Methodsīetween 20, 849 consecutive NPBLs detected at US and classified as BI-RADS category 4C (505) or 5 (344) initially underwent US-guided fine needle aspiration (FNA) at our institution. The downstream testing and procedures that resulted from these incidental findings contributed significantly to the overall reimbursement of screening.The purpose of this study was to determine the pathological and ultrasound (US) features of benign nonpalpable breast lesions (NPBLs) classified as Breast Imaging Reporting and Data System (BI-RADS) category 4C or 5. Virtually every patient had at least one incidental finding and one out of every seven patients had further evaluation. Our data showed that incidental findings on low-dose CT scan for lung cancer screening are common. Of the total reimbursement, 46.2 percent was related to the evaluation and treatment of incidental findings. Reimbursement for the screening, including all downstream evaluation after the low-dose CT including the evaluation of screen detected incidental findings, averaged $817 per screened patient.

Other serious diagnoses found during the evaluation of the incidental findings included severe triple vessel coronary artery disease which resulted in coronary artery bypass grafting in one patient, and two patients with renal cell carcinomas that resulted in partial nephrectomies. This discrepancy is likely explained by the existence of clinical care paths to guide the management of coronary artery calcification and aortic aneurysms, and to the lack of evidence suggesting management changes for incidental radiographic findings related to COPD in asymptomatic patients.Īmong the patients included in our study, two were diagnosed with lung cancer and received definitive treatment. In contrast, 15.3 percent of cardiovascular findings resulted in cardiology consultation or further testing. Only 1.8 percent of these patients required further evaluation for pulmonary abnormalities. COPD was a known comorbidity in 31.6 percent of patients, but local emphysema was reported in 50.6 percent. The most frequently reported findings were in the respiratory (69.6 percent) and cardiovascular (67.5 percent) systems. Virtually every patient had at least one abnormality other than a lung nodule described on the radiology report with 15 percent of patients undergoing further evaluation of an incidental finding. We reviewed 320 patients who participated in our lung cancer screening program from April 2015 to February 2016. We recently published a study analyzing the presence of any incidental finding on the baseline low-dose CT scan. Incidental findings are common in low-dose CT scan for lung cancer screening These care paths are based on specialist expertise and national guidelines. Our program uses clinical care paths which guide the management of common incidental findings such as coronary artery calcification and thyroid nodules. It is a multidisciplinary program structured to meet the core components of a high quality screening program outlined by the American Thoracic Society and American College of Chest Physicians. The Cleveland Clinic lung cancer screening program was implemented in 2012. Our group set out to define the frequency of incidental findings found on low-dose CT for lung cancer screening and determine their clinical and financial downstream effects. Few studies have addressed these incidental findings, none of which has been in an actual clinical setting. The low-dose chest CT scan used for lung cancer screening frequently demonstrates incidental findings in the anatomic structures imaged from the neck to the upper abdomen. We do not endorse non-Cleveland Clinic products or services Policy Advertising on our site helps support our mission. Cleveland Clinic is a non-profit academic medical center.

Benign findings