A game-changer in breast cancer treatment

By Sarah Brennan, Consulting Manager | October 2024

I’ve been closely following Olivia Munn’s breast cancer diagnosis, soon after welcoming her first child, and subsequent double mastectomy.  As our children are close in age and having a maternal history of breast cancer in my family, Olivia’s story hit a note with me and made me take a second look at proactive screening. Munn’s cancer was detected early through the Tyrer-Cuzick Breast Cancer Assessment.  Naturally, I was concerned seeing my own similarities in her story.

I promptly scheduled a physical with my primary care doctor and when he asked if there were any concerns I had, immediately asked if I should get a mammogram.  We went through my risk factor and made a plan that was right for me related to my cancer assessment.  However, this was something that never would have come up for me had I not addressed my concerns, and had the assessment not been reviewed with Olivia, her cancer might have been detected later in its formulation.  The Affordable Care Act requires health plans to cover mammograms every 2 years for women 50 and older, but only if recommended by a health care provider for those between 40-49 – and not required for under 40 even though breast cancer rates are rising in this demographic – and usually in those with a high-risk in the assessment.

While many states have made progress in mandating breast cancer screening coverage, we shouldn’t rely solely on legislation to drive change. Health plans have a unique opportunity to take the lead in promoting early detection and prevention strategies. By proactively expanding coverage for comprehensive screening methods, insurers can significantly impact breast cancer outcomes and potentially reduce long-term healthcare costs.

Comprehensive screening: a win-win for health plans and patients

Health plans should consider covering:

  1. Genetic testing for high-risk individuals
  2. More frequent screenings for those at elevated risk
  3. Advanced imaging techniques like MRI and 3D mammography

Investing in these early detection methods offers numerous benefits:

  • Reduced treatment costs: Catching breast cancer in its earliest stages often leads to less invasive and less expensive treatments.
  • Improved patient outcomes: Early detection significantly increases survival rates and quality of life for patients.
  • Enhanced reputation: Health plans that prioritize preventive care can differentiate themselves in a competitive market.

 

A call to action for health plans

It’s time for health plans to take a proactive stance on breast cancer prevention. By voluntarily expanding coverage for a wider range of early detection methods, especially for high-risk individuals, insurers can lead the charge in improving breast cancer outcomes. This approach not only saves lives but also reduces the emotional and financial burden on families affected by breast cancer. Moreover, it positions health plans as leaders in preventive care, potentially attracting more customers who value comprehensive health coverage.

Early detection is more than just a medical strategy – it’s a lifeline for countless women and their families. Let’s make it accessible to everyone who needs it, not through mandates, but through the proactive efforts of forward-thinking health plans committed to the well-being of their members.  As I continue to make my health a priority, not just for me, but my daughter, I will continue to look towards preventative screening and advocate for these solutions.