Authors' recommendations: After considering the strength of the available evidence in relation to the safety, clinical effectiveness and cost-effectiveness of breast MRI, MSAC deferred the application for the current interim funded items to seek inclusion of ultrasound in the economic modelling, as well as adjustment to reflect the withdrawal from surveillance of high risk women who choose to undergo prophylactic mastectomy. MSAC discussed that there is currently no MBS item for mammography for asymptomatic patients, and considered the option of the inclusion in the MBS of a mammography item to complement breast MRI for surveillance of high risk patients. Further information should also be provided to support access to MRI surveillance based on the patient's estimated risk of cancer over the next year or 10 years. MSAC suggested lifetime risk of breast cancer >30% and 10-year risk of breast cancer death >8%. MSAC also deferred the application for the new high risk population of women who have a prior history of radiotherapy to seek additional information regarding breast cancer risk and MRI surveillance. If the interim funded items are reviewed and based on a risk of breast cancer or risk of breast cancer death, this population may fulfil the risk estimates and qualify. Evidence would have to support this. MSAC did not support public funding for the new high risk populations of women with a prior history of invasive breast cancer and with a prior history of treatment for lobular carcinoma in situ (LCIS) or ductal carcinoma in situ (DCIS) due to uncertain clinical benefit and cost-effectiveness. MSAC considered that reconsideration should be via ESC and would require external evaluation. MSAC supported amending the current interim MBS items 63464 and 63467 for breast MRI screening to be gender neutral.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.msac.gov.au/internet/msac/publishing.nsf/Content/1098.1-public

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Medical Services Advisory Committee

Contact Address: MSAC (MDP 107), GPO Box 9848, Canberra, ACT 2601, Australia. Tel: +61 2 6289 6811; Fax: +61 2 6289 8799.

Contact Name: msac.secretariat@health.gov.au

Contact Email: msac.secretariat@health.gov.au

Copyright: Medical Services Advisory Committee (MSAC)