MetroHealth Breast Specialist Wants Ohioans to Know More Breast Cancer Screenings Are Now Covered
Insurers must now cover additional breast cancer screening exams for women in Ohio, and MetroHealth’s Dr. Christina Clemow wants to make sure everyone knows about the new life-saving benefit.
“Our goal with breast screening is to detect small, early-stage cancer and breast disease, giving patients more treatment options and a better chance at a cure,” says Dr. Clemow, MetroHealth’s Division Chief of Breast Imaging and Intervention. “Access to annual screening mammograms and supplemental screening exams for qualifying patients will allow us to do that more often.”
The Breast Cancer Bill, approved by both chambers of the Ohio legislature in the past year, was signed into law by Gov. Mike DeWine on Friday, June 24, and goes into effect after 90 days.
It requires most insurers to cover one screening mammogram a year, regardless of age or risk factors. That coverage includes digital breast tomosynthesis, also known as 3-D mammography, which makes it easier for radiologists to identify cancer. At MetroHealth, every patient receives 3-D breast tomosynthesis as part of their annual breast cancer screening.
The law also requires most insurers to cover supplemental screening exams for those patients with dense breasts or at an increased risk of breast cancer because of personal or family history, ancestry, a genetic predisposition to the disease or other reasons determined by their health care provider. The additional screening exam can be an MRI (magnetic resonance imaging), ultrasound or molecular breast imaging. But the exam must be performed in a hospital or in a facility or mobile unit accredited by the American College of Radiology.
Insurers required to cover the screenings are the Medicaid program, health insurance corporations, sickness and accident insurers and public employee benefit plans.
The expanded coverage might not have happened without a push from cancer survivors, advocates and physicians, including Dr. Clemow, who testified twice before lawmakers, urging passage of the bill.
Before the change, insurers did not always cover annual or supplemental screening exams. As a result, many patients would sometimes skip them because they could not pay the out-of-pocket costs.
“Most breast cancers occur in those without known risk factors or significant family history,” says Dr. Clemow. “This is why yearly coverage for screening mammograms is so important. However, if you are found to be at high risk for breast cancer you may benefit from an additional screening exam, such as an MRI.
“Having dense breasts is normal,” Dr. Clemow adds. Forty percent of all women have dense breasts and 70% of those between the ages of 40 and 50 have dense breasts.
“This simply means your breasts are made up of more glandular tissue than fat,” she explains. “Dense breasts can make cancer harder to detect, and an increase in breast density increases the risk of breast cancer.”
In the United States, women have a one in eight chance of developing breast cancer, which is the second leading cause of cancer death in women after lung cancer, according to the American Cancer Society. Treatment is most successful when the cancer is detected early.
“This law is a game-changer for all patients and especially those with dense breasts and at high risk for breast cancer,” says Dr. Clemow. “Patients will now have access to additional screening, giving me and other breast imaging radiologists an extra tool to find cancers earlier and more easily.”
To learn more about MetroHealth's Center for Breast Health, visit metrohealth.org/breast-health.
Founded in 1837, MetroHealth is leading the way to a healthier you and a healthier community through service, teaching, discovery, and teamwork. Cuyahoga County’s public, safety-net hospital system, MetroHealth meets people where they are, providing care through four hospitals, four emergency departments, and more than 20 health centers and 40 additional sites. Each day, our 8,000 employees focus on providing our community with equitable health care–through patient-focused research, access to care, and support services–that seeks to eradicate health disparities rooted in systematic barriers. For more information, visit metrohealth.org.