Diagnostics Committee Meeting Minutes
March 17, 2011
0700-0800
Summary
Diagnostic Recommendations

Recommendations for average risk patient
-
Screening mammograms starting at age 40 and continuing annually as long as
healthy and willing to undergo treatments for breast cancer

Continue CBE and SBE
Recommendations for women of high risk
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Annual mammogram starting at age 30
o
BRCA1 or BRCA2 (Tested or 1st degree relative tested)
o
> 20% Lifetime Risk (paternal and maternal hx)
o
Women with mothers/sisters with premenopausal breast cancer (by age 30
or 10 years earlier than age of dx or relative, whichever is later)
-
-
Annual mammogram starting at age 30 (not before age 25)
o
Mantle radiation before age 30
o
Premenopausal Ovarian Cancer history or other genetic predisposition
Annual screening breast MRI at age 30
o
Timing of Mammograms VS Breast MRI because of interval cancer
development (staggered approach at 6-month interval)
o
CBE at every six months inte
Diagnostics Committee
March 17, 2011
A motion to accept mammography and breast MRI recommendations for healthy and
high risk patients was made and approved.
INPATIENT UTILIZATION/GENETIC SCREENING

Recommendation – any test listed that is ordered on an inpatient will be held by
laboratory staff, and the physician will be contacted by a pathologist on-call to
obtain justification for ordering the test in the in-patient setting.

Exceptions –testing will be performed without screening
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Genetic tests not appearing on the newly revised listing
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Testing of pathologic tissue or other samples used in the work-up of a known or
suspected cancer (example, KRAS mutation testing)
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Outpatient populations
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Perinatal screening of neonates
A motion to accept this recommendation was made and approved. Dr. Yelcick will
continue to follow-up with data analysis and recommendations for genetic tests with
order activity currently excluded from this policy.
OPERATIONAL UPDATES/EDUCATION
link
Radiation Exposure from Medical Diagnostic Imaging Procedures
Clostridium difficile testing methodology change LAB ALERT – Effective 3/1/11
Preterm infant chest x-ray – NY Times Article Response
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