BlueCross BlueShield of Tennessee Medical Policy Manual

Positron Emission Mammography


Positron emission mammography (PEM) is a form of positron emission tomography (PET) that uses a high-resolution, mini-camera detection technology for imaging the breast. As with PET, a radiotracer, usually 18F-fluorodeoxyglucose (FDG) is administered and PEM provides functional rather than anatomic information about the breast. PEM has been studied primarily for use in presurgical planning and staging; it also has been used to monitor therapy response and breast cancer recurrence.


See also: Magnetic Resonance Imaging (MRI) of the Breast



Published clinical studies comparing PEM to existing modalities are limited, and impacts on net health outcome are uncertain. Therefore this procedure remains investigational.


American College of Radiology. ACR Appropriateness Criteria┬« (2012, reviewed last in 2016) Breast cancer screening. Retrieved April 6, 2017 from

American College of Radiology. ACR Appropriateness Criteria┬« (2012, reviewed last in 2016) Palpable breast masses. Retrieved April 22, 2014 from

Berg, W., Madsen, K., Schilling, K., Tarter. M., Pisano, E., Larson, L., et al. (2011). Breast cancer: Comparative effectiveness of positron emission mammography and MRI in presurgical planning of the ipsilateral breast. RSNA Radiology, 256 (1), 1-19. (Level 3 evidence)

BlueCross BlueShield Association. Medical Policy Reference Manual. (9:2016). Positron Emission Mammography (6.01.52). Retrieved April 6, 2017 from BlueWeb. (30 articles and/or guidelines reviewed)

ECRI Institute. Health Technology Information Services. (January, 2013) AHRQ Comparative Effectiveness Review Surveillance Program. Retrieved June 11, 2015 from ECRI Institute. (5 articles and/or guidelines reviewed)

Heusner, T., Hahn, S., Jonkmanns, C., Kuemmel, S., Otterback, F. (2011) Diagnostic accuracy of fused positron emission tomography/magnetic resonance mammography: initial results. The British Institute of Radiology. 10.1259/bjr/93330765. (Level 3 evidence)

National Comprehensive Cancer Network (2016, July) NCCN Guidelines ® Breast cancer screening and diagnosis. Retrieved April 6, 2017 from

Schilling, K., Narayanan, D., Kalinyak, J., The, J., Velasquez. M., Kahn, S., et al. (2010) Positron emission mammography in breast cancer pre-surgical planning: comparisons with magnetic resonance imaging. European Journal of Nuclear Medicine and Molecular Imaging, 38 (1), 23-36. (Level 3 evidence - Industry sponsored)

U. S. Food and Drug Administration. (2003. August). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K032063. Retrieved March 22, 2011 from

U. S. Food and Drug Administration. (2008. November). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K082354. Retrieved March 22, 2011 from

U. S. Preventive Services Task Force (2016, February) Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. Retrieved April 6, 2017 from:

Yoon, J. H., Kim, M. J., Kim, E. K., & Moon, H. J. (2015). Imaging surveillance of patients with breast cancer after primary treatment: current recommendations. Korean Journal of Radiology,16 (2), 219-228. (Level 2 evidence)




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