🔒Insurers holding back access to advances in women’s health

One of the most rewarding moments of a doctor's career is witnessing firsthand advances in medicine that saves lives. As a breast cancer imaging specialist in practice for three decades, one of the most remarkable advances I've seen is the advent of 3D mammography.

3D mammograms provide enhanced clarity, which leads to fewer false alarms and increased cancer detection. Given the notable benefits, I wish someone could explain why some private insurance companies aren't covering this important technology.

Since the Food and Drug Administration first approved the technology in 2011, multiple peer-reviewed studies have shown that 3D mammograms provide greater accuracy than 2D mammograms alone. Doctors can now look at the breast tissue layer-by-layer, which is especially helpful for women with dense breasts. With this technology, we're calling back fewer patients due to inconclusive images, saving women the inconvenience, cost and anxiety of needless follow-up visits and the healthcare system the cost of unnecessary additional testing.

The benefits do not stop there — not only does 3D mammography help reduce false positives, it helps find cancers that might be obscured by, or look like, normal tissue. The technology has shown a 41 percent higher invasive cancer detection rate when compared to conventional mammograms. This is a game-changer for women, and it's not surprising that Medicare has recognized its value and is now covering and paying for 3D mammography screening. However, some private insurers' policies, such as Cigna and Aetna, based here in Connecticut, are considering this “experimental” technology, which it certainly is not.

Until private insurers cover 3D mammography, not all women will benefit from these more accurate mammograms. I've made it my personal mission to educate Aetna, Cigna, Anthem (of which Blue Cross Blue Shield of Connecticut is a subsidiary) and others, explaining the clinical and economic data supporting the superiority of this technology. Furthermore, I believe coverage of this technology is particularly important for the state of Connecticut, which currently ranks second in breast cancer incidence rates nationwide.

With health insurers so focused on their bottom line, you'd think they'd be eager to reimburse for 3D mammography — but that has not been the case. A study published last year in the Journal of ClinicoEconomics and Outcomes Research found that 3D mammography leads to significant cost savings because of the significant reduction in unnecessary follow-up visits due to false alarms. It showed that insurance companies could save $28.53 per every woman screened with 3D mammography. It's hard to understand why insurers are hesitant to cover a technology that not only saves lives but dollars too.

But beyond the bottom line, lack of reimbursement is a shame given we are talking about the lives of real women. Women whose 3D mammogram meant this year they may not need to go in for an unnecessary follow-up exam or biopsy. Women deserve better than this.

The sad fact is, when insurers' policies don't keep pace with the new standard of care, it slows innovation and the adoption rate of vital advances. Many doctors will only be able to invest in 3D mammogram equipment when they know insurance will cover it. 3D mammography is an important advancement in breast cancer screening; it is a victory for women, their families and our healthcare system. I call on all of Connecticut's insurance providers to join our state's doctors in ensuring all women have access to 3D mammograms.

Dr. Jean Weigert is a breast cancer researcher, physician and patient advocate who serves as director of breast imaging at The Hospital of Central Connecticut in New Britain and Southington, and is president of the Radiological Society of Connecticut.