Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide
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: FollowupScreeningResult_eve-biopsyresult_atypical_act-highriskreferral - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id
      value="FollowupScreeningResult_eve-biopsyresult_atypical_act-highriskreferral"/>
  <type value="collection"/>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/336"/>
    <resource>
      <CarePlan>
        <id value="336"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="CarePlan_336"> </a><p class="res-header-id"><b>Generated Narrative: CarePlan 336</b></p><a name="336"> </a><a name="hc336"> </a><a name="336-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-flow-FollowupScreeningResult.html">Followup Screening Result</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href="Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient">Jane Doe</a></p><p><b>created</b>: 2024-12-10 00:00:00+0000</p><h3>Activities</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Reference</b></td></tr><tr><td style="display: none">*</td><td><a href="Bundle-FollowupScreeningResult_eve-biopsyresult_atypical_act-highriskreferral.html#RequestGroup_337">Bundle: type = collection</a></td></tr></table></div>
        </text>
        <instantiatesCanonical
                               value="http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-FollowupScreeningResult"/>
        <status value="draft"/>
        <intent value="proposal"/>
        <subject>
          <reference value="Patient/defaultPatient"/>
          <display value="Jane Doe"/>
        </subject>
        <created value="2024-12-10T00:00:00.0Z"/>
        <activity>
          <reference>
            <reference value="RequestGroup/337"/>
          </reference>
        </activity>
      </CarePlan>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/337"/>
    <resource>
      <RequestGroup>
        <id value="337"/>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="RequestGroup_337"> </a><p class="res-header-id"><b>Generated Narrative: RequestGroup 337</b></p><a name="337"> </a><a name="hc337"> </a><a name="337-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-flow-FollowupScreeningResult.html">Followup Screening Result</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href="Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient">Jane Doe</a></p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>FollowupAtypicalBiopsyResult</blockquote><p><b>Recommendation Flag Extension</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system due}">Due</span></p><p><b>title</b>: Refer to breast surgeon</p><p><b>description</b>: Atypical fndings, including ADH and non-classic LCIS, should be referred for potential excision.

Atypical ductal hyperplasia (ADH) and non-classic lobular carcinoma in situ (LCIS), including pleomorphic or florid LCIS, should be referred to breast surgeon for potential excision.

Classic LCIS and atypical lobular hyperplasia (ALH) are typically candidates for observation with clinical and imaging follow-up but may benefit from excision in certain circumstances.</p><p><b>code</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system surgicalreferral}">Breast surgeon referral</span></p><h3>Documentations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Label</b></td><td><b>Display</b></td><td><b>Url</b></td></tr><tr><td style="display: none">*</td><td>Citation</td><td>ASBrS</td><td>The American Society of Breast Surgeons Resource Guide: Surgical Management of Benign or High-Risk Lesions (Feb 2025)</td><td><a href="https://www.breastsurgeons.org/docs/statements/asbrs-rg-high-risk-lesions.pdf">https://www.breastsurgeons.org/docs/statements/asbrs-rg-high-risk-lesions.pdf</a></td></tr></table><p><b>timing</b>: Events: 2024-10-01 10:00:00+0000 </p><p><b>resource</b>: <a href="Bundle-FollowupScreeningResult_eve-biopsyresult_atypical_act-highriskreferral.html#ServiceRequest_338">Bundle: type = collection</a></p></blockquote></div>
        </text>
        <instantiatesCanonical
                               value="http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-FollowupScreeningResult"/>
        <status value="draft"/>
        <intent value="proposal"/>
        <subject>
          <reference value="Patient/defaultPatient"/>
          <display value="Jane Doe"/>
        </subject>
        <action id="FollowupAtypicalBiopsyResult">
          <extension
                     url="http://cancerscreeningcds.github.io/bcsm-cds/StructureDefinition/csm-recommendation-flag">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system"/>
                <code value="due"/>
                <display value="Due"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <title value="Refer to breast surgeon"/>
          <description
                       value="Atypical fndings, including ADH and non-classic LCIS, should be referred for potential excision.

Atypical ductal hyperplasia (ADH) and non-classic lobular carcinoma in situ (LCIS), including pleomorphic or florid LCIS, should be referred to breast surgeon for potential excision.

Classic LCIS and atypical lobular hyperplasia (ALH) are typically candidates for observation with clinical and imaging follow-up but may benefit from excision in certain circumstances."/>
          <code>
            <coding>
              <system
                      value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
              <code value="surgicalreferral"/>
              <display value="Breast surgeon referral"/>
            </coding>
          </code>
          <documentation>
            <type value="citation"/>
            <label value="ASBrS"/>
            <display
                     value="The American Society of Breast Surgeons Resource Guide: Surgical Management of Benign or High-Risk Lesions (Feb 2025)"/>
            <url
                 value="https://www.breastsurgeons.org/docs/statements/asbrs-rg-high-risk-lesions.pdf"/>
          </documentation>
          <timingTiming>
            <event value="2024-10-01T10:00:00.000+00:00"/>
          </timingTiming>
          <resource>
            <reference value="ServiceRequest/338"/>
          </resource>
        </action>
      </RequestGroup>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/338"/>
    <resource>
      <ServiceRequest>
        <id value="338"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_338"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 338</b></p><a name="338"> </a><a name="hc338"> </a><a name="338-en-US"> </a><p><b>basedOn</b>: <a href="ActivityDefinition-BreastCancerScreeningServiceRequest.html">Breast Cancer Screening Service Request</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system surgicalreferral}">Breast surgeon referral</span></p><p><b>subject</b>: <a href="Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient">Jane Doe</a></p><p><b>occurrence</b>: 2024-10-01 10:00:00+0000</p><p><b>reasonCode</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/biopsy-result-observation-code-system Atypical}">Atypical breast finding</span></p></div>
        </text>
        <basedOn>🔗 
          <reference
                     value="http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"/>
        </basedOn>
        <status value="option"/>
        <intent value="proposal"/>
        <code>
          <coding>
            <system
                    value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
            <code value="surgicalreferral"/>
            <display value="Breast surgeon referral"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/defaultPatient"/>
          <display value="Jane Doe"/>
        </subject>
        <occurrenceDateTime value="2024-10-01T10:00:00.000+00:00"/>
        <reasonCode>
          <coding>
            <system
                    value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/biopsy-result-observation-code-system"/>
            <code value="Atypical"/>
            <display value="Atypical breast finding"/>
          </coding>
        </reasonCode>
      </ServiceRequest>
    </resource>
  </entry>
</Bundle>