Legislators, experts push for better insurance coverage on 3D breast cancer screenings

By Lindsey Vickers / Boston University Statehouse Program / October 18, 2019

BOSTON – Health insurance coverage has not kept pace with advances in mammography, despite clear benefits from more advanced breast cancer screening technology, advocates told a legislative panel at a recent health care hearing.

Better access to hospital grade breast pumps for mothers with premature infants, women’s fertility, aqua therapy and wigs for people with alopecia were among the topics covered by 22 health care bills discussed by the Legislature’s Financial Services Committee last week.

A major subject at the hearing was tomosynthesis, or 3D breast cancer screening, which provide clearer, more detailed images of breast tissue, according to the Massachusetts General Hospital Department of Radiology.

“At Massachusetts General Hospital, more than 70% of the women who died of breast cancer in the past were among the 20% of women not participating in (breast cancer) screenings,” Dr. Daniel Kopans, a radiologist who founded the Breast Imaging Division at Massachusetts General Hospital said.

“A standard mammogram is as if you had a book with clear pages, that you can hold up to the light. You can see all the words from one side of the book to the other, but it is hard to read because they’re… one top of the other… 3D mammography is read one page at a time, (which) reveals cancer that cannot be seen in 2D mammography.”

Despite this, 3D breast screenings are only covered by some insurance policies in the commonwealth, including Medicare and Medicaid. Bills discussed would mandate all insurers cover the screenings.

From 2009-2014 breast cancer accounted for 29.4% of cancer incidents among women in Massachusetts and 13.4% of cancer deaths among women in the commonwealth, according to the Massachusetts Bureau of Community Health and Prevention.

“Current mammography technology is not good enough or sufficient enough to detect breast cancer in women with dense breast tissue or minimal breast tissue … many women in the commonwealth who, even if they are doing the breast screening and… exams… still cannot have [cancer] detected under traditional mammography,” said Rep. Shawn Dooley, R-Norfolk.

Sarah Blodgett, a spokeswoman for Senate President Karen Spilka, D-Ashland, declined to comment specifically on how bills related to women’s health would affect female residents of MetroWest. However, she said Spilka “has had a long-standing commitment to ensuring robust health care access for women.”

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