Excerpt

Since the advent of mammography and clinical breast examination, many asymptomatic women have had an abnormal finding. Typically, suspicious lesions are evaluated with tissue biopsy, either by excision or by needle sampling. However, only a low percentage of women undergoing biopsy actually have cancer, suggesting that many of them could avoid biopsy if a non-invasive diagnostic test were available that could, with high sensitivity, rule out malignancy. Several technologies have been proposed for this purpose, yet the outcomes of using these non-invasive diagnostic technologies remains unclear. The ultimate purpose of this evaluation is to help patients, policymakers, and clinicians determine when it is appropriate to use these non-invasive technologies.

Contents

• Preface
• Acknowledgments
• Executive Summary
• 1. Introduction
  • Background
  • Methods
• 2. Evidence Base
  • Literature Searches
  • Inclusion/Exclusion Criteria for Questions 1 and 2
  • Data Abstraction
• 3. Analysis
  • Strength and Stability of Evidence Assessment
  • Data Synthesis
  • Peer Review
• 4. Results
  • Overview of Evidence Base for Questions 1 and 2
  • Summary of Results
• 5. Overall Summary
• Appendixes
  • Appendix A Literature Search Strategies
  • Appendix B Study Quality and Strength of Evidence Evaluation
  • Appendix C List of Studies Excluded from Questions 1 and 2
  • Appendix D Peer Reviewers
  • Appendix E Evidence Tables
• References

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.¹ Contract No. 290-02-0019. Prepared by: ECRI Evidence-based Practice Center, Plymouth Meeting, Pennsylvania.

Suggested citation:

Bruening W, Launders J, Pinkney N, Kostinsky H, Schoelles K, Turkelson C. Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities. Comparative Effectiveness Review No. 2. (Prepared by ECRI Evidence-based Practice Center under Contract No. 290-02-0019.) Rockville, MD: Agency for Healthcare Research and Quality. February 2006. Available at: http://effectivehealthcare.ahrq.gov/healthInfo.cfm?infotype=all&reptype=allfinal.

This report is based on research conducted by the ECRI Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0019). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers, patients and clinicians, health system leaders, and policymakers make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. Neither AHRQ's nor the U.S. Department of Health and Human Services' endorsement of such derivative products may be stated or implied.

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