Treatment planning imaging – Biopsy not possible (Practice Point)
For patients with a breast lesion where the results of conventional diagnostic imaging (mammography or tomosynthesis and ultrasound) are inconclusive but suspicious for the presence of breast cancer and biopsy has not been possible, consider the use of contrast mammography or magnetic resonance imaging (MRI).
How this guidance was developed
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using an expert consensus process. Development of this guidance was informed by the introduction of MBS items for MRI for this indication. The MBS items refer to ‘conventional imaging’ which has been clarified as ‘mammography or tomosynthesis and ultrasound’.
Treatment planning imaging – MRI (Practice Point)
For patients with breast cancer where a discrepancy exists between clinical assessment and conventional diagnostic imaging (mammography or tomosynthesis and ultrasound), or there is a discrepancy in conventional imaging, consider the use of magnetic resonance imaging (MRI) if the results from this imaging are expected to alter treatment planning.
How this guidance was developed
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using an expert consensus process. Development of this guidance was informed by the introduction of MBS items for MRI for this indication. The MBS items refer to ‘conventional imaging’ which has been clarified as ‘mammography or tomosynthesis and ultrasound’.
Treatment planning imaging – Lobular breast cancer (Practice Point)
Consider imaging with magnetic resonance imaging (MRI) or Contrast Enhanced Spectral Mammography (CESM) (where available) for patients with lobular breast cancer.
How this guidance was developed
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using an expert consensus process.
Treatment planning imaging – PET (Practice Point)
For patients who are considered suitable for active treatment and in whom staging of locally advanced (stage III) breast cancer is required or there is a high index of suspected metastatic breast cancer, consider the use of 18F-FDG positron emission tomography (PET).
How this guidance was developed
This practice point was developed using an expert consensus process informed by a potential source recommendation from KCE 2013 (Belgium) guideline (evidence review to January 2010) that was graded ‘Expert Opinion’. The practice point was also informed by the introduction of the MBS item for PET, which is restricted to patients with a high index of suspicion.
Reporting of pathology and imaging findings (Practice Point)
(a) Report breast pathology findings according to the Structured Reporting Protocols of the Royal College of Pathology Australia (RCPA);
(b) Report breast imaging findings according to the standards of the Royal Australian and New Zealand College of Radiologists (RANZCR), Faculty of Clinical Radiology.
How this guidance was developed
This practice point was developed using an expert consensus process informed by the evidence-based RCPA protocols.
