Scintimammography
DESCRIPTION
Scintimammography is a diagnostic tool using radiopharmaceuticals to provide tumor-specific imaging of the breast. The breast is evaluated using planar or single positron emission computed tomography (SPECT) radionuclide imaging after injection of the radiopharmaceutical. Scintimammography has been proposed as an adjunct to mammography and physical examination. It is proposed as a technique to aid in selection of individuals for biopsy who have palpable masses or suspicious mammograms.
POLICY
Scintimammography in all applications, including, but not limited to, its use as an adjunct in breast imaging or in staging the axillary lymph nodes is considered investigational.
ADDITIONAL INFORMATION
An example of a radiopharmaceutical approved by the U.S. Food and Drug Administration (FDA) for use in scintimammography is technetium-99m sestamibi (e.g., Miraluma®). FDA labeling states that it is to be used as a second-line diagnostic tool for individuals with an abnormal mammography of a breast mass. It is not to be used for breast screening or to confirm the presence or absence of a malignant breast.
Scintimammography does not meet the following technology evaluation criteria:
The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes.
The technology must improve the net health outcome.
The technology must be as beneficial as any established alternatives.
The improvement must be attainable outside the investigational settings.
SOURCES
Agency for Healthcare Research & Quality. (2006, February). Noninvasive tests may miss breast cancer, AHRQ study finds. Retrieved March 29, 2006 from http://hstat.nlm.nih.gov/ftrs/dbaccess/htr95-9.
Brem, R. F., Rapelyea, J. A., Zisman, G., Mohtashemi, K., Raub, J., Teal, C. B., et al. (2005). Occult breast cancer: Scintimammography with high-resolution breast-specific gamma camera in women at high risk for breast cancer. Radiology, 237 (1), 274-280. Abstract retrieved March 29, 2006 from PubMed database.
BlueCross BlueShield Association. Medical Policy Reference Manual. (1:2005). Scintimammography (6.01.18). Retrieved March 29, 2006 from BlueWeb.
Health Technology Assessment Information Service. TARGET database. (2000, August). Scintimammography. Retrieved March 29, 2006 from ECRI HTAIS.
Liberman, M., Sampalis, F., Mulder, D. S., & Sampalis, J. S. (2003). Breast cancer diagnosis by scintimammography: A meta-analysis and review of the literature. Breast Cancer Research and Treatment, 80 (1), 115-126.
Lumachi, F., Ferretti, G., Povolato, M., Marzola, M. C., Zucchetta, P., Geatti, O., et al. (2001). Sestamibi scintimammography in pT1 breast cancer: alternative or complementary to X-ray mammography? Anticancer Research, 21 (3C), 2201-2205. Abstract retrieved March 29, 2006 from PubMed database.
National Cancer Institute. (2006, February). Breast cancer screening modalities. Retrieved August 7, 2003 from http://www.cancer.gov/cancerinfo/pdq/screening/breast/HealthProfessional#Section_63.
National Guideline Clearinghouse. (2004, June). Procedure guideline for breast scintigraphy. Retrieved March 29, 2006 from http://www.guidelines.gov.
Polan, R. I., Klein, B. D., & Richman, R. H. (2001). Scintimammography in patients with minimal mammographic or clinical findings. Radiographics, 21 (3), 641-653. Abstract retrieved March 29, 2006 from PubMed database.
Sampalis, F. S., Denis, R., Picard, D., Fleiszer, D., Martin, G., Nassif, E., et al. (2003). International prospective evaluation of scintimammography with (99m) technetium sestamibi. American Journal of Surgery, 185 (6), 544-549. Abstract retrieved March 29, 2006 from PubMed database.
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EFFECTIVE DATE |
5/25/2006 |
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