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Triple assessment guideline for secondary care (legacy)

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Description: Triple assessment guideline for secondary care for the initial assessment of women with suspected breast cancer

Publet Introduction:

Computerised decision support for the initial assessment of women referred to specialist breast units.
Triple assessment covers: imaging (typically mammography and ultrasound); clinical examination; pathology (needle sampling). Genetic risk assessment is also included in this application.

 Information
Guideline Objectives
The application
includes decision support for
four areas crucial to the evaluation of a patient
attending a triple assessment clinic.

  • Genetic risk assessment.
    The application helps assess familial and genetic risk
    of breast cancer.
    The RAGs applet is used here to construct a
    pedigree and calculate
    genetic risk for the individual patient, expressed as
    high, medium or low.
    Support for this task is based on NHS NICE Familial
    Breast Cancer guidelines.
  • Selection of correct mode of imaging (mammography,
    ultrasound or neither).
    The medical knowledge for this task is derived mainly
    from ACR guidelines.
  • Selection of the right mode of biopsy (if any). The
    knowledge for this task is derived from NHSBSP guidelines.
  • Selection of the optimum way to manage the patient
    based on examination, imaging and cytology results
    (it is assumed that core biopsy results if any would
    not be available on same day). The knowledge for this task is derived
    mainly from BASO guidelines.

 

Target SettingSecondary care
Target Users
  • Author
  • Release Date 20/07/2004
Overview
ProvenanceAdvanced Computation Laboratory, Cancer Research UK, London in collaboration with the specialist breast units at Guy's hospital, London and Addenbrooke's hospital Cambridge
Management
The application
includes decision support for
four areas crucial to the evaluation of a patient
attending a triple assessment clinic.

  • Genetic risk assessment.
    The application helps assess familial and genetic risk
    of breast cancer.
    The RAGs applet is used here to construct a
    pedigree and calculate
    genetic risk for the individual patient, expressed as
    high, medium or low.
    Support for this task is based on NHS NICE Familial
    Breast Cancer guidelines.
  • Selection of correct mode of imaging (mammography,
    ultrasound or neither).
    The medical knowledge for this task is derived mainly
    from ACR guidelines.
  • Selection of the right mode of biopsy (if any). The
    knowledge for this task is derived from NHSBSP guidelines.
  • Selection of the optimum way to manage the patient
    based on examination, imaging and cytology results
    (it is assumed that core biopsy results if any would
    not be available on same day). The knowledge for this task is derived
    mainly from BASO guidelines.

 

Safety Case
Sources
References
  • NICE
    (Familial
    Breast Cancer guidelines);

  • BASO (Management of symptomatic breast disease in the UK,
    1998);

  • NCCN (Breast Cancer Screening and Diagnosis);

  • SIGN (Breast Cancer in Women);

  • ACR (Appropriate imaging work-up of palpable breast
    masses;
    Appropriate imaging work-up of breast
    microcalcifications;
    Performance of diagnostic mammography;
    Performance of a breast ultrasound examination);

  • ASCO (Breast cancer surveillance, 1998);

  • NHSBSP (Breast cancer screening assessment;

  • Non-operative diagnostic procedures and reporting in
    breast cancer screeni