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Digital Breast Tomosynthesis: The State of the Science and Current Reimbursement Issues
*President, MedCom Consultants Inc, Potomac, Maryland.
Address correspondence to: Steven Marks, MedCom Consultants Inc, 1311 Fallsmead Way, Potomac, Maryland, 20854. Email: email@example.com.
Disclosure statement: The author reports having no financial or advisory relationship with any corporate, medical, or political organization doing work related to this paper or other business activity at MedCom Consultants, Inc.
Breast cancer is the most frequently diagnosed cancer in women and is the second leading cause of cancer-related death. Mammography is recognized as the preferred methodology for detecting and evaluating patients with early stage breast cancer, however, it has a low positive predictive value. As a result, a high percentage of recalls for further imaging or biopsy do not yield higher rates of cancer detection. In fact, additional testing can place a substantial psychological and cost burden on patients and the healthcare system. By generating a 3-dimensional image of the breast tissue during standard mammographic compression, digital breast tomosynthesis (DBT) has been shown to reduce the noise from overlapping and superimposed breast tissue. In so doing, DBT has the potential to overcome the limits of mammography. Studies have shown that DBT is a highly cost-effective imaging technology in screening and diagnostic populations compared with full-field digital mammography, and as a result, advanced applications are now under investigation. Recent approvals of DBT by the US Food and Drug Administration and the Centers for Medicaid and Medicare Services for reimbursement have led to its increasing adoption by clinicians, and DBT also has found favor with women. The standard approaches to utilization and the most appropriate applications for clinical use are still being determined.
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