A review of the cost-effectiveness of Tc-99m sestamibi scintimammography in diagnosis of breast cancer in Taiwanese women with indeterminate mammographically dense breast

Chen, Yi-Shan; Wang, Wei-Hua Andrew; Chan, T; Sun, Shan; Kao, Albert

doi:10.1016/s0960-7404(02)00030-0

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…There is evolving evidence that MIBI is cost-effective in predicting the response to chemotherapy in patients with lung cancer [ 38 ] and also for diagnosing breast cancer in patients with indeterminate mammography and dense breasts [ 45 ] .…”

Section: In Vivo Imaging Of Abc Transporters In Multidrug Resistancementioning

confidence: 99%

Imaging of multidrug resistance in cancer

Dizdarevic

Peters

2011

Cancer Imaging

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Primary intrinsic and/or acquired multidrug resistance (MDR) is the main obstacle to successful cancer treatment. Functional molecular imaging of MDR in cancer using single photon or positron emitters may be helpful to identify multidrug-resistant tumours and predict not only those patients who are resistant to treatment, with a clinically unfavourable prognosis, but also those who are susceptible to the development of drug toxicity or even certain tumours . Variations in the mdr1 gene product may directly affect the therapeutic effectiveness, and single nucleotide polymorphisms for the mdr1 gene may be associated with altered oral bioavailability of MDR1 substrates, drug resistance, and a susceptibility to some human diseases. The challenge of translating the concept of MDR modulation in vivo involves a complex cellular interplay between both malignant and normal cells. Integration and correlation of functional single photon emission tomography or positron emission tomography imaging findings with mdr1 genotype and clinical data may contribute to efficient management by selecting cancer patients with the appropriate molecular phenotype for maximal individual therapeutic benefit, as well as those who are non-responders. This review describes a role for functional imaging of classical mechanisms of MDR with an emphasis on readily available [99mTc]MIBI scintigraphy. MIBI scintigraphy has been shown to be a non-invasive cost-effective in vivo assay of ATP-binding cassette transporters associated with MDR in cancer, including P-glycoprotein, multidrug-resistant protein 1 and breast cancer resistant protein. New imaging agents for molecular targets such as vascular endothelial growth factor and HER2 receptors, may potentially be combined with MDR imaging substrates to more accurately predict the therapeutic response to anticancer drugs, guiding individualised treatment while minimising the economic health costs of ineffective therapy in an era of personalised medicine.

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Section: In Vivo Imaging Of Abc Transporters In Multidrug Resistancementioning

confidence: 99%

Imaging of multidrug resistance in cancer

Dizdarevic

Peters

2011

Cancer Imaging

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“…For example, the cost of cancer treatment is important to the National Health Insurance (NHI) system because it must decide the reimbursement policy for new cancer medications and endstage cancer treatments [4]. It is also important to breast cancer screening for deciding the optimal screening frequency, the age to screen [5], and the diagnostic methods to use [6]. The efficacy of colorectal cancer screening and the alternative diagnostic tool choices also need cost data to help decide their utility [7,8].…”

Section: Introductionmentioning

confidence: 99%

Lifetime costs of the top five cancers in Taiwan

Lang

2011

Eur J Health Econ

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The purpose of this study was to determine cancer-related medical care costs for long-term cancer care costs of breast, cervical, liver, lung, and colorectal cancer. Data were sourced from Taipei Veterans General Hospital cancer registry and claim data during 1999-2002. Besides, claimed data from National Health Insurance were used to match the comparison group. To estimate lifetime cost (10 years), the whole disease process was divided into initial, continuing, and terminal three phases. The expected lifetime cost of a specific cancer patient was estimated by incorporating the average phase-specific costs with the survival rate and mortality rate. The undiscounted average lifetime costs (10 years) for lung cancer, colorectal cancer, liver cancer, cervical cancer, and breast cancer were NT$448,371 (1USD≒NTD 33), NT$584,985, NT$351,222, NT$511,563, and NT$674,282 (in 2002 NTD), respectively. The aggregate lifetime cost of cancer is useful for health policymaking and clinical decision-making.

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“…These prior attempts to detect changes in breast tissue 9,10 have been limited by the ability to change blood flow and subsequent isotope uptake into mitochondrial tissue. This limitation was overcome with the development of breast-enhanced scintigraphy test (BEST) imaging, [11][12][13] which takes advantage of evaluating both mitochondrial activity and changes in blood flow.…”

mentioning

confidence: 99%

Are there differences in Breast Tissue as a Result of Hormone Replacement Therapy? Can BEST Imaging Distinguish these Differences?

Fleming¹

2003

Integr Cancer Ther

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Although it has been speculated that estrogen therapy may promote changes in breast tissue that could lead to cancer, no information exists as to differences in breast tissue for women who do and do not take hormone replacement (HRT) therapy. This study seeks to determine if there are differences in the tissue of women taking HRT in contrast to those who do not and if these differences are apparent in cases of breast cancer, cellular atypia, fibrocystic (FCD) disease and normal breasts. A total of 327 non-pregnant, non-lactating, pre-menopausal women were enrolled in the study, including 139 women who were actively taking HRT and 188 women who never had taken HRT. Using breast enhanced scintigraphy test (BEST) imaging, differentiation of breast tissue was determined. The groups were then analyzed to determine the effect of hormone therapy within each category of breast tissue. Differentiation between normal, FCD, cellular atypia, and breast cancer represent statistically significant differences (p.001) in metabolic activity and vascularity as demonstrated by differences in both average count activity (ACA) and maximal count activity (MCA). The distinction between cellular atypia and infiltrating breast cancer was statistically (p.05) different when looking at the maximal activity. Normal breast tissue and breasts with FCD appear more homogenous with no statistical differences in variability in breast tissue. Tissue variability is statistically greater when localized processes, such as cellular atypia and breast cancer, are present. Differentiation of cellular metabolic activity in breast tissue can be statistically determined when looking at the average and maximal metabolic activity. The final distinction between cellular atypia and cancer occurs when a focal region of breast tissue becomes metabolically more active than the surrounding breast tissue as shown by statistical increases in MCA. These findings are confirmed by the increased metabolic variability seen in regions of cellular atypia and cancer compared with the homogenous metabolic activity present in normal and fibrocystic breasts.

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A review of the cost-effectiveness of Tc-99m sestamibi scintimammography in diagnosis of breast cancer in Taiwanese women with indeterminate mammographically dense breast

Cited by 6 publications

References 20 publications

Imaging of multidrug resistance in cancer

Imaging of multidrug resistance in cancer

Lifetime costs of the top five cancers in Taiwan

Are there differences in Breast Tissue as a Result of Hormone Replacement Therapy? Can BEST Imaging Distinguish these Differences?

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