Survey: Tomosynthesis use on the rise despite reimbursement questions

Digital breast tomosynthesis (DBT) has made the jump from a research technology to a clinically used technique, with nearly 30 percent of surveyed members from the Society of Breast Imaging reporting they use DBT.

The full survey results, published in the June issue of the Journal of the American College of Radiology, also revealed that the majority of respondents who did not currently have DBT are planning to obtain it.

While numerous studies have looked at the effectiveness of DBT and its use in combination with digital mammography, lead author Lara A. Hardesty, MD, University of Colorado Denver, and colleagues noted that little was known about how and where DBT is being used in the U.S.

To help fill in these knowledge gaps, Hardesty and colleagues created an online survey for Society of Breast Imaging members, which received 670 responses.

A total of 29.9 percent said they used DBT, with 88.5 percent of those reporting they used it clinically. DBT use was more likely in academic practices, those with more than three breast imagers and those with seven or more mammography units. Of those who did not current have DBT, 62.3 percent plan to obtain it. DBT fees ranged from $25 to $250.

“However, DBT is far from being the accepted standard of care. Even among those using DBT for patient care, only 11.3 percent reported performing all clinical mammograms using DBT,” wrote the authors. The cost of converting all of a practice’s existing mammography units to DBT is a likely barrier slowing adoption, as is the lack of a CPT code for DBT—14 percent of respondents reported they will obtain DBT when a valid CPT code is available.

“Standardization of reimbursement for DBT via the adoption of a CPT code would help practitioners make adoption decisions based on science, rather than cost,” wrote Hardesty and colleagues.

Respondents were not consistent in how they determined who should receive DBT. While the majority (68.2 percent) made the decision based on whether the procedure was a screening exam or diagnostic, others based the decision on mammographic density or breast cancer risk.

“DBT is becoming more common but remains a limited resource,” wrote the authors. “Clinical guidelines would assist practices in deciding whether to adopt DBT and in standardizing which patients should receive DBT.”