Can annual screenings include ultrasound?

maiyen

Hello,

I've had a small lump that was found via ultrasound (never seen on mammos) and I would be interested in adding this extra step in with mammos for my annual breast cancer screenings.  Does anybody else do this and will insurance pay for it?  I have seen various articles on the subject online, but nothing definitive.

Thanks!

ballet12

If you have dense breasts, various states have now required that radiologists need to indicate if you have extremely dense breasts.  That should be a reason for your primary care provider to request ultrasound on annual screenings, which is better at seeing solid masses in individuals with dense breasts.  If you are in one of those states, I think it should be covered by insurance. I routinely ask for sonograms and the insurance does seem to be paying for it.  I am from New York State, which did pass that legislation.  I should state that my mammos and sonos are now considered "diagnostic" because I have a diagnosis of DCIS, but I also used the diagnosis of atypical ductal and lobular hyperplasia before, which got me the "diagnostic" mammo and sono for many years.  I didn't actually find sonos to be that helpful to me in the past, but now, I'm asking for them, especially since I won't be having MRI's.

Anonymous

with my LCIS, I get diagnostic mammos and MRIs  (each yearly, alternating 6 months schedule), but no US is included routinely.  (only if they see something suspicious). I wish it would include US, but I am thankful that they do approve my MRIs. (although I still have to pay a hefty price due to our high insurance deductible),

anne

Blessings2011

Because I had a family history of BC, plus extremely dense, fibrocystic breasts, I always requested an ultrasound along with my annual mammogram.

Every year, it was denied, because "Ultrasound is not considered a screening tool."

Well, I got plenty of ultrasounds after my left nipple started bleeding, and guess what - there was the IDC, hiding next to the DCIS, which the mammogram I'd had a few months previously had completely missed. And the tumors were so small I never would have felt them.

Had I not had the bleeding, who knows how long it would have take to find the cancer?

I firmly believe it should be the added step with anyone at high risk.

SpecialK

I always had palpable lumps that did not show on mammography, so my annual mammograms were routinely followed by ultrasound.  My 2cm tumor was not seen on mammography, but was on US.  My initial care was done in military facilities (that do immediate US) so I am not sure about insurance coverage, but if you can prove that mammos do not image you well due to density it seems that US would be appropriately covered.

ballet12

awb--Wish I could also get routine MRI's, but I won't be getting them.  They were only given after I received the DCIS dx (prior to re-excision) They found something on the other breast which they were following, but the second facility ultimately deemed it was benign (after 6 month follow-up).  The first facility wanted to biopsy it. I guess my treating facility is concerned about chasing lots of false positives.

Blessings--I've got the family hx of bc and the extremely dense breasts, and now the DCIS, and still won't be getting routine screening MRI, so I am insisting on the sonos, which I will be getting. No difficulty obtaining that, but I had to ask for it. I'll inquire as to what the official position is at my esteemed NCI-designated Cancer facility, as to why the MRI's aren't routine. It seems that individuals with high risk conditions (not at my facility) get more screening than I do.  Hopefully, I'm no longer high risk.

cp418

For my peace of mind, I've been having an Sonocine US done during my yearly mammogram visit. This procedure is not covered by insurance and costs me $300. (My surgeon and previous oncologist refused to do MRI or US and I got tired of fighting with them. Both my GP and GYN had no issue writing Sonocine script as there is no insurance to deal with.)

maiyen

I live in Texas where Henda’s Law passed, which states “If your mammogram demonstrates that you have dense breast tissue, which could hide abnormalities, and you have other risk factors for breast cancer that have been identified, you might benefit from supplemental screening tests that may be suggested by your ordering physician.”

My concern is not only the small lump that was found (but not seen on mammos), but I recently got path results from an excisional biopsy that noted microcalcifications due to a complex fibroadenoma. I have had multiple mammos and ultrasounds within the past two years and none of my radiology reports ever indicated microcalcifications. I am also considered high risk because of family history/gail model %. Maybe these factors in addition to having dense breasts will be enough for some additional screening tests?

Does coverage for MRI screenings vary by state as well?

ballet12

To my knowledge, there is no governmental regulation of coverage of breast MRI's. It is up to the individual insurance company. Unfortunately, some companies will only pay for an MRI if one already has a bc diagnosis, but that is not a screening MRI.

Momcat1962

I have a diagnostic mammo and ultrasound at LEAST once a year. My ins pays for it. Very dense breasts with breast issue history here.