Mammograms, X-ray photos of the breast, are used to check for breast cancer. Handout TNS
Mammograms, X-ray photos of the breast, are used to check for breast cancer. Handout TNS

State Politics

Women don’t have to pay extra for 3-D mammograms anymore, under new state law

By Anna M. Tinsley

atinsley@star-telegram.com

September 01, 2017 4:16 PM

Texas women may soon have a better chance of catching and beating breast cancer.

A new law that went into effect Sept. 1 requires commercial health insurance providers in Texas to cover the cost of high-tech 3-D mammograms, rather than just the traditional 2-D mammograms that have been offered for years.

“I think we are going to be able to detect more invasive cancers at an earlier stage,” said Dr. Jill Chilcoat, a breast radiologist at Texas Health Southwest Fort Worth and medical director for the Virginia Clay Dorman Breast Care Center. “If you can find invasive cancers at an earlier stage, you can save more lives.

“That’s the goal.”

The new state law, known as House Bill 1036, means that women in Texas soon will no longer be asked when they go to their annual mammogram if they want to pay an extra charge — perhaps $100 or more — to have a 3-D mammogram.

Instead, commercial insurance providers in Texas will automatically cover that cost, as they do now for regular 2-D mammograms, when patients are at least 35 years old.

This change — one of 673 new laws that went into effect Sept. 1 — applies to insurance plans that go into effect or are renewed after Jan. 1, 2018.

This makes Texas the sixth state — along with Connecticut, New York, Pennsylvania, Illinois and Arkansas — to have a law requiring insurance companies to cover all mammogram costs.

“This is a great day for the women of Texas as they now have the peace of mind that their 3-D mammograms, the most advanced form of screening available, will be covered by insurance with no additional out-of-pocket expense,” James Polfreman, president and CEO of Solis Mammography, said when the bill passed the Texas Legislature in May.

‘More accurate and meaningful’

Earlier this year, a bipartisan group of lawmakers led by breast cancer survivor state Rep. Senfronia Thompson, D-Houston, worked to pass a measure updating the definition of a mammogram.

Thompson has long said 3-D mammography could have caught her cancer earlier.

Mammograms are X-ray pictures of the breast. And 3-D mammography — also known as digital breast tomosynthesis — is the latest, most up-to-date technology being used to screen for breast cancer.

Medical officials say this type of mammogram, approved by the Food and Drug Administration six years ago, is able to detect breast cancer earlier than the traditional 2-D mammogram.

In this file photo, a radiologist compares an image from 2-D technology mammogram to the 3-D Digital Breast Tomosynthesis mammography, which can detect much smaller cancers earlier. ,
Torin Halsey AP

In a regular mammogram, breast tissue is examined through two-dimensional pictures, which radiologists study for any abnormalities.

But in a 3-D mammogram, radiologists have a better chance of finding abnormalities because they can look at the breast tissue one layer at a time — as if they were flipping the pages of a book — which ensures nothing small is hidden by thick or dense tissue.

“It allows you to see things much more clearly,” Chilcoat said. “It’s a much more accurate and meaningful mammogram.”

That means many problems are caught earlier and there are fewer call-backs asking women to return and repeat the mammogram.

Women shouldn’t notice much difference when having a 3-D mammogram, Chilcoat said.

Generally, women hold a pose for around three seconds while the mammogram captures the image of a breast and tissue. For a 3-D mammogram, it might take a few more seconds.

“It’s not perceivable to the person,” Chilcoat said. “There’s still a little bit of compression for a short period of time. But the experience is nearly the same.”

Early detection

Breast cancer is the one cancer most diagnosed in women, potentially impacting one out of every eight women. All women are at risk, whether or not they have a family history of problems.

State Rep. Nicole Collier, who became a joint author of the bill, knows that all too well.

State Rep. Nicole Collier, D-Fort Worth
Joyce Marshall jlmarshall@star-telegram.com

The Fort Worth Democrat found a lump in her breast in December 2015 and went to an emergency clinic, where a doctor examined her, confirming her suspicion.

“If I had that 3-D mammogram, we might have found it earlier,” Collier said. “This [new law] is important because early detection can be life-saving.

“It shouldn’t be just for those who are wealthy,” she said. “It should be available to everyone.”

In Collier’s case, she went through treatment for triple-negative breast cancer and, ultimately, “everything came out great.”

But she knows not everyone is as lucky.

“Early detection is key,” Collier said. “That’s what this technology offers. We want to be able to catch it early.

“That lowers the costs and the chance of it spreading.”

Anna Tinsley: 817-390-7610, @annatinsley

Do you need a mammogram?

Medical recommendations vary, but some suggest women 40 and older should have a mammogram performed every one or two years.

Women younger than 40, who have a family history or risk factors for breast cancer, should check with their doctor to see what he or she recommends.

Early signs of breast cancer may include hard lumps in the breast or armpit that generally don’t hurt, changes in the size or shape of a breast or nipple, and fluid coming from the nipple.

Anyone who finds a lump should schedule an appointment with their doctor. But know that 8 out of 10 lumps are not cancer.

Source: Texas Health Resources

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