Breast Cancer Limbo

This isn’t the first time and it, likely, will not be the last. I went for my annual screening mammogram and got the dreaded call. The next day a very nice but efficient woman from the breast center called me. “They have found an abnormality and want you to come back in for further testing”, she said. I knew that was the drill as soon as I saw the hospital name show up on my caller ID. “Don’t worry, this happens to a lot of people”. I know that. It is the same thing I tell my patients, but when it is you receiving the information it takes on different meaning. I scheduled my next appointment two weeks out and hung up.

Then many thoughts ran through my mind. “You’ll be fine-this happened before and it was nothing”, “I can’t have cancer, I take good care of myself”, “of course you could have cancer-my Mom had breast cancer and my Dad died of colon cancer at age 54”. Ugh, this will be a long two weeks! I assured myself that at least I am able to get the testing I need. My insurance does not cover 3 D mammography. This is newer mammography technology that provides better accuracy in imaging particularly for women with dense breast tissue who are at higher risk for breast cancer. I requested this testing and when I called to originally schedule I was informed that it would cost me $157 as my insurance wouldn’t cover 3D mammograms despite the fact that this was the better test for me. I paid the money as this could be the difference between life and death, the difference between finding breast cancer this year or next when it is far advanced. My nurse who I work with every day told me that no matter what, she would not be able to afford to pay for the testing. She has the same insurance, same diagnosis and is the same age as myself.

Does it make sense that better technology with a greater chance of detecting cancers early should be reserved only for those who can afford to pay the extra money? Then I found out, this is a state by state issue and differs based on your insurance. Medicare and Priority Health cover it but my insurance, Blue Care Network, does not. The CPA in me wonders if the cost/benefit analysis makes it worth it to my insurance company to have breast cancers found later ultimately leading to more expensive intervention. For the individual, the answer is obvious. Women would prefer to have a greater chance of catching their breast cancer early-that is the whole point to screening tests. I, personally, really do not want to be diagnosed with cancer. I want to live and, as the primary earner for my family, can’t afford to be sidelined by surgery and treatment-who can?

Being able to get the most up to date technology shouldn’t be based on your ability to pay extra. This is the most unfair form of medical elitism I can imagine. Does it make sense that this is the way it is in Michigan, but not in Connecticut? Joan Lunden went before Congress and argued for women to be informed of their breast density status so they would know they were at higher risk for breast cancer. Now we receive a pink notice with our results in the mail giving us this information. It is torture to give people this information and then withhold testing they need and deserve.

And let me be perfectly clear about this, these are not people without insurance. I pay dearly each month for the privilege of having coverage for my family. When they rescheduled me for the further testing, the nurse wanted to give me the diagnosis codes so I could call my insurance company and find out if they would cover the necessary testing. Are you kidding me? I declined the information-of course I will have the testing and pay for it if I have to. Many of my patients and friends would struggle with this choice.

It is time for us to stand up for what is right. Insurance companies need to cover 3D mammography. Life and death shouldn’t depend on whether you picked one insurer over another. The reality of the situation is I don’t want to be a cancer statistic. I do everything I can to take care of myself. But this is not always enough. Statistically, I live in THE county in Michigan with the highest rates of breast cancer in our state. There are factors that are obviously out of my control. Why don’t more people know these statistics? Why aren’t 3D mammogram available for everyone?

So, I march on-trying to inform everyone I can. More important-PREVENTION! I support the work of people like Bill Couzens, the founder of LESSCANCER.ORG. He has dedicated his life to try and ensure that people like you and I don’t get that dreaded diagnosis of cancer. But how will you ever know that you were spared that bullet? You won’t. I will be riding my bike June 23-24, 2018 to raise funds for LESSCANCER.ORG biking from Flint, Michigan to Traverse City, Michigan completing our ride at the Cowell Family Cancer Center’s cancer survivor’s picnic at Munson Medical Center. Open your eyes and realize that cancer prevention is our key to health. There are steps we can all take in our homes and communities to reduce the number of cancer diagnosis. I hope I have good news before this ride in June and have a cancer free summer. Please consider supporting us-in good health, Nancy

Breast Cancer Limbo was originally published in Less Cancer Journal on Medium, where people are continuing the conversation by highlighting and responding to this story.