Brief Description of Measure: 

CMS125: Breast Cancer Screening:

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period

Description of Issue:

CMS 125 (e.g. v10) currently includes digital breast tomosynthesis (DBT) codes in the value set Mammography (2.16.840.1.113883.3.464.1003.108.12.1018). Although the USPSTF clinical recommendation states that current evidence of DBT is insufficient to assess the balance of benefits and harms, the measure also takes into consideration the recommendations from the National Comprehensive Cancer Network (NCCN) and the American College of Radiology (ACR) which support inclusion of DBT.

Proposed Solution:

Since the measure takes into consideration recommendations from the National Comprehensive Cancer Network (NCCN) and the American College of Radiology (ACR) for inclusion of DBT, we proposed adding the following Clinical Recommendation Statement:
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)
Add the following References:
National Comprehensive Cancer Network (NCCN). 2021. “Breast Cancer Screening and Diagnosis.” https://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf (Accessed August 29, 2021)
American College of Radiology (ACR). 2017. “ACR Appropriateness Criteria: Breast Cancer Screening.” https://acsearch.acr.org/docs/70910/Narrative/ (Accessed March 20, 2017)

Rationale for Change:
The goal of this change is to provide clarity on the inclusion of DBT codes in the measure specification.