12-10 00:00:00+0000

Activities

-Reference
*Bundle: type = collection
" }, "instantiatesCanonical" : ["http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/PrimaryScreeningDecision"], "status" : "draft", "intent" : "proposal", "subject" : { "reference" : "Patient/JosephineGreene", "display" : "Josephine38 Greene57" }, "created" : "2024-12-10T00:00:00.0Z", "activity" : [{ "reference" : { "reference" : "RequestGroup/15" } }] } }, { "fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/15", "resource" : { "resourceType" : "RequestGroup", "id" : "15", "text" : { "status" : "extensions", "div" : "

Generated Narrative: RequestGroup 15

instantiatesCanonical: Primary Screening Decision

status: Draft

intent: Proposal

subject: Josephine38 Greene57

action

id

ACSMammoAtypicalBiopsy

Recommendation Flag Extension: Not due

title: Annual screening mammogram starting age 30

description: An annual screening mammogram starting at age 30 is recommended.\n\nWomen who are at higher than average risk for breast cancer based on past atypical biopsy should get a mammogram every year, typically starting at age 30.\n

code: MG Breast Screening

Documentations

-TypeLabelDisplayUrl
*CitationACSAmerican Cancer Society Recommendations for the Early Detection of Breast Cancerhttps://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html

timing: Events: 2025-11-15 , Once per 1 year

resource: Bundle: type = collection

action

id

ACSAtypicalBiopsy

title: Perform lifetime risk assessment

description: Consider performing assessment of lifetime risk. \n\nIf estimated lifetime risk is >20%, patient may be eligible for supplemental screening with annual screening MRI.

code: Perform lifetime risk assessment

Documentations

-TypeLabelDisplayCitationUrl
*CitationACSAmerican Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography

Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA. 2015;314(15):1599–1614.

\n
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.57.2.75

resource: Bundle: type = collection

" }, "instantiatesCanonical" : ["http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/PrimaryScreeningDecision"], "status" : "draft", "intent" : "proposal", "subject" : { "reference" : "Patient/JosephineGreene", "display" : "Josephine38 Greene57" }, "action" : [{ "id" : "ACSMammoAtypicalBiopsy", "extension" : [{ "url" : "http://cancerscreeningcds.github.io/bcsm-cds/StructureDefinition/csm-recommendation-flag", "valueCodeableConcept" : { "coding" : [{ "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system", "code" : "not-due", "display" : "Not due" }] } }], "title" : "Annual screening mammogram starting age 30", "description" : "An annual screening mammogram starting at age 30 is recommended.\n\nWomen who are at higher than average risk for breast cancer based on past atypical biopsy should get a mammogram every year, typically starting at age 30.\n", "code" : [{ "coding" : [{ "system" : "http://loinc.org", "code" : "24606-6", "display" : "MG Breast Screening" }] }], "documentation" : [{ "type" : "citation", "label" : "ACS", "display" : "American Cancer Society Recommendations for the Early Detection of Breast Cancer", "url" : "https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html" }], "timingTiming" : { "event" : ["2025-11-15"], "repeat" : { "boundsPeriod" : { "start" : "2024-10-10" }, "frequency" : 1, "period" : 1, "periodUnit" : "a" } }, "resource" : { "reference" : "ServiceRequest/16" } }, { "id" : "ACSAtypicalBiopsy", "title" : "Perform lifetime risk assessment", "description" : "Consider performing assessment of lifetime risk. \n\nIf estimated lifetime risk is >20%, patient may be eligible for supplemental screening with annual screening MRI.", "code" : [{ "coding" : [{ "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system", "code" : "lifetimeriskassessment", "display" : "Perform lifetime risk assessment" }] }], "documentation" : [{ "type" : "citation", "label" : "ACS", "display" : "American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography", "citation" : "Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA. 2015;314(15):1599–1614.", "url" : "https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.57.2.75" }], "resource" : { "reference" : "ServiceRequest/17" } }] } }, { "fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/16", "resource" : { "resourceType" : "ServiceRequest", "id" : "16", "text" : { "status" : "generated", "div" : "

Generated Narrative: ServiceRequest 16

basedOn: Breast Cancer Screening Service Request

status: option

intent: Proposal

code: MG Breast Screening

subject: Josephine38 Greene57

occurrence: 2025-11-15

reasonCode: Atypical biopsy

" }, "basedOn" : [{ "reference" : "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest" }], "status" : "option", "intent" : "proposal", "code" : { "coding" : [{ "system" : "http://loinc.org", "code" : "24606-6", "display" : "MG Breast Screening" }] }, "subject" : { "reference" : "Patient/JosephineGreene", "display" : "Josephine38 Greene57" }, "occurrenceDateTime" : "2025-11-15", "reasonCode" : [{ "coding" : [{ "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system", "code" : "atypicalbx", "display" : "Atypical biopsy" }] }] } }, { "fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/17", "resource" : { "resourceType" : "ServiceRequest", "id" : "17", "text" : { "status" : "generated", "div" : "

Generated Narrative: ServiceRequest 17

basedOn: Breast Cancer Screening Service Request

status: option

intent: Proposal

code: Perform lifetime risk assessment

subject: Josephine38 Greene57

reasonCode: Atypical biopsy

" }, "basedOn" : [{ "reference" : "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest" }], "status" : "option", "intent" : "proposal", "code" : { "coding" : [{ "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system", "code" : "lifetimeriskassessment", "display" : "Perform lifetime risk assessment" }] }, "subject" : { "reference" : "Patient/JosephineGreene", "display" : "Josephine38 Greene57" }, "reasonCode" : [{ "coding" : [{ "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system", "code" : "atypicalbx", "display" : "Atypical biopsy" }] }] } }] }