1682 – Amendment to MBS Item 63464 – MRI for the detection of breast cancer in asymptomatic high-risk patients

Page last updated: 03 September 2021

Application Detail

Description of Medical Service

Breast Magnetic Resonance Imaging (MRI) for asymptomatic patients at high risk of developing breast cancer. Breast MRI is most valuable for patients aged less than 60 years.

Description of Medical Condition

Amendment to MBS item 63464 for breast MRI for asymptomatic patients at high risk of developing breast cancer, to increase the age cut-off for the eligible population from 50 to 60 years. Breast MRI is most valuable for patients aged less than 60 years.

Reason for Application

The Diagnostic Imaging Clinical Committee of the Medicare Benefits Schedule (MBS) Review Taskforce recommended an amendment to the item descriptor for breast MRI item 63464 for asymptomatic patients at high risk of developing breast cancer to increase the age cut-off for the eligible population from 50 to 60 years. The incidence of breast cancer for carriers of both BRCA1 and BRCA2 mutations increased rapidly in early adulthood with peak incidence shown to occur in the 41 to 50-year age group for breast cancer gene-1 (BRCA1) and 51 to 60-year age group for BRCA2. Beyond this age, in the presence of a high-risk breast cancer gene mutation, the vast majority of cancers would have become apparent. There is a reduction in breast density that occurs after age 60 which is associated with increased sensitivity of mammography, making it a comparatively more appropriate test. Therefore, the Committee agreed that 60 is the appropriate age to restrict access to this procedure.

Medical Service Type

Investigative technology

Previous Application Number/s

Not Applicable

Associated Documentation

Application Form

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Consultation Survey

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Please provide any comments on the proposed amendment to commentsMSAC@health.gov.au.

PASC Consultation
Not applicable

MSAC Consultation
MSAC Consultation closes 8 October 2021

For further information please refer to PASC, ESC, MSAC Key Dates
For further information on the consultation proves please refer to MSAC Consultation Process

PICO Confirmation

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Assessment Report

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Public Summary Document

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Meetings for this Application

PASC

Bypassing PASC

ESC

Bypassing ESC

MSAC

25-26 November 2021