D.15 SCREENING FOR BREAST CANCER 36C24423R0132.pdf
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- 36C24423R0132
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This memorandum establishes policy for breast screening services at the Lebanon VA Medical Center and community clinics. Eligible Veterans will be referred to accredited community mammography facilities for annual or biennial screening based on age. Veterans may choose alternative providers but will be responsible for any associated costs. Ordering practitioners must communicate results to patients within set timeframes and refer those with abnormalities for follow up. The Women Veterans Program Manager will monitor screening outcomes as part of the medical center's quality assurance program. Practitioners are responsible for performing breast exams and referring Veterans for mammography as indicated. The related federal contract opportunity is a solicitation for Schuylkill County Community Based Outpatient Clinic services to be provided at the Lebanon VA Medical Center.
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VA MEDICAL CENTER 595 MEDICAL CENTER MEMORANDUM 400-32
Lebanon, PA 17042 April 30, 2019
SCREENING FOR BREAST DISEASE
1. PURPOSE: To establish policy for breast screening at the Lebanon Veterans Affairs (VA) Medical Center and VA Community Clinics.
2. POLICY:
a. Screening for breast disease and diagnostic mammography will be made available to eligible Veterans.
b. Mammography findings will be view alerted to the treating practitioner and the Women Veterans Program Manager (WVPM). The treating practitioner will make appropriate referrals for evaluation and subsequent mammograms.
3. PROCEDURES:
a. Eligible Veterans will be referred to an accredited community mammography facility for a mammogram. Veterans choosing not to use approved VA mammography services will be responsible for all fees incurred for mammography services elsewhere.
(1) The provider must enter a consult into Computerized Patient Record System
(CPRS).
(2) Office of Care Coordination (OCC) staff will contact Veteran following approval of consult on how to schedule the mammogram with the local provider (imaging service), as appropriate. Patients will also be able to schedule mammogram with the Women’s Health Medical Support Assistant (MSA) during her check-out process.
(3) Reports of the mammogram will be scanned into CPRS by OCC staff upon receipt, with view alerts to the treating practitioner who originated the request, as well as the WVPM. The treating practitioner will be responsible for following-up on abnormal findings.
(4) Primary Care/Women’s Health Clinics will contact Veterans when they are due for routine follow-up.
b. The suggested frequency for diagnostic and screening mammography according to American Cancer Society (ACS) and Veterans Health Administration (VHA) recommends:
MCM 400-32, 4-30-19
(1) Women with an average risk for breast cancer undergo regular screening mammography starting at age 45 years.
(2) Women aged 45-54 years old should be screened annually.
(3) Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually.
(4) Women should have the opportunity to begin annual screening between the ages of 40 and 44 years.
(5) Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer.
c. The Medical Center Quality Assurance Plan will include monitoring of the screening for breast disease.
d. Documentation:
(1) The ordering practitioner is responsible for communicating the results of Breast Imaging Reporting and Data System (BI-RADS) Code category findings to the patient within 14 calendar days from the date on which the results are available. Results requiring action must be communicated by the provider or designee no later than 7 calendar days from the date the results are available.
(2) Significant abnormalities may require review and communication in shorter timeframes to minimize risk to the patient.
4. RESPONSIBILITIES:
a. The Director and Chief of Staff have overall responsibility for compliance with this medical center memorandum.
b. Practitioners are responsible for:
(1) Performing appropriate clinical breast examinations when indicated.
(2) Referring appropriate Veterans for mammography by entering a consult or order in CPRS.
5. REFERENCES:
Current VHA Handbook 1330.01, Health Care Services For Women Veterans- Section I.
MCM 400-32, 4-30-19
6. KEY WORDS: Breast Screen, Breast Cancer, Mammography, Mammogram, Women Veterans
7. AUTHOR: Women Veterans Program Manager
8. RESCISSION: MCM 400-32, 8-12-15, same subject
9. REISSUE DATE: April 2022
Robert W. Callahan, Jr.
Director
VA MEDICAL CENTER 595 MEDICAL CENTER MEMORANDUM 400-32
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