mommyoffive Posted July 11 Share Posted July 11 If you have dense breasts, what do you do for cancer screenings? Do you just do mammograms? Do you do something else? If you do how did that happen? Did your doctor suggest it? Did you have to push for it? And did your insurance cover anything beyond mammograms? Quote Link to comment Share on other sites More sharing options...
Kassia Posted July 11 Share Posted July 11 Ugh, it's a hassle. I go for regular screening mammograms and then am almost called back for ultrasound and/or diagnostic mammograms. Usually it's yearly, but this year I have to go for a second diagnostic mammogram six months after the last one. It's frustrating because they can't really see anything, but I've been lucky that I haven't had to move on to anything invasive. My insurance only covers the screening at 100%. The rest goes towards our high deductible, so I get really stressed about it being a yearly expense just because they can't see enough on the screening. 1 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted July 11 Share Posted July 11 My insurance does not cover anything else unless you had breast cancer. Even then, they only cover MRIs for a few years. So when they start rejecting MRIs, my oncologist put in the request for ultrasound mammogram and that was approved. Mine is Blue Cross Blue Shield under my husband’s employee benefits so coverage would differ from other BCBS plans. 2 Quote Link to comment Share on other sites More sharing options...
Hyacinth Posted July 11 Share Posted July 11 18 minutes ago, Kassia said: Ugh, it's a hassle. I go for regular screening mammograms and then am almost called back for ultrasound and/or diagnostic mammograms. Usually it's yearly, but this year I have to go for a second diagnostic mammogram six months after the last one. It's frustrating because they can't really see anything, but I've been lucky that I haven't had to move on to anything invasive. My insurance only covers the screening at 100%. The rest goes towards our high deductible, so I get really stressed about it being a yearly expense just because they can't see enough on the screening. Same. Go for the screening. Inevitably get called back for an ultrasound. Repeat six months or a year later. 1 1 Quote Link to comment Share on other sites More sharing options...
mommyoffive Posted July 11 Author Share Posted July 11 Is it a bad sign if you do a mammogram they say you have dense breasts, but they don't call you back? Like I am wondering if that isn't good enough or something. 1 Quote Link to comment Share on other sites More sharing options...
Meriwether Posted July 11 Share Posted July 11 I did an out-of-pocket breast scan a few months ago that is supposed to be good for dense tissue. 2 Quote Link to comment Share on other sites More sharing options...
Kassia Posted July 11 Share Posted July 11 5 minutes ago, mommyoffive said: Is it a bad sign if you do a mammogram they say you have dense breasts, but they don't call you back? Like I am wondering if that isn't good enough or something. It's hard to say since the dense breast tissue makes it so difficult for them to see anything. Very frustrating. 😞 I wouldn't say it's a bad sign, but I wouldn't say you have the *all clear* either if that makes sense. I wouldn't let it worry me, though (and I'm a very anxious person), but I'd definitely keep up with regular screenings. Our hospital system does offer reasonably priced breast MRIs for this situation - maybe you can look into that? A friend of mine who is a breast cancer survivor gets those regularly. She does have dense breasts and was diagnosed with Stage 2 breast cancer just a few months after a screening mammogram that didn't have a callback (she found a lump and that's how she got diagnosed). 2 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted July 11 Share Posted July 11 9 minutes ago, mommyoffive said: Is it a bad sign if you do a mammogram they say you have dense breasts, but they don't call you back? Like I am wondering if that isn't good enough or something. https://www.npr.org/sections/health-shots/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers (April 2015) ”Twenty-one states, including California, have passed laws requiring health facilities to notify women when they have dense breasts. Eleven other states are considering similar laws and a nationwide version has been introduced in Congress. … About 40 percent of women have dense or extremely dense breast tissue, which can obscure cancer that might otherwise be detected on a mammogram. … But in some states, not including California, the laws go further by requiring health providers to offer a supplemental screening, such as an ultrasound, to women with dense breasts even if their mammograms are clean. Connecticut, Illinois and Indiana even require insurers to pay for screening ultrasound after mammography if a woman's breast density falls above a certain threshold. Otherwise insurers don't routinely cover supplemental screening for women with clean mammograms, even if they have dense breasts. The Affordable Care Act doesn't require it.” 4 Quote Link to comment Share on other sites More sharing options...
Lady Florida. Posted July 11 Share Posted July 11 (edited) A timely post. I go through this every year with my insurance plan and it's frustrating. They won't pay for an ultrasound or anything other than a basic mammogram. Then I get a letter saying I have dense breast tissue and my doctor might order further testing. Doctor orders it, they approve it, and I go. It seems nuts that they pay for both tests when my records clearly show I need more than just the regular mammo. It would make more sense to let me go straight to the high level tests but then, insurance in the US often doesn't make sense. I said timely because I just had my mammogram last month and received the expected letter. I then got a call from my doctor's office saying he ordered an ultrasound and scheduling will call me. Ugh. Edited July 11 by Lady Florida. 1 2 Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted July 11 Share Posted July 11 20 minutes ago, mommyoffive said: Is it a bad sign if you do a mammogram they say you have dense breasts, but they don't call you back? Like I am wondering if that isn't good enough or something. I've been informed for years and years that I have dense breasts, but I've only had a call back one time, and none of my providers have recommended additional routine screening. I'm guessing there's a range of denseness, and those on the higher end are most likely to get call backs. But yeah, that's just a guess. I have gotten the 3D mammos for quite awhile now, even back when I had to pay extra OOP for them. I don't know if that makes a difference or not. 2 Quote Link to comment Share on other sites More sharing options...
Kassia Posted July 11 Share Posted July 11 9 minutes ago, Lady Florida. said: It seems nuts that they pay for both tests when my records clearly show I need more than just the regular mammo. It would make more sense to let me go straight to the high level tests but then, insurance in the US often doesn't make sense. Right???? 2 Quote Link to comment Share on other sites More sharing options...
mommyoffive Posted July 11 Author Share Posted July 11 13 minutes ago, Pawz4me said: I've been informed for years and years that I have dense breasts, but I've only had a call back one time, and none of my providers have recommended additional routine screening. I'm guessing there's a range of denseness, and those on the higher end are most likely to get call backs. But yeah, that's just a guess. I have gotten the 3D mammos for quite awhile now, even back when I had to pay extra OOP for them. I don't know if that makes a difference or not. I wish they would put your rating on there, so you might have a better idea on it or something. 2 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted July 11 Share Posted July 11 (edited) 20 minutes ago, mommyoffive said: I wish they would put your rating on there, so you might have a better idea on it or something. Mine is on the mammogram report. Mine says “extremely dense” which corresponds with D on this link. My scans are not as dense as D but a lot more similar to D than C. Link has images. https://www.mayoclinic.org/breast-density-mdash-the-four-levels/img-20008862#:~:text=According to this system%2C the,dense and D%3A extremely dense. ”Healthcare professionals use the Breast Imaging Reporting and Data System to report breast density. According to this system, the levels of density are (from left to right) A: almost entirely fatty, B: scattered areas of fibroglandular density, C heterogeneously dense and D extremely dense.” Edited July 11 by Arcadia : with C or D become emojis 4 Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted July 11 Share Posted July 11 Oregon has a mammogram law: ORS 743A.100. Every insurance company must provide coverage for a yearly mammogram for everyone over 40. If you are under 40 and at high risk or or are symptomatic as designated by your health care provider, you are also guaranteed coverage. So, I get a yearly 3D mammo. The 3D allows you to see beyond the area of density. I've had to have a diagnostic ultrasound when one 3D mammogram didn't quite get the imaging needed, but haven't had to do a MRI yet. All of it was covered by insurance...3D mammo fully (I don't even need a dr referral to go)....the diagnostic ultrasound was covered per plan--my OOP was under $100 IIRC on the 80/20 split. 2 Quote Link to comment Share on other sites More sharing options...
QueenCat Posted July 11 Share Posted July 11 I always get the 3D mammo. Normal mammo is covered & I pay $35 for the upgrade. For that low price, it's worth it to me. 2 Quote Link to comment Share on other sites More sharing options...
TexasProud Posted July 11 Share Posted July 11 I never had follow up done even though I have always had dense breasts, until my mom died from breast cancer. Then my doc has gone nuts. I kind of wonder if it is overkill. I now see him twice a year for breast exames. I have a regular mammography and abus and then 6 months later I am having a diagnostic MRI. Still curious to see if the insurance will pay for the diagnostic MRI... They pushed back against the ABUS, but eventually paid. We have met our deductable for this year (Heck my husband's migraine treatments have us meeting our deductible within the first 4 months every year.) Anyway, he wants me to be screened every 6 months with my family history. But I do think they are fighting the insurance to get that done. 1 Quote Link to comment Share on other sites More sharing options...
East Coast Sue Posted July 11 Share Posted July 11 12 minutes ago, TexasProud said: I never had follow up done even though I have always had dense breasts, until my mom died from breast cancer. Then my doc has gone nuts. I kind of wonder if it is overkill. I now see him twice a year for breast exames. I have a regular mammography and abus and then 6 months later I am having a diagnostic MRI. Still curious to see if the insurance will pay for the diagnostic MRI... They pushed back against the ABUS, but eventually paid. We have met our deductable for this year (Heck my husband's migraine treatments have us meeting our deductible within the first 4 months every year.) Anyway, he wants me to be screened every 6 months with my family history. But I do think they are fighting the insurance to get that done. I’m in the same situation with every 6 months either MRI or mammogram. 1 Quote Link to comment Share on other sites More sharing options...
scholastica Posted July 11 Share Posted July 11 My insurance covers the more powerful mammogram if my doctor writes it that way. Different insurances operate differently obviously, though. I have my doc write the order and only schedule a that’s in the system. 1 Quote Link to comment Share on other sites More sharing options...
Wheres Toto Posted July 11 Share Posted July 11 I get a mammogram and a breast US every year. Initially they would order just the mammogram, then I'd get the letter saying to go for the US. A few years ago I asked if we could just skip all that and schedule both at the same time, and I've been doing that for the past few years. My insurance covers the mammogram 100% but not the US. I think it's partially covered since I only pay about $100 for it. 2 Quote Link to comment Share on other sites More sharing options...
ShepCarlin Posted July 11 Share Posted July 11 I get my screening mammogram every year. 6 months after the mammogram, I get an ultrasound. I have to pay out of pocket for the ultrasound. I meet with a nurse practitioner that I adore. She is the one who recommended I start getting the ultrasound 6 months after my mammogram after my first 3 mammograms resulted in call backs due to the dense breast tissue. Her reasoning was 1) ultrasound can catch some things mammograms don't and 2) I'm just going to keep getting call backs anyway so might as well do the ultrasound on a regular basis. I'm considered high risk but insurance won't cover the ultrasound no matter what. It's incredibly annoying but at least I've eliminated the stress that a call back letter brings. 2 Quote Link to comment Share on other sites More sharing options...
itsheresomewhere Posted July 11 Share Posted July 11 A mammo and ultrasound. The really nice ladies at the breast center knew how to word it so it is not denied now. 4 Quote Link to comment Share on other sites More sharing options...
***** Posted July 11 Share Posted July 11 I've wondered about Thermography, but I see no one has mentioned this one. Anyone? Quote Link to comment Share on other sites More sharing options...
J-rap Posted July 12 Share Posted July 12 I have both a mammogram and a breast MRI yearly, with six months between them. Sometimes they'll want me to have an ultrasound too, usually to get a closer look at something seen in the mammogram. I've been doing this for years. 1 Quote Link to comment Share on other sites More sharing options...
sbgrace Posted July 13 Share Posted July 13 (edited) I do yearly mammogram and ABUS. I have to pay a some for the ultrasound. My sister had to pay a lot more for hers, so it might be worth shopping around if insurance doesn't cover it as preventative. Edited July 13 by sbgrace 1 Quote Link to comment Share on other sites More sharing options...
iamonlyone Posted July 13 Share Posted July 13 In the past, the imaging center would immediately do an ultrasound after viewing the mammogram. I missed a few years at the height of Covid, and when I went back, they didn't view the images until later, and I got a call to return. I asked about an ultrasound, but instead they said a higher compression mammogram was ordered. Both tests were painful, particularly the second. I was sore for weeks. Next time I plan to go to a clinic in a bigger city about an hour away that is specifically for women with dense breasts. Women participate in determining the amount of pressure, and they always read the test while you're onsite and do an ultrasound, if needed, after they read the test. 1 Quote Link to comment Share on other sites More sharing options...
iamonlyone Posted July 13 Share Posted July 13 On 7/11/2024 at 5:28 PM, ***** said: I've wondered about Thermography, but I see no one has mentioned this one. Anyone? I had this test several times years ago (primarily because mammograms are so painful for me, I don't love what I read about compression, and I'm not crazy about even the low levels of radiation). However, I don't know if they are particularly accurate. Quote Link to comment Share on other sites More sharing options...
iamonlyone Posted July 13 Share Posted July 13 For those who have medical knowledge: why don't those with dense breasts just have ultrasounds instead of mammograms? Quote Link to comment Share on other sites More sharing options...
Arcadia Posted July 13 Share Posted July 13 25 minutes ago, iamonlyone said: For those who have medical knowledge: why don't those with dense breasts just have ultrasounds instead of mammograms? According to my oncologists, it is an insurance coverage issue. FYI https://news.feinberg.northwestern.edu/2023/06/05/improving-cancer-detection-for-women-with-dense-breasts/#:~:text=The use of ultrasound screening,the Journal of Clinical Oncology. “In the study, investigators at the University of Pittsburgh Medical Center Magee-Womens Hospital tracked more than 6,200 women aged 40-75 with dense breasts as they underwent three rounds of annual breast cancer screening. The screening included digital breast tomosynthesis, a type of 3D mammography, in combination with ultrasound screening. Investigators found that the use of ultrasound screening in combination with 3D mammography yielded only a modest cancer detection rate of one in 1,000. The results underscore the need for a variety of detection strategies for women with dense breasts, Houshmand said. “Tomosynthesis slightly improves cancer detection over 2D mammography in dense breasts. Adding ultrasound to the 3D mammography increased the sensitivity to some extent but this increase was not significant,” Houshmand said. “Due to several studies demonstrating a much higher detection of cancer with breast MRI, we are currently recommending supplemental screening in women with dense breasts with magnetic resonance imaging, instead of ultrasound. In our next study to follow, we hope to compare the sensitivity of abbreviated MRI to ultrasound to prove MRI’s effectiveness in cancer detection.” The use of 3D mammography combined with ultrasound screening may still be a good option for patients who cannot undergo MRI screening, she said.” 1 1 Quote Link to comment Share on other sites More sharing options...
mommyoffive Posted July 13 Author Share Posted July 13 Wow, so much information and things I never knew. Thank you everyone!! 1 Quote Link to comment Share on other sites More sharing options...
iamonlyone Posted July 13 Share Posted July 13 13 hours ago, Arcadia said: Investigators found that the use of ultrasound screening in combination with 3D mammography yielded only a modest cancer detection rate of one in 1,000. The results underscore the need for a variety of detection strategies for women with dense breasts, Houshmand said. “Tomosynthesis slightly improves cancer detection over 2D mammography in dense breasts. Adding ultrasound to the 3D mammography increased the sensitivity to some extent but this increase was not significant,” Houshmand said. “Due to several studies demonstrating a much higher detection of cancer with breast MRI, we are currently recommending supplemental screening in women with dense breasts with magnetic resonance imaging, instead of ultrasound. In our next study to follow, we hope to compare the sensitivity of abbreviated MRI to ultrasound to prove MRI’s effectiveness in cancer detection.” Oh, wow. So much pain and aggravation, and it doesn't read like mammography and ultrasound are very effective screening tools for those with dense breasts. Quote Link to comment Share on other sites More sharing options...
Kassia Posted July 13 Share Posted July 13 32 minutes ago, iamonlyone said: Oh, wow. So much pain and aggravation, and it doesn't read like mammography and ultrasound are very effective screening tools for those with dense breasts. Our hospital system offers breast MRIs at a reasonable cost. Probably less than I pay now for diagnostic mammo/ultrasound after my screening mammograms. https://www.uhhospitals.org/services/obgyn-womens-health/conditions-and-treatments/breast-health/mammography/fast-mri 2 Quote Link to comment Share on other sites More sharing options...
iamonlyone Posted July 13 Share Posted July 13 2 hours ago, Kassia said: Our hospital system offers breast MRIs at a reasonable cost. Probably less than I pay now for diagnostic mammo/ultrasound after my screening mammograms. https://www.uhhospitals.org/services/obgyn-womens-health/conditions-and-treatments/breast-health/mammography/fast-mri That's great! I Googled earlier to see about the test and within an hour's drive of me, it looks like I could possibly get the rapid MRI for $450, but only with a dr.'s order at one place, and only with the order and after a mammogram within 12 months at the other. After learning more here, I want to go that route next time, if possible. 1 Quote Link to comment Share on other sites More sharing options...
mlktwins Posted July 14 Share Posted July 14 I get a 3D mammogram each year. I was concerned because I do have dense breast and spoke to my GYN. She recommended an ABUS, which I did along with my mammogram a few years back (before Covid). I did get a call back about my mammogram and went back in for an extra check and ultrasound. All was good. I felt better having also had the ABUS results for a baseline. 2 Quote Link to comment Share on other sites More sharing options...
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