Mixed mammogram messages upset survivor

FORT WAYNE, Ind. (WANE) - Sue Miller's mother died from breast cancer after a 13-year battle. When Miller was 25, she wanted to get a baseline mammogram to be safe.

"They found some very early stages of breast cancer in that mammogram," Miller said.

Miller had a lumpectomy and then a mastectomy to be safe. In February 2010, she'll be cancer free for 22 years.

"I had breast cancer, got rid of it and now it's gone. I didn't have to have chemo or radiation because it was caught early," Miller said. "This mammogram ... saved my life."

Which is why Miller was so disheartened to hear the U.S. Preventive Services Task Force changed its recommendations for mammograms to every other year for women 50 and older. Current guidelines call for women to start yearly mammograms at age 40.

"Maybe they'll catch it when they're 50, but they'll be further along and have to have more treatment and have a higher risk of it spreading," Miller said.

Dr. Christine Tremper of Summit Radiology also doesn't support the new recommendations.

"From what we understand, these are based on looking at numbers and cancer deaths and patient anxiety and it wasn't based on randomized clinical trial," Tremper said. "We don't support any change in the screening guidelines."

Barbara Gard, an Oncology Clinical Nurse Specialist at the Lutheran Hospital Cancer Resource Center, estimated about 10 percent of breast cancer diagnoses at Lutheran happen in women younger than 50.

"We see a lot of cancer in women in their 40s," Tremper agreed. "It's not an uncommon disease for women in their 40s."

A mammogram costs around $120 to $160 and insurance companies generally cover them under preventive benefits.

As of right now, insurance companies don't seem to be changing their coverage for mammograms either. Aetna, Blue Cross Blue Shield and Physicians Health Plan (PHP) all told NewsChannel 14 that yearly mammograms are covered for women starting at age 40 and that will stay the same.

"It's very early and we need to analyze it. We're not changing anything right now," Scott Roskelley, an Aetna spokesman, said.

But, Physicians Health Plan CEO Jay Gilbert said he wouldn't be surprised if larger insurance companies cut back mailings reminding women under 50 to get a mammogram.

"There may be less focus on education, but if a mammogram is ordered, they'll cover it," Gilbert said.

Given the heightened sensitivity to health care coverage on the national level, Gilbert expects any changed in coverage wouldn't come for a while.

"I think the national debate will mute anything they might do down the road," he said.

But, he added PHP's coverage isn't changing. If a doctor orders a mammogram for a woman younger than 40, that would be covered too.

Medicare also covers yearly mammograms for women starting at age 40.

The American Cancer Society does not support the new recommendations.

The following is the statement sent to NewsChannel 15 from Blue Cross Blue Shield:

Anthem Blue Cross and Blue Shield’s preventive health guidelines recommend that women over the age of 40 receive a clinical breast exam by their health care provider and a mammogram every year. The majority of our health plans include this as a preventive care benefit.

 

In developing its Medical Policy on preventive health guidelines, Anthem accepts the recommendations of a variety of nationally recognized organizations including the American College of Obstetrics and Gynecology, the American Cancer Society and the US Preventive Services Task Force (USPSTF). The American College of Obstetrics and Gynecology and the ACS still recommend an annual screening mammography for women aged 40-49.

 

Anthem's position will remain unchanged for the immediate future and continues to consider annual screening mammography medically necessary for women aged 40-49 years. We will continue to review and analyze the research surrounding breast cancer and other preventive screening procedures and if appropriate, will evaluate medical policy revisions.