Understanding mammograms, Medicare coverage and breast health

By the time you’ve joined the 60+ club, you’ve probably known at least one woman who had breast cancer.

That’s because 1 in 8 women in the U.S. will be diagnosed with breast cancer in their lifetime. But here’s the good news: many women survive and even thrive after diagnosis! When breast cancer is caught in its earliest stages, the survival rate is over 99 percent. About two-thirds of cases are diagnosed at this point, before cancer has spread outside the breast.

Unfortunately, those positive outcomes don’t reflect the experience of all women.

Keep reading to learn more about:

• Differences in access to preventive care and diagnostics

• Medicare coverage for mammograms

• How to conduct breast self-exams

Disparities in Early Detection

With advances in early detection and treatment methods, breast cancer death rates are down a whopping 44 percent since 1989. However, not all women have benefited equally from those reduced rates — as Black, Hispanic and Native American women often face delays in detection and diagnosis.

Case in point: Black women are more often diagnosed in later stages of the disease than white women (45 percent vs. 35 percent). And when breast cancer is diagnosed at a later stage, it typically leads to poorer health outcomes. Black women are 42 percent more likely to die from breast cancer than any other racial group, even among patients with similar staging and tumor subtypes.

That’s why annual screenings are absolutely critical. Women who receive regular screenings for breast cancer have a 26 percent lower breast cancer death rate than women who don’t get screened.

But Black and Hispanic women are more likely to experience longer intervals between screening mammograms, which contributes to the higher rate of late-stage diagnosis. In addition, the wait between an abnormal mammogram and receiving a diagnosis is significantly delayed: 20 percent of Black women had to wait more than 60 days, compared to 12 percent of white women.

Promoting Access for All

A key contributor to these differences? Access to healthcare and screenings.

Socioeconomic status should also not play a role in your access to preventive screenings. Annual screening mammograms (2D or 3D) are covered by Medicare Advantage, typically at no cost to you. Just be sure to see an in-network provider to access your plan’s full benefits.

If your doctor needs to get a closer look at the breast tissue, they will order a diagnostic mammogram. Medicare Advantage plans cover these mammograms, though they may apply cost-sharing. Check your plan’s coverage to learn about any estimated out-of-pocket expenses.

ArchWell Health accepts many Medicare Advantage plans, including those from UnitedHealthcare, Anthem Blue Cross Blue Shield, Devoted, Cigna, Aetna and Humana insurance providers. To find out if an ArchWell Health primary care provider is in-network with your Medicare Advantage plan, contact a center near you.

LEARN MORE: Your Mammogram Questions, Answered

Breast Self-Exams: What to Look and Feel for

While there’s no substitute for annual screening mammograms, it’s also a good idea to check your breasts yourself each month. Here’s why: About 15 percent of breast cancers present with a lump or other symptoms that aren’t detected on mammograms, and about 30 percent present with a lump or other symptoms between screening mammograms.

Here are some tips on what to look and feel for during your monthly breast exam.

While upright:

1. Stand in front of a mirror with your arms at your sides.

2. Look at the shape, color and texture of your breasts and nipples to track any changes.

3. Apply gentle pressure to your nipples and report any discharge or bleeding to your healthcare provider.

4. Using a range of pressures, from gentle to firm, press into your breasts and armpits with the pads of your three middle fingers.

While lying down:

1. Lie flat on your back.

2. Place a pillow under your right shoulder and put your right arm behind your head.

3. Use the pads of the three middle fingers on your left hand to press into the right breast and armpit area using light, medium and firm pressure.

4. Repeat steps 2-4 for the left breast and armpit.

What does a breast cancer lump feel like? Women with breast cancer have said their lumps feel like a pea, grape, marble or golf ball. A lump might feel firm or mushy, with or without defined edges.

That said, if you see or feel anything out of the ordinary — like an unusually thick area, swelling or general changes in texture — follow up with your primary care provider right away.

ArchWell Health Is Here to Help

The latest guidelines suggest that women get a mammogram every year until they reach age 74. After that, the decision to get screened should take your overall health, life expectancy and values into account.

Talk with your ArchWell Health provider for personalized guidance on the optimal screening schedule for you. Your care team can also help you make a mammogram appointment at an imaging center in your area.

Contact us today to discover the many ways ArchWell Health can support your overall health and well-being as you age.