A mammogram at age 42 saved her life. Now, more women will get the chance at early breast cancer detection [The Morning Call]

Jennifer DeFrancisco is grateful her breast cancer was detected early.

At 42, her gynecologist felt something odd in her breast and insisted she get a mammogram to confirm. The Bedminster Township, Bucks County, resident said she had to fight Aetna, her then-health insurance provider, to authorize the mammogram screening due to her age. But when they did, it confirmed her and her gynecologist’s fears.

DeFrancisco was diagnosed with Stage 1 invasive ductal breast cancer. The cancer had already spread outside of her milk ducts to the breast tissue, but not to her lymph nodes. She went through about three years of treatment including a double mastectomy, reconstructive surgery and hormone therapy.

Now 49, DeFrancisco’s cancer is in remission and she has become a breast cancer advocate. She said every woman should start screening early to protect themselves.

“Anything you can do to save lives and prevent more women from dying of breast cancer, it’s not even up for discussion in my opinion,” DeFrancsico said. “Especially for women like me with dense breast tissue, earlier is better.”

Recent changes could help her mission.

The U.S. Preventive Services Task Force released draft recommendations last week stating women and other people with breasts should begin mammogram screenings every other year starting at age 40.

The current guidance from the task force states that women should start getting screened every other year at age 50, and that private insurance providers must cover those procedures. That leaves biannual screening for younger women up to the patient, and insurance providers may choose not to cover it.

The possible change in guidance means little for either Lehigh Valley Health Network or St. Luke’s University Health Network. Both already recommend their patients start receiving mammograms annually at age 40, which is consistent with guidance from the American College of Radiology and Society of Breast Imaging.

The task force’s new recommendations align with its previous guidelines, which were moved from 40 to 50 years of age in 2016. Dr. Priya K. Sareen, chief of mammography for LVHN, said much of the decision at that time was based on concerns about false positives among women in their 40s, which led to distress, anxiety, apprehension and “diagnosis and treatment of breast cancer that would never have become a threat to a woman’s health, or even apparent, during her lifetime.”

But Sareen and other doctors questioned the later guidelines.

“Their point was perhaps there wasn’t as much benefit to these women, which isn’t true. In our own populations there is actually a significant portion of women we diagnose in their 40s,” Sareen said.

Breast cancer kills more than 43,000 women per year. The number of women in their 40s being diagnosed with breast cancer has increased over the last 20 years; between 2015 and 2019, the occurrence of breast cancer in younger women increased by an average of 2% each year.

Despite this, the task force still only recommends mammograms on a semiannual basis, meaning that private insurers are only required to cover the procedure every other year.

Dr. Karl Yaeger, section chief of women’s imaging for St. Luke’s, and Dr. Joseph Bucich, diagnostic radiologist with St. Luke’s, said it’s especially important to diagnose and begin treatment early because many of the cancers detected in women ages 40-49 are more aggressive, which makes early detection even more important.

Sareen said on top of that, catching and diagnosing the disease earlier significantly decreases the likelihood of overtreating the patient or of using advanced treatments like chemotherapy.

In Pennsylvania, the barriers to getting a yearly mammogram will become lower than ever for those at high risk, thanks to legislation recently signed by Gov. Josh Shapiro. The legislation requires insurance companies to completely cover the cost of mammograms for women at higher risk of breast cancer starting next year.

However, this legislation and the draft guidance leave potential financial barriers for those at lower risk of breast cancer from getting annual screening that could prove key to an early diagnosis. Sareen said the task force should support annual mammogram screening.

“I’m glad they’re finally coming closer to what we know is best for women, however, it still has a ways to go,” Sareen said.

©2023 The Morning Call. Visit mcall.com. Distributed by Tribune Content Agency, LLC.