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Molecular Breast Imaging Increases Accurate Cancer Diagnoses, Mayo Clinic Finds

Study shows four-fold increase in detection rates in women with dense breast tissue

A study conducted by the Mayo Clinic has determined that the addition of molecular breast imaging (MBI) for women with dense breast tissue resulted in a lower cost per cancer detected than screening with mammography alone. Approximately 45% of all women have dense breast tissue.

The study, published in the American Journal of Roentgenology, found that MBI technologies led to more accurate diagnosis and, in combination with mammography, resulted in a cost savings of approximately 15%.

Investigators at the Mayo Clinic in Rochester, Minnesota, evaluated additional diagnostic workups and costs generated by the addition of a single MBI examination to screening mammography in 1,585 women with mammographically dense breasts.

Screening mammography alone prompted the diagnostic workup of 175 (11.0%) patients and biopsy of 20 (1.3%), and yielded five malignancies (PPV3, 25.0%). In comparison, the results of combining screening mammography with MBI prompted the diagnostic workup of 279 patients (17.6%) and biopsy of 67 (4.2%), and yielded 19 malignancies (PPV3, 28.4%). The benign biopsy rates were 0.9% (15/1,585) for screening mammography alone and 3.0% (48/1,585) for the combination (P < 0.001).

The addition of MBI increased the cost per patient screened from $176 for mammography alone to $571 for mammography plus MBI. However, the cost per cancer detected was lower for the combination ($47,597) than for mammography alone ($55,851).

An additional Mayo Clinic study published in the AJR concluded that there was a four-fold increase in detection rates compared with standard mammography when using the LumaGEM MBI technology as a secondary screening method. Unlike mammography, tomosynthesis, and ultrasound –– all of which are anatomical imaging tests –– the LumaGEM system highlights metabolic activity in the breast regardless of tissue density, thereby allowing radiologists to identify early-stage cancers, according to the system’s manufacturer (Gamma Medica, Inc.). MBI provides equivalent sensitivity and improved specificity compared with magnetic resonance imaging, but at roughly one-third of the cost, Gamma says.

It has been estimated that approximately 12.5% of women in the U.S. will develop breast cancer during their lifetimes. Nearly half of women have dense breast tissue, which masks early stages of cancer in traditional screening methods, often leading to missed opportunities for early intervention. Early detection through screening remains the most reliable method for managing breast cancer. However, for women with dense breast tissue, standard mammography and 3-D tomonsynthesis lack the accuracy to detect early-stage cancers.

Sources: Gamma Medica, Inc.; August 17, 2015; and AJR; June 2015.

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