Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide
1.0.0 - ci-build

Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: FollowupScreeningResult_eve-biopsyresult_discordant_act-discordantbiopsy - XML Representation

Raw xml | Download


<Bundle xmlns="http://hl7.org/fhir">
  <id
      value="FollowupScreeningResult_eve-biopsyresult_discordant_act-discordantbiopsy"/>
  <type value="collection"/>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/339"/>
    <resource>
      <CarePlan>
        <id value="339"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="CarePlan_339"> </a><p class="res-header-id"><b>Generated Narrative: CarePlan 339</b></p><a name="339"> </a><a name="hc339"> </a><a name="339-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_discordant_act-discordantbiopsy.html#RequestGroup_340">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/340"/>
          </reference>
        </activity>
      </CarePlan>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/340"/>
    <resource>
      <RequestGroup>
        <id value="340"/>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="RequestGroup_340"> </a><p class="res-header-id"><b>Generated Narrative: RequestGroup 340</b></p><a name="340"> </a><a name="hc340"> </a><a name="340-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>FollowupDiscordantBiopsyResult</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>: Benign histology findings on core needle biopsy that are discordant with imaging findings should be referred for potential excisional biopsy.

A histologic result may be discordant if the pathology result does not account for imaging findings that are suspicious for malignancy. The designation of discordance may require input from radiologist, breast surgeon, and breast pathologist. 

A repeat needle biopsy may be considered if the initial biopsy procedure was felt to be inadequate. Refer to radiologist recommendations for guidance.</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_discordant_act-discordantbiopsy.html#ServiceRequest_341">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="FollowupDiscordantBiopsyResult">
          <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="Benign histology findings on core needle biopsy that are discordant with imaging findings should be referred for potential excisional biopsy.

A histologic result may be discordant if the pathology result does not account for imaging findings that are suspicious for malignancy. The designation of discordance may require input from radiologist, breast surgeon, and breast pathologist. 

A repeat needle biopsy may be considered if the initial biopsy procedure was felt to be inadequate. Refer to radiologist recommendations for guidance."/>
          <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/341"/>
          </resource>
        </action>
      </RequestGroup>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/341"/>
    <resource>
      <ServiceRequest>
        <id value="341"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_341"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 341</b></p><a name="341"> </a><a name="hc341"> </a><a name="341-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 Discordant}">Discordant 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="Discordant"/>
            <display value="Discordant breast finding"/>
          </coding>
        </reasonCode>
      </ServiceRequest>
    </resource>
  </entry>
</Bundle>