Katie Couric and I have two things in common: our breasts. We both have dense breast tissue.
If you have no idea what I am talking about, consider yourself lucky. The imaging equipment used to perform most standard annual mammogram screenings for breast cancer is not good at detecting cancer in dense breasts.
People like Couric and me have a higher risk of getting breast cancer. More than 40 percent of women over age 40 have dense breasts and therefore need more advanced equipment — ultrasound or MRIs — for effective annual screenings.
Breast cancer screening is supposed to be free. Both the federal Affordable Care Act and Massachusetts law require insurers to provide preventive cancer screening at no charge. But for the last two years mine have cost $800.
Each time it went like this: my free mammogram at Outer Cape Health Services was inconclusive and resulted in a referral to Cape Cod Healthcare’s Cuda Women’s Health Center in Hyannis for an ultrasound. My ultrasounds, unlike Couric’s, found no cancer.
But ultrasounds are considered “diagnostic,” not “preventive,” and are therefore not fully covered — even though we pay $10,000 a year for high-end health insurance from Blue Cross Blue Shield. And even though the ultrasound is being done as a screening.
Journalists have to use caution when covering news stories about things that affect them personally. Our obligation is to be aware of our biases and seek the facts and diverse views that allow us to report evenhandedly. But writing about this issue reminded me that sometimes having a stake in a story can be an asset. As a patient, I felt the unfairness of this but knuckled under and paid up. As a reporter, I dug in. Maybe more stories should be pursued with the doggedness and sensitivity that personal experience can inspire.
In reporting this story, I found a way to help some of us dense-breasted women: If you have dense tissue, have your screening done on a 3D mammography machine, which detects more cancers than traditional 2D mammograms do — and also reduces false positives.
Cape Cod Healthcare has one, and Outer Cape Health has a grant to help them acquire one. According to my Blue Cross Blue Shield service rep, a 3D mammogram is covered by my plan. (You should check the details of your own policy.)
It should not be this hard to figure out how to get the right kind of screening and have it covered. It took many hours for me to get this far. A helpful email from Lori Jewett, the COO of Cape Cod Healthcare, was key. But I’m not sure I would have reached her if I were just a patient and not a journalist.
In 1970, activist Carol Hanisch popularized the phrase “the personal is political” in response to the criticism that feminists were bringing their own experiences — with gender discrimination, oppressive standards of beauty, and abortion — into the public arena.
This week, I got to do my part.