ginna

Hi

I thougth the standard of care with all DCIS was  lumpectomy, rads and tamoxefin. I had lumpectomy, rads and took tamoxifen for 4 months , til I developed abnormal bleeding and then had a lesion taken off my uterus.  My doctors believe the lesion was there before the meds, but it just fuel it. I have decided not to take the tamoxifen any more and my oncoligist it fine with that. I too am fine with it. I see my oncoligist every 6 months.

Hi ladies

Dx with breast cancer in 2006. Before my surgery I had a Breast specific gamma Imagining test( medical name Mammoscintigraphy) . My insurance paid for it. I also had another one 18 months later. The Insurance company paid for that one as well. I  am now going for a my check up and My doctor wants me to have another one. But for some reason the insurance company denied it. Here is there reason.....A mammoscintigraphy is considered to be investigational.  I already had two and they paid for it? Why deny it now.... I wrote that on my first appeal and they denied it... This is my second lever appeal...i havent had a MRI in quite some time before my cancer surgery. We have been using the BSGI test results to look back at my past results to compare my breast changes... So to do a MRI now I would be starting from scratch, no feed back to look back at my breast and to see any changes.....I need help to put togther a very goods appeal letter...... I have this ....

I do not understand this denial as I have breast cancer with surgery and radiation and have had two previous mammoscintigraphy,when my docotr order them and these were paid for by you ( oxford) . Why now is oxford saying this is Investigational?

The medical Director who participated in this appeal knows nothing about me, how can he deny a medical treatment he ahs never even seen me, I am but just a name on a piece of paper... A doctor wouldn't give a precerption before seeing a patient and he is denying a test my medical Doctor says I need,  , why are you Questioning her? She after all has treated my cancer for that past 2 years.  I might add succussfully, so following her medical  advice and getting all the test I need is in line with my health and to keep me cancer free. I would think in the long run that would be helpful to you the insurance company as well.... can any one please help me with my letter... I am not good with wording and getting  my pint across..... Here is artical I read...And that was my exact DX...

 Study results recently published in the Journal of Academic Radiology indicate that Breast-Specific Gamma Imaging (BSGI) provides higher sensitivity for the detection of Ductal Carcinoma In Situ (DCIS) than mammography or MRI and can reliably detect small, sub centimeter lesions. The study, performed by Dr. Rachel Brem and colleagues at The George Washington University Medical Center, evaluated the procedure on women with mammographically suspicious microcalicifications and other high risk factors