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Burns, Surgical Treatment
Philippine College of Surgeons Dear PCS Fellows, We at the PCS Committee on HMO, RVS, & PHIC & The PCS Board of Regents are pleased to announce the Adoption of PAHMOC of our new & revised RVS. We are currently under negotiations with them with regard to the multiplier to be used to arrive at our final professional Fees. Rest assured that we will have a graduated & staggered increase of PF thru the years from what we are currently receiving due to the proposed yearly increments in the multiplier. To those Fellows who haven’t signed the USA (Universal Service Agreement found here in our PCS website) please be reminded to sign and submit to the PCS Secretariat, as only those who did and are in good standing (updated annual dues) will be eligible to avail of the benefits of the new RVS scale. Indeed, we are hoping & looking forward to a merrier 2020 Christmas for our Fellows. Yours truly, FERNANDO L. LOPEZ, MD, FPCS Chairman Noted by: JOSELITO M. MENDOZA, MD, FPCS Regent-in-Charge JOSE ANTONIO M. SALUD, MD, FPCS President For many years now the PCS Committee on HMO & RUV has been compiling, with the assistance of the different surgical subspecialties, a new updated list of RUV for each procedure to replace the existing manual of 2009. This new version not only has a more complete listing of cases but also includes the newly developed procedures particularly for all types of minimally invasive operations. Sometime last year, the Department of Health released Circular 2019-0558 on the Public Access to the Price Information by all Health Providers as required by Section 28.16 of the IRR of the Universal Health Care Act. -
Evicore Breast Imaging Guidelines
CLINICAL GUIDELINES Breast Imaging Guidelines Version 2.0 Effective September 1, 2021 eviCore healthcare Clinical Decision Support Tool Diagnostic Strategies: This tool addresses common symptoms and symptom complexes. Imaging requests for individuals with atypical symptoms or clinical presentations that are not specifically addressed will require physician review. Consultation with the referring physician, specialist and/or individual’s Primary Care Physician (PCP) may provide additional insight. CPT® (Current Procedural Terminology) is a registered trademark of the American Medical Association (AMA). CPT® five digit codes, nomenclature and other data are copyright 2017 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in the CPT® book. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for the data contained herein or not contained herein. © 2021 eviCore healthcare. All rights reserved. Breast Imaging Guidelines V2.0 Breast Imaging Guidelines Abbreviations for Breast Guidelines 3 BR-Preface1: General Considerations 5 BR-1: Breast Ultrasound 8 BR-2: MRI Breast 10 BR-3: Breast Reconstruction 12 BR-4: MRI Breast is NOT Indicated 13 BR-5: MRI Breast Indications 14 BR-6: Nipple Discharge/Galactorrhea 18 BR-7: Breast Pain (Mastodynia) 19 BR-8: Alternative Breast Imaging Approaches 20 BR-9: Suspected Breast Cancer in Males 22 BR-10: Breast Evaluation in Pregnant or Lactating Females 23 ______________________________________________________________________________________________________ -
Ductal Lavage in Women from BRCA1/2 Families: Is There a Future for Ductal Lavage in Women at Increased Genetic Risk of Breast Cancer?
1243 Ductal Lavage in Women from BRCA1/2 Families: Is There a Future for Ductal Lavage in Women at Increased Genetic Risk of Breast Cancer? Jennifer T. Loud,1 Anne C.M. Thie´baut,4 Andrea D. Abati,2 Armando C. Filie,2 Kathryn Nichols,5 David Danforth,2 Ruthann Giusti,6 Sheila A. Prindiville,3 and Mark H. Greene1 1Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, 2Division of Clinical Sciences, and 3Office of the Director, National Cancer Institute, NIH, Bethesda, Maryland; 4INSERM, U657, Pasteur Institute, Paris, France; and 5Westat Corporation; 6Center for Biologics Evaluation and Research, Food and Drug Administration, Department of Health and Human Services, Rockville, Maryland Abstract Purpose: Ductal lavage has been used for risk stratifi- z10 cells. Postmenopausal women with intact ovaries cation and biomarker development and to identify compared with premenopausal women [odds ratio intermediate endpoints for risk-reducing intervention (OR), 4.8; P = 0.03] and women without a prior breast trials. Little is known about patient characteristics cancer history (OR, 5.2; P = 0.04) had an increased associated with obtaining nipple aspirate fluid (NAF) likelihood of yielding NAF. Having breast-fed (OR, and adequate cell counts (z10 cells) in ductal lavage 3.4; P = 0.001), the presence of NAF before ductal specimens from BRCA mutation carriers. lavage (OR, 3.2; P = 0.003), and being premenopausal Methods: We evaluated patient characteristics associat- (OR, 3.0; P = 0.003) increased the likelihood of ductal ed with obtaining NAF and adequate cell counts in lavage cell count adequacy. In known BRCA1/2 ductal lavage specimens from the largest cohort of mutation carriers, only breast-feeding (OR, 2.5; P = women from BRCA families yet studied (BRCA1/2 = 0.01) and the presence of NAF (OR, 3.0; P = 0.01) were 146, mutation-negative = 23, untested = 2). -
Biopsy Needles and Drainage Catheters
Needles & Accessories | Catheters & Accessories Dilation & Accessories Spinal & Accessories | Implantable & Accessories Product Catalog ISO 13485 & ISO 9001 Certified Company Rev. 01 - 2019/03 About ADRIA Srl. Adria is a worldwide leader in developing, manufacturing and marketing healthcare products. The main focus is on Radiology, Oncology, Urology, Gynecology and Surgery . Adria' s corporate headquarter is based in Italy, it is ISO Certified and products are CE . marked. Adria was incorporated more than 20 years ago in Bologna , where the corporate headquarter and production plant is located. Adria is leader in developing and manufacturing healthcare products and keeps the status to be one of the first companies aimed to develop single patient use biopsy needles and drainage catheters. Over the time, thanks to the experience of specialized doctors and engineers , Adria product range and quality have been progressively enhanced, involving and developing the spine treatment line. Nowadays Adria has a worldwide presence . Reference markets are France, Spain, Turkey and products are distributed in more than 50 countries, through a large and qualified network of dealers. Since far off the very beginning, many things have changed, but Adria' s philosophy and purpose have always remained unchanged: helping healthcare providers to fulfill their mission of caring for patients. Table of Contents Needles & Accessories …………………………………………….....…...3 Catheters & Accessories ……………………….………………..…...…...18 Dilation & Accessories ……………………………………………...…...25 Spinal & Accessories ……………………………………………...…...30 Implantables & Accessories……………………………………………...…...35 Needles & Accessories HYSTO SYSTEM Automatic Biopsy Instrument……………………….……….…….. 4 HYSTO SYSTEM II Automatic Biopsy Instrument…………………….……….……...5 SAMPLE MASTER Semi-Automatic Biopsy Instrument…………………………….. 6 HYSTO-ONE Automatic Reusable Biopsy Instrument & MDA Biopsy Needle ....... 7 HYSTO-TWO Automatic Reusable Biopsy Instrument & MDS Biopsy Needle…... -
Evaluation of Nipple Discharge
New 2016 American College of Radiology ACR Appropriateness Criteria® Evaluation of Nipple Discharge Variant 1: Physiologic nipple discharge. Female of any age. Initial imaging examination. Radiologic Procedure Rating Comments RRL* Mammography diagnostic 1 See references [2,4-7]. ☢☢ Digital breast tomosynthesis diagnostic 1 See references [2,4-7]. ☢☢ US breast 1 See references [2,4-7]. O MRI breast without and with IV contrast 1 See references [2,4-7]. O MRI breast without IV contrast 1 See references [2,4-7]. O FDG-PEM 1 See references [2,4-7]. ☢☢☢☢ Sestamibi MBI 1 See references [2,4-7]. ☢☢☢ Ductography 1 See references [2,4-7]. ☢☢ Image-guided core biopsy breast 1 See references [2,4-7]. Varies Image-guided fine needle aspiration breast 1 Varies *Relative Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate Radiation Level Variant 2: Pathologic nipple discharge. Male or female 40 years of age or older. Initial imaging examination. Radiologic Procedure Rating Comments RRL* See references [3,6,8,10,13,14,16,25- Mammography diagnostic 9 29,32,34,42-44,71-73]. ☢☢ See references [3,6,8,10,13,14,16,25- Digital breast tomosynthesis diagnostic 9 29,32,34,42-44,71-73]. ☢☢ US is usually complementary to mammography. It can be an alternative to mammography if the patient had a recent US breast 9 mammogram or is pregnant. See O references [3,5,10,12,13,16,25,30,31,45- 49]. MRI breast without and with IV contrast 1 See references [3,8,23,24,35,46,51-55]. -
Breast Care / Breast Cancer
BREAST CARE / BREAST CANCER Overview The Kaiser Permanente Breast Care Management Algorithm provided on this site was developed by the Inter-Regional Breast Cancer leaders group (IRBC). This multidisciplinary group includes physicians from Primary Care, Surgery, Oncology, Obstetrics and Gynecology, Radiology, Mammography, Genetics and Women’s Services and representatives from various regional Breast Cancer Task force groups, Clinical Nursing, Quality Resource & Risk Management, Public Relations & Issues Management, Prevention Services, and the Permanente Federation. The algorithm was developed to: • Improve the quality of care for our members with breast complaints, • Improve the timeliness of the identification of breast abnormalities and diagnosis of breast cancer, • Improve the satisfaction of members with breast complaints, and • Respond to the increase in malpractice allegations of failure to diagnose breast cancer. In 2002, the IRBC group held periodic conference calls to develop information to assist primary care clinicians in improving the quality of care for patients with breast complaints. A multidisciplinary consensus-based method was used to develop the content of the algorithm. The group also identified additional information and resources available internally and externally which would support implementation.The Breast Care Leaders in each Region have been encouraged to review and modify the algorithm to reflect local operations. Therefore, prior to use, PCPs are advised to contact a Regional member of the Inter-Regional Breast Care leaders group about revisions for your Region This site is for use within Kaiser Permanente only. What is Available on this Site? The IRBC group and the project management staff from the Permanente Federation worked together to define the project scope and develop the following products and information: I. -
5. Effectiveness of Breast Cancer Screening
5. EFFECTIVENESS OF BREAST CANCER SCREENING This section considers measures of screening Nevertheless, the performance of a screening quality and major beneficial and harmful programme should be monitored to identify and outcomes. Beneficial outcomes include reduc- remedy shortcomings before enough time has tions in deaths from breast cancer and in elapsed to enable observation of mortality effects. advanced-stage disease, and the main example of a harmful outcome is overdiagnosis of breast (a) Screening standards cancer. The absolute reduction in breast cancer The randomized trials performed during mortality achieved by a particular screening the past 30 years have enabled the suggestion programme is the most crucial indicator of of several indicators of quality assurance for a programme’s effectiveness. This may vary screening services (Day et al., 1989; Tabár et according to the risk of breast cancer death in al., 1992; Feig, 2007; Perry et al., 2008; Wilson the target population, the rate of participation & Liston, 2011), including screening participa- in screening programmes, and the time scale tion rates, rates of recall for assessment, rates observed (Duffy et al., 2013). The technical quality of percutaneous and surgical biopsy, and breast of the screening, in both radiographic and radio- cancer detection rates. Detection rates are often logical terms, also has an impact on breast cancer classified by invasive/in situ status, tumour size, mortality. The observational analysis of breast lymph-node status, and histological grade. cancer mortality and of a screening programme’s Table 5.1 and Table 5.2 show selected quality performance may be assessed against several standards developed in England by the National process indicators. -
Breast Cancer Screening and Chemoprevention
Management of Breast Diseases Ismail Jatoi Manfred Kaufmann (Eds.) Management of Breast Diseases Dr. Ismail Jatoi Prof. Dr. Manfred Kaufmann Head, Breast Care Center Breast Unit National Naval Medical Center Director, Women’s Hospital Uniformed Services University University of Frankfurt of the Health Sciences Theodor-Stern-Kai 7 4301 Jones Bridge Rd. 60590 Frankfurt Bethesda, MD 20814 Germany USA [email protected] [email protected] ISBN: 978-3-540-69742-8 e-ISBN: 978-3-540-69743-5 DOI: 10.1007/978-3-540-69743-5 Springer Heidelberg Dordrecht London New York Library of Congress Control Number: 2009934509 © Springer-Verlag Berlin Heidelberg 2010 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the German Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and appli- cation contained in this book. -
Ultrasound, Elastography and MRI Mammography
EAS Journal of Radiology and Imaging Technology Abbreviated Key Title: EAS J Radiol Imaging Technol ISSN 2663-1008 (Print) & ISSN: 2663-7340 (Online) Published By East African Scholars Publisher, Kenya Volume-1 | Issue-2 | Mar-Apr-2019 | Research Article Ultrasound, Elastography and MRI Mammography Correlation in Breast Pathologies (A Study of 50 Cases) Dr Hiral Parekh.1, Dr Lata Kumari.2, Dr Dharmesh Vasavada.3 1Professor, Department of Radiodiagnosis M P Shah Government Medical College Jamnagar, Gujarat, India 2Resident Doctor in Radiodiagnosis Department of Radiodiagnosis M P Shah Government Medical College Jamnagar, Gujarat, India 3Professor, Department of Surgery M P Shah Government Medical College Jamnagar, Gujarat, India *Corresponding Author Dr Dharmesh Vasavada Abstract: Introduction: The purpose of this study is to investigate the value of MRI in comparison to US and mammography in diagnosis of breast lesions. MRI is ideal for breast imaging due to its ability to depict excellent soft tissue contrast. Methods: This study of 50 cases was conducted in the department of Radiodiagnosis, Guru Gobinsingh Government Hospital, M P Shah Government Medical College, Jamnagar, Gujarat, India. All 50 cases having or suspected to have breast lesions were chosen at random among the indoor and outdoor patients referred to the Department of Radiodiagnosis for imaging. Discussion: In the present study the results of sonoelastography were compared with MRI. The malignant masses were the commonest and the mean age of patients with malignant masses in our study was 45 years, which is in consistent with Park‟s statement that the mean age of breast cancer occurrence is about 42 years in India3. -
Diagnostic Accuracy of Shear Wave Elastography for Prediction of Breast Malignancy in Patients with Pathological Nipple Discharge
Open Access Research BMJ Open: first published as 10.1136/bmjopen-2015-008848 on 22 January 2016. Downloaded from Diagnostic accuracy of shear wave elastography for prediction of breast malignancy in patients with pathological nipple discharge Xiaobo Guo,1 Ying Liu,1 Wanhu Li2 To cite: Guo X, Liu Y, Li W. ABSTRACT Strengths and limitations of this study Diagnostic accuracy of shear Objectives: Pathological nipple discharge (PND) may wave elastography for indicate malignant breast lesions. As the role of shear ▪ prediction of breast Diagnostic accuracy of shear wave elastography wave elastography (SWE) in predicting these malignant malignancy in patients with (SWE) for detecting malignancy of patients with pathological nipple discharge. lesions has not yet been evaluated, we aim to evaluate PND has rarely been studied. BMJ Open 2016;6:e008848. the diagnostic value of SWE for this condition. ▪ For the first time, this study tested diagnostic doi:10.1136/bmjopen-2015- Design: Prospective diagnostic accuracy study accuracy of a synthesised measurement of quali- 008848 comparing a combination of qualitative and quantitative tative and quantitative measures of SWE for measurements of SWE (index test) to a ductoscopy detecting malignancy in patients with PND. ▸ Prepublication history for and microdochectomy for histological diagnosis ▪ Limitations include the fact that the weight of this paper is available online. (reference test). each measurement in the synthesised score was To view these files please Setting: Fuzhou General Hospital of Nanjing military assigned evenly and the surgeon was not visit the journal online command. blinded. (http://dx.doi.org/10.1136/ Participants: A total of 379 patients with PND were bmjopen-2015-008848). -
Official Proceedings
Scientific Session Awards Abstracts presented at the Society’s annual meeting will be considered for the following awards: • The George Peters Award recognizes the best presentation by a breast fellow. In addition to a plaque, the winner receives $1,000. The winner is selected by the Society’s Publications Committee. The award was established in 2004 by the Society to honor Dr. George N. Peters, who was instrumental in bringing together the Susan G. Komen Breast Cancer Foundation, The American Society of Breast Surgeons, the American Society of Breast Disease, and the Society of Surgical Oncology to develop educational objectives for breast fellowships. The educational objectives were first used to award Komen Interdisciplinary Breast Fellowships. Subsequently the curriculum was used for the breast fellowship credentialing process that has led to the development of a nationwide matching program for breast fellowships. • The Scientific Presentation Award recognizes an outstanding presentation by a resident, fellow, or trainee. The winner of this award is also determined by the Publications Committee. In addition to a plaque, the winner receives $500. • All presenters are eligible for the Scientific Impact Award. The recipient of the award, selected by audience vote, is honored with a plaque. All awards are supported by The American Society of Breast Surgeons Foundation. The American Society of Breast Surgeons 2 2017 Official Proceedings Publications Committee Chair Judy C. Boughey, MD Members Charles Balch, MD Sarah Blair, MD Katherina Zabicki Calvillo, MD Suzanne Brooks Coopey, MD Emilia Diego, MD Jill Dietz, MD Mahmoud El-Tamer, MD Mehra Golshan, MD E. Shelley Hwang, MD Susan Kesmodel, MD Brigid Killelea, MD Michael Koretz, MD Henry Kuerer, MD, PhD Swati A. -
Mammary Ductoscopy, Aspiration and Lavage
Cigna Medical Coverage Policy Effective Date ............................ 2/15/2014 Subject Mammary Ductoscopy, Next Review Date ...................... 2/15/2015 Coverage Policy Number ................. 0057 Aspiration and Lavage Table of Contents Related Coverage Policies Coverage Policy .................................................. 1 Emerging Breast Biopsy/Localization General Background ........................................... 1 Procedures Coding/Billing Information ................................. 10 Electrical Impedance Scanning (EIS) and References ........................................................ 10 Optical Imaging of the Breast Genetic Testing for Susceptibility to Breast and Ovarian Cancer (e.g., BRCA1 & BRCA2) Magnetic Resonance Imaging (MRI) of the Breast Mammography Prophylactic Mastectomy INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna companies. Coverage Policies are intended to provide guidance in interpreting certain standard Cigna benefit plans. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD) or similar plan document] may differ significantly from the standard benefit plans upon which these Coverage Policies are based. For example, a customer’s benefit plan document may contain a specific exclusion related to a topic addressed in a Coverage Policy. In the event of a conflict, a customer’s benefit plan document always supersedes the information in the Coverage Policies. In the absence of a controlling federal or state coverage mandate, benefits are ultimately determined by the terms of the applicable benefit plan document. Coverage determinations in each specific instance require consideration of 1) the terms of the applicable benefit plan document in effect on the date of service; 2) any applicable laws/regulations; 3) any relevant collateral source materials including Coverage Policies and; 4) the specific facts of the particular situation.