06/07/2017

NCCN has published updates to the NCCN Guidelines® for Breast Cancer Screening and Diagnosis

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Breast Cancer Screening and Diagnosis. These NCCN Guidelines^® are currently available as Version 1.2017. 

• “History and physical exam” was replaced with “Clinical encounter including risk assessment” with the following modified and new footnotes stating, “At minimum medical and family history should be obtained and clinical encounter should encompass ongoing risk assessment, risk reduction counseling, as well as clinical breast exam” and “Medicare and insurers allow the patient direct access to scheduling for mammography.”  (BSCR-1)
• A new footnote was added to the recommendation for consideration of tomosynthesis stating, “Tomosynthesis improves cancer detection and reduces recall rates.” (BSCR-1)
• For palpable mass, the terms used for ultrasound findings were updated to align with the BI-RADS categories for ultrasound assessment. Also, a new footnote was added stating, ”In the context of numerous simple cysts, a complicated cyst may be considered a benign finding,” this footnote corresponds to “complicated cyst” BI-RADS category 3. (BSCR-6)
• A list of clinical signs and symptoms for inflammatory breast cancer have been included and a new footnote added stating, “Inflammatory breast cancer is a clinical diagnosis and is not dependent on a positive punch biopsy.” (BSCR-15)
• Under Breast Screening Considerations (BSCR-A 1 of 2), the bullet noting, “For women with heterogeneous dense breasts and dense breast tissue, recommend counseling on the risks and benefits of supplemental screening” is new.
• Under “Recommend Annual MRI Screening (Based on Evidence)” (BSCR-A 2 of 2), an age range of 25-29 years was provided for commencing screening for individuals with BRCA mutation and for un-tested individuals with first-degree relatives carrying a BRCA mutation.
• Under “Recommend Annual MRI Screening (Based on Expert Consensus Opinion)” (BSCR-A 2 of 2), NF1 and NBN were added to the list of genes for individuals with >20% risk of breast cancer based on gene and/or risk level.

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium®), the NCCN Biomarkers Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.