eMeasure Title Breast Cancer Screening
eMeasure Identifier
(Measure Authoring Tool)
125 eMeasure Version number 3
NQF Number Not Applicable GUID 19783c1b-4fd1-46c1-8a96-a2f192b97ee0
Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward National Committee for Quality Assurance
Measure Developer National Committee for Quality Assurance
Endorsed By None
Description
Percentage of women 40–69 years of age who had a mammogram to screen for breast cancer.
Copyright
Physician Performance Measure (Measures) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). 

The Measures are copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices). Commercial use is defined as the sale, licensing, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial use of the Measures requires a license agreement between the user and NCQA. NCQA is not responsible for any use of the Measures. 

(c) 2008 -2014 National Committee for Quality Assurance. All Rights Reserved. 

Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets.  NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2013 American Medical Association. LOINC(R) copyright 2004-2013 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2013 International Health Terminology Standards Development Organisation. ICD-10 copyright 2013 World Health Organization. All Rights Reserved.
Disclaimer
These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.

THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND.
 
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
Breast cancer is one of the most common types of cancers, accounting for a quarter of all new cancer diagnoses for women in the U.S. (BreastCancer.Org, 2011). It ranks as the second leading cause of cancer-related mortality in women, accounting for nearly 40,000 estimated deaths in 2013 (American Cancer Society, 2011).

According to the National Cancer Institute’s Surveillance Epidemiology and End Results program, the chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 30, it is one in 2,212. By age 40, the chances increase to one in 235, by age 50, it becomes one in 54, and, by age 60, it is one in 25. From 2004 to 2008, the median age at the time of breast cancer diagnosis was 61 years among adult women (Tangka et al, 2010). 

In the U.S., costs associated with a diagnosis of breast cancer range from $451 to $2,520, factoring in continued testing, multiple office visits and varying procedures. The total costs related to breast cancer add up to nearly $7 billion per year in the U.S., including $2 billion spent on late-stage treatment (Lavigne et al, 2008; Boykoff et al, 2009).
Clinical Recommendation Statement
The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation). The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms (C recommendation). (USPSTF, 2009) The Task Force concludes the evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years and older (I statement). 
U.S. Preventive Services Task Force (2009)
Grade: B recommendation. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.
Grade: C recommendation. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms.
Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.
Grade: D recommendation. The USPSTF recommends against teaching breast self-examination (BSE).
Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older.
Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.
Improvement Notation
Higher score equals better quality.
Reference
American Cancer Society. 2010. Cancer Facts & Figures 2010. Atlanta: American Cancer Society.
Reference
National Cancer Institute. 2010. “Breast Cancer Screening.” http://www.cancer.gov/cancertopics/pdq/screening/breast/healthprofessional
Reference
National Business Group on Health. 2011. Pathways to Managing Cancer in the Workplace. Washington: National Business Group on Health.
Reference
U.S. Preventive Services Task Force (USPSTF). 2009. 1) “Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement.” 2) “December 2009 addendum.” Ann Intern Med 151(10):716-726.
Reference
American Cancer Society. 2010. Cancer Facts & Figures 2010. Atlanta: American Cancer Society.
Reference
National Cancer Institute. 2010. “Breast Cancer Screening.” http://www.cancer.gov/cancertopics/pdq/screening/breast/healthprofessional
Reference
National Business Group on Health. 2011. Pathways to Managing Cancer in the Workplace. Washington: National Business Group on Health.
Reference
U.S. Preventive Services Task Force (USPSTF). 2009. 1) “Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement.” 2) “December 2009 addendum.” Ann Intern Med 151(10):716-726.
Reference
BreastCancer.org. 2012. U.S. Breast Cancer Statistics. www.breastcancer.org/symptoms/understand_bc/statistics.jsp
Definition
None
Guidance
None
Transmission Format
TBD
Initial Patient Population
Women 41–69 years of age with a visit during the measurement period
Denominator
Equals Initial Patient Population
Denominator Exclusions
Women who had a bilateral mastectomy or for whom there is evidence of two unilateral mastectomies
Numerator
Women with one or more mammograms during the measurement period or the year prior to the measurement period
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
Measure Population
Not Applicable
Measure Observations
Not Applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex.

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Reporting Stratification

Supplemental Data Elements




Measure Set
None