This measure assesses the percentage of inconclusive or high-risk BI-RADS assessments that received appropriate follow-up within 90 days of the assessment for members 40–74 years of age.
Why It Matters?
Breast cancer accounts for 15% of all new cancer diagnoses in the U.S. In 2020, over 3 million women were estimated to be living with breast cancer in the U.S and it is estimated that 13% of women will be diagnosed with breast cancer at some point during their lifetime.1
The National Comprehensive Cancer Network (NCCN) provides breast cancer screening and diagnostic follow-up guidelines based on the American College of Radiology’s (ACR) breast imaging reporting and data system (BI-RADS) assessment categories.2 BI-RADS standardizes the reporting of findings into six assessment categories for further management. The measure addresses appropriate and timely follow-up after inconclusive (BI-RADS 0) or high-risk (BI-RADS 4–5) assessments.
Successful identification of cancer relies on appropriate follow-up of abnormal results, and failure to complete timely diagnostic testing can undermine the significance of screening. It is estimated that up to 30% of women do not receive recommended immediate follow-up for high-risk mammograms.3 Additionally, some populations experience greater delays in follow-up than others. For example, women in minority groups and those with underlying health conditions or previous clinical diagnoses tend to experience delays in follow-up care for abnormal mammograms.4,5 Moreover, studies have found that delayed time to follow-up after abnormal mammography plays a role in the decreased survival rates observed among underserved minority women.5
*This measure was supported by Cooperative Award NU380T000303 from the Centers for Disease Control and Prevention and the National Network of Public Health Institutes (NNPHI). Its contents are the sole responsibility of the authors (NCQA) and do not necessarily represent the official position of the Centers for Disease Control and Prevention, the US Department of Health and Human Services, the US government or the NNPHI.
Historical Results – National Averages
Performance results for this measure are currently unavailable.
References
- Cancer Stat Facts: Female Breast Cancer. National Cancer Institute. Accessed July 14, 2023. https://seer.cancer.gov/statfacts/html/breast.html
- Sickles, E.A., C.J. D’Orsi, L.W. Bassett, C.M. Appleton, W.A. Berg, and E.S. Burnside. 2013. “ACR Bi-Rads® Mammography.” ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System 5 2013.
- Reece, J.C., E.F.G. Neal, P. Nguyen, J.G. McIntosh, J.D. Emery. 2021. “Delayed or Failure to Follow-Up Abnormal Breast Cancer Screening Mammograms in Primary Care: A Systematic Review.” BMC Cancer 21(1):373. doi:10.1186/s12885-021-08100-3
- Nguyen, K., R. Pasick, S. Stewart, K. Kerlikowske, L. Karliner. 2017. “Disparities in Abnormal Mammogram Follow-Up Time for Asian Women Compared to non-Hispanic Whites and between Asian Ethnic Groups.” Cancer 123(18):3468–75. doi:10.1002/cncr.30756
- Petersen, S.S., M. Sarkissyan, Y. Wu, S. Clayton, J.V. Vadgama. 2018. “Time to Clinical Follow-Up after Abnormal Mammogram among African American and Hispanic Women.” J Health Care Poor Underserved 29(1):448–62. doi:10.1353/hpu.2018.0030
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