| Title |
Breast Cancer Screening |
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|---|---|---|---|
| CMS eCQM ID | CMS125v14 | CBE ID | Not Applicable |
| MIPS Quality ID | 112 | ||
| Measure Steward | National Committee for Quality Assurance | ||
| Description | Percentage of women 40-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period | ||
| Measure Scoring | Proportion | ||
| Measure Type | Process | ||
| Stratification | Report a total rate, and each of the following age strata:
Stratum 1: Patients age 42-51 by the end of the measurement period Stratum 2: Patients age 52-74 by the end of the measurement period |
||
| Risk Adjustment | None | ||
| Rationale | Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Noone et al., 2018). In 2015, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Noone et al., 2018).
While there are other factors that affect a woman’s risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Noone et al., 2018). The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 68; by age 50 it becomes 1 in 43; by age 60, it is 1 in 29 (American Cancer Society, 2017). |
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| Clinical Recommendation Statement | The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 40-74 years (B recommendation) (USPSTF, 2024).
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement) (USPSTF, 2024). The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I statement) (USPSTF, 2024). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography and magnetic resonance imaging in women identified to have dense breasts on an otherwise negative screening mammogram (I statement) (USPSTF, 2024). The National Comprehensive Cancer Network (NCCN) and the American College of Radiology (ACR) recommend using conventional mammography or DBT for screening women at low, intermediate or high risk for breast cancer (NCCN, 2021) (ACR, 2017). |
||
| Improvement Notation | Higher score equals better quality | ||
| Definition | None | ||
| Guidance | This measure evaluates primary screening. Do not count biopsies, breast ultrasounds, or MRIs because they are not appropriate methods for primary breast cancer screening.
Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
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| Initial Population | Women 42-74 years of age by the end of the measurement period with a visit during the measurement period | ||
| Denominator | Equals Initial Population | ||
| Denominator Exclusions | Exclude patients who are in hospice care for any part of the measurement period.
Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy on or before the end of the measurement period. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: – Advanced illness diagnosis during the measurement period or the year prior – OR taking dementia medications during the measurement period or the year prior Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients receiving palliative care for any part of the measurement period. |
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| Numerator | Women with one or more mammograms any time on or between October 1 two years prior to the measurement period and the end of the measurement period | ||
| Numerator Exclusions | None | ||
| Denominator Exceptions | None | ||
| Telehealth Eligible | Yes | ||
| Next Version | No Version Available | ||
| Previous Version | CMS125v13 | ||
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