Breast screening guidelines you should know

Are you confused by imaging guidelines for breast cancer screening? Knowing when to start and continue annual screening mammography is vital to your health. Routine screening can detect cancer early when it is most treatable, reducing the risk of dying from breast cancer by more than 40%. Screening mammography can also find cancer 2 – 3 years before it can be felt.

At Advanced Imaging, we follow the American College of Radiology guidelines and recommend these guidelines to referring healthcare providers. We also recommend that all women stay informed about annual screening based on their personal risk for breast cancer.

The ACR recommends:

WOMEN ASSESS BREAST CANCER RISK BY AGE 25

Start talking with your healthcare provider around age 25 to assess your risk of breast cancer. Earlier evaluation may be appropriate if you have a significant family history or known genetic risk.

WOMEN AT AVERAGE RISK OF BREAST CANCER

Begin annual screening mammograms at age 40 and continue every year as long as you are in good health and would pursue treatment if cancer were found. Breast cancer remains common in older women, with one in five breast cancers diagnosed in women age 75 or older. 3D mammography is the gold-standard screening tool.

WOMEN AT HIGH RISK OF BREAST CANCER

Begin annual screening mammograms at age 30 if you have a greater than 20% lifetime risk of breast cancer. Your healthcare provider will help you assess your lifetime risk based on family history, genetic markers and other assessment tools. In addition to annual mammography, high-risk patients often receive an annual breast MRI as a supplemental screening tool.

WOMEN WITH DENSE BREASTS

Know your breast density. It will be noted on your post-mammogram report. Dense breast tissue can mask small abnormalities on a mammogram. Depending on your breast density and overall risk, your healthcare provider may recommend supplemental screening with full or abbreviated breast MRI or Automated Breast Ultrasound (ABUS). Learn more about dense breasts and supplement screening.

The number one thing to remember is to prioritize your annual screening mammogram — every year no matter your risk or need for supplemental imaging.

Are you covered?

Nearly half of all women have dense breast tissue, which — similarly to cancer — appears white or light gray on mammograms. While our 3D™ Digital Mammography remains the gold standard for annual breast cancer screening, it’s common for additional screening, such as breast MRI or breast ultrasound (ABUS), to be recommended — especially for women with dense breasts or at high risk of breast cancer. However, very few women schedule follow-up scans despite the recommendation.

Be it lack of awareness, cost or insurance barriers, numerous reasons keep women from these potentially life-saving scans. Annual mammograms are generally covered by insurance, but what if additional screening is recommended? Do you know what your insurance covers? We encourage you to become your own best advocate and get the breast screening you need.

Questions for your healthcare provider

First, regularly talk with your healthcare provider about your personal risk of breast cancer. Consider asking:

• Do I have dense breasts? Where can I find that info on my mammogram report?
• Based on my family history or other risk factors, is supplemental screening, like a breast MRI or ABUS, right for me?

Questions for your insurance company

In Montana, we are fortunate to have a state insurance law addressing supplemental screening, but this law doesn’t necessarily apply to all policies. For instance, self-funded plans, out-of-state plans and national insurance plans (like Medicare, VHA, TRICARE) may be exempt. You can learn more at DenseBreast-info.org. To confirm your coverage, ask your insurance company questions like these:

• Does my plan cover supplemental breast imaging, such as MRI or ABUS, if recommended by my provider? Where can I review the exact language in my policy?
• Are there specific billing codes my provider must use to ensure coverage as supplemental screening rather than diagnostic?
• Are there out-of-pocket costs or copays for these exams?
• If I’m told my plan doesn’t cover these exams, who else in your office can confirm this? (Ask for a manager if necessary; sometimes you’ll get a different answer.)

Take charge of your health

At Advanced Imaging, we encourage you to take this initiative and educate yourself about all your options. If supplemental screening exams are not covered by your plan, keep in mind we offer abbreviated breast MRIs (AB-MRIs) — high-quality, faster and more affordable than full breast MRIs. Learn more about your imaging options on our Screening Mammography and Diagnostic Breast Imaging pages. Don’t let barriers prevent you from getting the breast imaging that could save your life. You are your own best advocate!