Choosing Wisely® Campaign

The American Society of Breast Surgeons Releases New List of Five Things Clinicians and Patients Should Question

The American Society of Breast Surgeons has released its second list of specific tests or procedures that clinicians and patients should question as part of Choosing Wisely®, an initiative of the ABIM Foundation. The Choosing Wisely® campaign is designed to promote conversations between physicians and patients about utilizing the most appropriate tests and treatments and avoiding care whose harm may outweigh the benefits.

The Society’s new list was developed after careful consideration and review, using the most current evidence about management and treatment options. The list identifies five targeted, evidence-based recommendations related to the care of benign breast disease that can support conversations between patients and clinicians about what care is truly necessary.

The Society identified the following five recommendations:

  • Don’t routinely excise areas of psuedoangiomatous stromal hyperplasia (PASH) of the breast in patients who are not having symptoms from it.
  • Don’t routinely surgically excise biopsy proven fibroadenomas that are smaller than 2 centimeters in size.
  • Don’t routinely operate for a breast abscess without an initial attempt to drain it.
  • Don’t perform screening mammography in asymptomatic patients with normal exams who have less than 5-year life expectancy.
  • Don’t routinely drain non-painful fluid-filled breast cysts.

View the Society’s recommendations to learn more about how the list was developed.

The Society’s first list of Choosing Wisely® recommendations which focused on breast cancer treatment was released on June 27, 2016:

  • Don’t routinely order breast MRI in new breast cancer patients.
  • Don’t routinely excise all lymph nodes beneath the arm in patients having lumpectomy for breast cancer
  • Don’t routinely order specialized tumor gene testing in all new breast cancer patients.
  • Don’t routinely re-operate on patients with invasive cancer if the cancer is close to the edge of the excised lumpectomy tissue.
  • Don’t routinely perform a double mastectomy in patients who have a single breast with cancer.

View the Society’s recommendations of Five Things Clinicians and Patients Should Question about breast cancer treatment to learn more about how the recommendations were developed. The Society’s list of recommendations related to breast cancer care were also published online in the Annals of Surgical Oncology. The Society also worked with Consumer Reports to create patient-oriented messages on treatments for breast cancer.

To learn more about the Choosing Wisely® campaign visit

Download PDF