Table 1.
Breast appropriateness measures in the Choosing Wisely ® Campaign
| Society | Recommendation |
|---|---|
| AMDA The Society for Post-Acute and Long-Term Care Medicine | Don’t recommend screening for breast, colorectal or prostate cancer if life expectancy is estimated to be less than 10 years |
| American Geriatrics Society | Don’t recommend screening for breast, colorectal, prostate, or lung cancer without considering life expectancy and the risks of testing, overdiagnosis, and overtreatment |
| American Society of Clinical Oncology | Don’t use combination chemotherapy (multiple drugs) instead of chemotherapy with one drug when treating an individual for metastatic breast cancer unless the patient needs a rapid response to relieve tumor-related symptoms |
| American Society of Clinical Oncology | Don’t perform surveillance testing (biomarkers) or imaging (PET, CT, and radionuclide bone scans) for asymptomatic individuals who have been treated for breast cancer with curative intent |
| American Society of Clinical Oncology | Don’t perform PET, CT, and radionuclide bone scans in the staging of early cancer at low risk for metastasisa |
| American Society for Radiation Oncology | Don’t initiate whole breast radiotherapy as a part of breast conservation therapy in women age ≥50 years with early-stage, invasive breast cancer without considering shorter treatment schedules |
| American Society for Radiation Oncology | Don’t routinely recommend follow-up mammograms more often than annually for women who have had radiotherapy following breast conserving surgery |
| American Society for Radiation Oncology | Don't routinely use intensity modulated radiotherapy (IMRT) to deliver whole breast radiotherapy as part of breast conservaiton therapy |
| American Society of Plastic Surgeons | Avoid performing routine and follow-up mammograms of reconstructed breast after mastectomiesa |
| American Society of Plastic Surgeons | Avoid using drains in breast reduction mammoplasty |
| American Society of Plastic Surgeons | Avoid performing routine mammograms before breast surgery |
| American College of Surgeons | Don’t perform axillary lymph node dissection for clinical stages I and II breast cancer with clinically negative lymph nodes without attempting sentinel node biopsya |
| Commission on Cancer | Don’t perform surgery to remove a breast lump for suspicious findings unless needle biopsy cannot be donea |
aChoices that were ranked in the “highest tier” by the ASBrS but not included in the ASBrS list to avoid redundancy