Anthem Blue Cross Connecticut SURG.00044 Breast Ductal Examination and Fluid Cytology Analysis Form

This document addresses the examination of breast ducts via fiberoptic ductoscopy, and the cytological analysis of breast ductal fluid, for the presence of hyperplasia. Fiberoptic ductoscopy provides direct visual examination of breast ducts by means of a small endoscope, whereas breast ductal fluid may be obtained for cytologic analysis by ductal lavage or nipple aspiration. Ductoscopy and cytologic analysis of breast ductal fluid have been proposed as diagnostic and risk assessment tools in individuals at high risk for breast cancer.

Position Statement

Investigational and Not Medically Necessary:

Cytologic analysis of breast ductal fluid, acquired invasively or noninvasively, is considered investigational and not medically necessary as a diagnostic or risk assessment tool for those considered at high risk for breast cancer, as well as for general population screening.

Breast fiberoptic ductoscopy is considered investigational and not medically necessary for the detection, diagnosis or treatment of breast cancer.