Clinical Standards of Excellence

Breast Cancer Division

Division Co-Chiefs:  Stanley Waintraub, MD, Richard Davies, MD

Quality Indicators (Medical/Surgical/Radiation):

  1. Sentinal Node Biopsy for routine staging in early breast cancer with clinically negative axillary nodes.
  2. Biphosphonates in women with bone metastases.
  3. Postop surveillance for detection and treatment of recurrent breast cancer.
  4. Radiation oncology consultation for patients who underwent breast conserving surgery.
  5. Medical oncology consultation for patients who have invasive breast cancer.

All Patients

  1. All patients with solid tumors are staged according to ACoS standards.
  2. All patients who are receiving chemotherapy have a plan documented prior to administration of therapy.

Diagnostic Work Up:

Breast Cancer
ICD 9 Codes
174.0
174.1
174.2
174.3
174.4
174.5
174.6
174.7
174.8
174.9
175.0
175.9
233.0
238.3
239.3
Diagnostic Work Up
Test/Exam:
History & Physical Exam
CBC
Chemistry
CA 27.29
Diagnostic mammography
Breast ultrasound or sonogram
Biopsy Options:
Fine needle biopsy
Core needle biopsy
Mammogram directed stereotactic needle biopsy
Ultrasound guided biopsy
Surgical Biopsy
Pathology and Cytology Review
Breast cancer profile on the tumor: Estrogen and progesterone receptors & HER2 neu
Gene profiling of tumor
Tumor grade
Chest x-ray
Bone scan
CT Chest/Abdomen/Pelvis with contrast
Breast MRI with and without gadolinium
PET Scan
Prognostic Work Up

Histologic features of pathology:

  1. LVI - Lymphovascular invasion
  2. Grade of tumor
Tumor stage
Recurrence Score
 
Last updated: 2010-07-30