Mastery of Breast Surgery®
The American Society of Breast Surgeons Mastery of Breast Surgery® Program is designed to help surgeons document their clinical performance of breast procedures, as well as their care of breast cancer patients and patients at risk for breast cancer. The program is housed on masterybreastsurgeons.org.
"What is this program and why was it developed?"
The program is intended to help surgeons document their clinical performance of breast procedures, as well as their care of breast cancer patients and patients at risk for breast cancer. It includes modules on surgery, percutaneous breast procedures, cancer, risk assessment and diagnostic imaging. There are varying levels of participation in each module. The levels of participation and the modules used can be changed by the user at any time.
The program was developed in response to the need to document quality outcomes in patient care, and for individual surgeons to know and be able to report their performance. The goal of this program is to provide the surgeon with the tools to meet this challenge via a voluntary reporting system, open to all surgeons, to report on all breast surgical procedures for both benign and malignant disease.
Surgeons may choose to participate in any or all of the following modules in order to best meet their practice needs.
1. Surgery Module
Using the Surgery Module, participants can enter such information as indication, procedure performed, and complications for each of their surgical procedures. Participants may opt to enter additional pre- and post-procedure information, which is compiled into a summary report.
The module's quality measures section enables surgeons to also report on breast-related quality measures, including preoperative needle biopsy, sentinel lymph node biopsy, specimen orientation, and image confirmation of successful excision of image-localized breast lesions.
2. Cancer Module
The Cancer Module demonstrates how the Mastery Program can adapt to many styles of practice. In this module, participants must complete 2 required data fields to provide basic information regarding the cancer. However, depending on their reporting needs, participants may choose to also enter data on histology/markers, staging, treatment, quality measures, and survival/recurrence. This module provides users with a data summary screen.
3. Percutaneous Procedures Module
The Percutaneous Procedures Module allows participants to enter data on 10 different procedures, including image-guided biopsies, cyst aspirations, needle wire localizations, insertion of accelerated partial breast irradiation devices, and cryotherapy. Participants have the option of entering post-procedure/surgical follow-up and nonsurgical follow-up information, when applicable. Data entered on each percutaneous procedure are compiled into a synoptic report, which may be printed by the participant or viewed on-line and edited at a later date.
4. Risk Assessment Module
Through the Risk Assessment Module, participants have access to a variety of standard risk calculations and a method to record and document those values. In addition, the page can be printed and placed in the patient's chart to facilitate discussion of additional testing or imaging. Links to other risk assessment tools are available on the risk summary view in this module.
5. Diagnostic Module
The Diagnostic Module is used to document diagnostic procedures and is submitted as part of the case documentation when applying for breast ultrasound certification.
While participation in all modules of the Mastery Program is voluntary, completion of the information in the Surgery Module is required for those participants using the program to meet the practice improvement requirement for Continuous Certification.
"What does the program do for me? Why would I voluntarily participate?"
The program will provide you with the opportunity to participate in a data collection/self-review process. This self-reporting process is a fundamental first step in improving quality. Participation now, before such reporting programs become mandatory from outside agencies, will provide you, the surgeon, with the experience of self-reporting and, subsequently, the knowledge about your individual practice and patient outcomes.
The program has been listed as a resource under the American Board of Surgery Continuous Certification (ABS CC) practice improvement component for maintenance of certification, which requires ongoing participation in a local, regional, or national outcomes registry or quality assessment program. For information on ABS CC, go to www.absurgery.org.
"Who is eligible to participate in the program?"
Participation in the Mastery of Breast Surgery® program is offered at no cost to surgeons who are active or associate members of the American Society of Breast Surgeons.
Continuing Medical Education Credit
"Will this help me with American Board of Surgery recertification and maintenance of competence? Will this help me with my hospital credentials?"
Although no one can speak for other outside organizations, it is anticipated that this program will be valued by other entities as evidence of continuing medical education and commitment to individual quality assessment and improvement.
The American Board of Surgery has listed the Mastery of Breast Surgery® Program as a resource under its Continuous Education Program-Practice Improvement component, which requires evaluation of performance in practice through participation in quality improvement programs.
Similarities to Other Programs
"How does this program relate to other programs that propose to improve the quality of care for breast patients, such as those from the NCBC or the NAPBC?"
This program is designed for the individual surgeon, and is therefore fundamentally different from the center accreditation concept. There is every intention, however, to avoid duplication of reporting whenever possible, and to work collaboratively with other organizations interested in quality care. It is intended that this program will improve the quality of breast care provided by the surgeon regardless of practice setting or location.
Cost of Enrollment
"What is the cost of enrollment – both the direct and indirect costs (such as my staff time)?"
Participation in the program is free to members of the Society. As the program develops there may be some administrative and/or data management fees that may be passed on to you, but we are committed to creating an affordable and user-friendly program. We plan to make data collection and entry easy and accessible on the Internet.
"Who will have access to the data? Will other surgeons, insurance companies or the public have access to it?"
Your data will be regarded as strictly confidential and can only be viewed by you under the program. You will be able to compare your data with the entire group, or with surgeons who are similar to you in terms of practice type and location. Only the de-identified data will be available to the Society staff and appropriate Committee and Board members. The Society will not make individual surgeon data available to the public, insurance companies, advocacy groups, credentialing bodies, or any other interested parties except in strict accordance with the Business Associate Agreement that you must sign to participate in the program. You should note, however, that the Society cannot guarantee that it will not be forced to release data, including individual surgeon data, requested under the compulsion of a legally enforceable subpoena, search warrant, or court order.
Registry data (including personal health information of non-Medicare patients) may be inspected by CMS under their oversight authority for those surgeons who chose to participate in the QCDR registry component of the program.
Upcoming Quality Measures
"What new quality measures are being planned?"
The Patient Safety and Quality Committee of the Society has studied and identified many quality measures that can be linked to quality breast care. Feedback from you and the other participants will help to build this program including the addition of future quality measures.
Let Us Know What You Think
We are interested to know what you think about this important initiative. We want to answer any questions you may have. Most important, we need your input and participation to make this program successful. Please contact us at firstname.lastname@example.org.