title: The emergence of diagnostic imaging technologies in breast cancer: discovery, regulatory approval, reimbursement, and adoption in clinical guidelines.
abstract: In this article, we trace the chronology of developments in breast imaging technologies that are used for diagnosis and staging of breast cancer, including mammography, ultrasonography, magnetic resonance imaging, computed tomography, and positron emission tomography. We explore factors that affected clinical acceptance and utilization of these technologies from discovery to clinical use, including milestones in peer-reviewed publication, US Food and Drug Administration approval, reimbursement by payers, and adoption into clinical guidelines. The factors driving utilization of new imaging technologies are mainly driven by regulatory approval and reimbursement by payers rather than evidence that they provide benefits to patients. Comparative effectiveness research can serve as a useful tool to investigate whether these imaging modalities provide information that improves patient outcomes in real-world settings.
authors.affiliation: Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA 98195-9455, USA. goldl@uw.edu
authors.forename: Laura S
authors.initials: LS
authors.lastname: Gold
authors.forename: Gregory
authors.initials: G
authors.lastname: Klein
authors.forename: Lauren
authors.initials: L
authors.lastname: Carr
authors.forename: Larry
authors.initials: L
authors.lastname: Kessler
authors.forename: Sean D
authors.initials: SD
authors.lastname: Sullivan
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000266:history; D003952:Diagnostic Imaging / Q000191:economics / Q000266:history*; D057069:Diagnostic Test Approval / Q000266:history / Q000331:legislation & jurisprudence; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000266:history; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000266:history; D008327:Mammography / Q000191:economics / Q000266:history; D049268:Positron-Emission Tomography / Q000191:economics / Q000266:history; D017410:Practice Guidelines as Topic; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000266:history; D016217:Ultrasonography, Mammary / Q000191:economics / Q000266:history; D014481:United States; D014486:United States Food and Drug Administration