Initial Assessments
What is an initial assessment?
An initial assessment involves the physician's findings from the first set of images conducted. Initial assessment findings are only used for screening mammograms.
What does it mean if the initial assessment is input as a BI-RADS 0?
The input of an initial assessment as BI-RADS 0 means that additional imaging is needed for the patient. Further testing is required for the physician to determine an outcome for this patient.
What are the different outcomes of an initial assessment?
Initial assessments are recorded as BI-RADS 0, 1, 2, 3, 4, and 5. BI-RADS 1 and 2 are considered negative results, and 0, 3, 4, and 5 are considered positive results and will need additional testing.
When is an initial assessment not determined?
According to the Breast Cancer Surveillance Consortium, initial assessments may not be determined if the patient undergoes a diagnostic mammogram since the final assessment in the diagnostic case determines performance.
Why is an initial assessment outcome determined?
An initial assessment outcome is determined because the patient may require additional imaging after her screening mammogram. For example, if a patient is given an initial assessment of positive but is then found not to have breast cancer within a year, the case is assigned as a false positive. These outcomes help providers determine where they need to improve on specific diagnostic criteria to help strengthen the accuracy of their results.
Why is an initial assessment important for mammography audits?
Providing data containing information on initial assessments is important because it allows providers to see where inconsistent outcomes are throughout their practice. Initial assessment data can determine the total number of negative and positive initial assessments, performance measures relating to sensitivity, specificity, false-positive recall rate, false-negative recall rate, recall rate, cancer detection rate, and PPV1 (FDA Breast Cancer Surveillance Consortium, 2021).
How is the outcome of an initial assessment determined?
The physician’s interpretation of the screening mammogram determines the initial assessment outcome. The outcome can be either positive or negative for breast cancer and may be followed by additional imaging.
Who determines the outcome of the initial assessment?
The interpreting physician for the mammography case determines the outcome of the initial assessment. In some instances, other physicians may be added as second and third film readers to the case if the imaging is ambiguous in interpretation.
Sources:
FDA Breast Cancer Surveillance Consortium. (2021). BCSC Standard Definitions, Version 3. https://www.bcsc-research.org/application/files/6916/1429/6964/BCSC_Data_Definitions_v3__2020.09.23.pdf