The recommended age to start getting mammograms just dropped.
We’ve got some good news and bad news on the breast cancer front. Considering this is a deeply personal issue for me and an essential conversation that all women should be having, I hope everyone is paying close attention to these updates. So let’s break it all down, shall we?
What is the latest recommendation for when to get a mammogram?
The good news is that the United States Preventive Services Task Force, which offers official guidance for when and how we should get screened for cancer, has lowered the recommended age for a mammogram to 40. This will have a hugely positive impact for women across the country — especially for women of color, who are 40 percent more likely to die from the disease than white women.
The bad news, though, is the task force said there is insufficient evidence to recommend that women with dense breasts — that’s 45 percent of women 40 and over — get additional screening, like ultrasounds or MRIs.
This is an extremely unfortunate decision, because women with dense breasts need additional screening in order to catch breast cancer at its earliest and most treatable stage. With dense breasts, mammograms alone can’t always spot tumors or abnormal tissue. (My breast radiologist likens it to trying to find a snowball against a field of snow.)
Here’s why this decision is so important: If the task force had recommended additional screening, insurance companies would be required to cover it. And now that they don’t plan to recommend additional screenings, insurance companies will not cover them.
I happened to have my follow-up mammogram (and ultrasound) the day the news broke. I asked my breast radiologist, Dr. Susan Drossman, for her reaction. She was clearly angry about the decision.
“It’s disappointing to me that the new guidelines don’t include supplemental screening for women with dense breasts,” she told me. “My concern is this decision was made with financial considerations. There is no question that supplemental screening finds a significant number of invasive breast cancers, particularly in young women with dense breasts. Not recommending it does a real disservice to these patients. Sadly, lives will be lost.”
Without coverage from health insurance, women who have high breast density often have to pay out of pocket for additional screenings, which can cost more than $1,000 a pop. As a result, many choose to delay or forgo these additional tests — and that decision can lead to later stage diagnoses.
How the Find It Early Act could make detection easier for everyone
But here’s a bit of hopeful news. In the wake of this inaction, Rep. Rosa DeLauro (D-Conn.) and Rep. Brian Fitzpatrick (R-Penn.) have reintroduced their legislation, the Find It Early Act. The bill would “ensure all health insurance plans cover screening and diagnostic breast imaging, including mammograms, ultrasounds, breast ultrasounds, and MRIs with no cost sharing.”
I’m excited to be part of this proposed legislation — even though whenever I mention it, Molner says, “Who do you think you are? Nancy Pelosi?” 🤓
When it comes to making breast cancer screenings and early detection as accessible as possible, there is so much at stake — and so much factual information behind the push. Here’s just a sampling of information, straight from the mouths of the people working tirelessly to bring this much-needed legislation to the American people:
Congresswoman Rosa DeLauro (D-Conn.): “I am proud to join Katie Couric, Congressman Fitzpatrick, and breast cancer advocates to introduce legislation that will detect breast cancer early and save women’s lives. Early detection is key – 99 percent of women who receive an early breast cancer diagnosis survive it. That is why I am reintroducing the Find It Early Act, which would mandate all insurance programs cover additional screenings to detect breast cancer at no-cost to the patient.”
Congressman Brian Fitzpatrick (R-Penn.): “Cancer screening rates hit a critical low in 2022, with some states having screening rates as low as 1 percent. Increasing access to cancer screenings is one of the most effective tools to improve outcomes for women diagnosed with breast cancer, and I am proud to co-lead the Find It Early Act to increase access to these lifesaving tests.”
JoAnn Pushkin, executive director of DenseBreast-info: “We hear from women all the time who find out they have dense breasts and that they would benefit from additional screening, but then discover they have to navigate getting approvals from their insurance providers — and begin a frustrating cycle of phone calls, denials, appeals, and more phone calls. The Find it Early Act will help ensure that when a woman is told that her mammogram might not be enough, she will not have to struggle to pay for additional imaging, or choose between household bills and a recommended test, or spread the cost of an MRI over one year, and skip the next year because the cost of the exam has strained her budget.”
Dr. Rachel Brem, chief medical officer, Brem Foundation to Defeat Breast Cancer: “Study after study has shown that early detection of breast cancer saves lives. Still, a variety of barriers exist for women, preventing them from accessing essential screening and detecting cancers early. No woman should have to choose between paying her bills and getting the tests she needs for her breast health. The bipartisan Find It Early Act will require private and government insurers to cover the exorbitant out-of-pocket costs often faced by high-risk women who require screenings such as ultrasound and MRI to diagnose their cancer — removing this ‘hidden cost’ of breast cancer diagnosis.”
Why I’m hopeful about a recent FDA decision
There is one final piece of good news in our ongoing efforts to make sure all women have access to lifesaving screening — not just those who can afford it.
The first step for every woman, as you might guess, is actually knowing if you have dense breasts or not. In the past, not every state required clinicians to notify patients if this was the case. This past March, though, the FDA announced that starting in 2024, every state will be required to include an assessment of breast density in all mammography reports, with specific language covering what that means and what women should do with that information.
Soon, patients will be more informed than ever. But even with that knowledge, too many won’t be able to get the additional testing they need because they won’t be able to pay for it. That is unacceptable.
Please join us by calling your representative and tell them you support the Find It Early Act — they do pay attention to who calls!
