Medicare Benefits Schedule - Item 73306

Gene expression profiling testing using EndoPredict, for the purpose of profiling gene expression in formalin‑fixed, paraffin‑embedded primary breast cancer tissue from core needle biopsy or surgical tumour sample to estimate the risk of distant recurrence of breast cancer within 10 years, if:

(a) the sample is from a new primary breast cancer, which is suitable for adjuvant chemotherapy; and

(b) the sample has been determined to be oestrogen receptor positive and HER2 negative by IHC and ISH respectively on surgically removed tumour; and

(c) the sample is axillary node negative or positive (up to 3 nodes) with a tumour size of at least 1 cm and no more than 5 cm determined by histopathology on surgically removed tumour; and

(d) the sample has no evidence of distal metastasis; and

(e) pre‑testing of intermediate risk of distant metastases has shown that the tumour is defined by at least one of the following characteristics:

(i) histopathological grade 2 or 3;

(ii) one to 3 lymph nodes involved in metastatic disease (including micrometastases but not isolated tumour cells); and

(f) the service is not administered for the purpose of altering treatment decisions

Applicable once per new primary breast cancer diagnosis for any particular patient

Fee: $1,200.00 Benefit: 75% = $900.00 85% = $1,101.30

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