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Preventative Measures Screening/monitoring guidelines after completing BC treatment

I just want to check with this community about screening methods guidelines after you have gone thru your initiate breast cancer treatment. I am near the finish line and reading up on next steps. Read about the Survivorship Program (thank you for that Breastcancer.org). Trying to get in touch with a local place that offers that.

For screening, with dense breast tissue, the guideline is the annual mammogram with an optional breast MRI for high risk patients. I think having had BC is considered high risk of getting BC again. But this is where I think there may not be a hard definition that those whom have had BC is consider high risk for BC. So this goes to the health care coverage on prevention. Right now if you are over the age of 40 in the US the mammogram is covered as preventative. But not the MRI along with annual mammogram (for dense tissue) as far as I was able to find on the internet. Thus this post. Want to see what others here has gone thru or going thru as the preventative and monitoring after they have gone thru BC treatments.

Comments

  • zen1028
    zen1028 Member Posts: 25

    Just found this…if this does come out and it is very effective, and if prior BC folks are eligible for it…screening/monitoring for recurrence may not need to be a game of chance.

  • vlnrph
    vlnrph Member Posts: 474

    It can be difficult to get insurance to pay for MRI. Their best way of making profits is to deny treatments. You may need to obtain prior authorization. Even with that in place, my claim was refused and, as part of the appeal, I went to a meeting with their lawyer, the physician they employed and another MD who was remote, having called in by phone.

    I had my documents & showed how they were wrong. Their decision was reversed and the hospital was finally paid. I’m sure many people don’t have the energy (we’re cancer patients!) or confidence to pursue a proper resolution but I always tell folks not to give up. I also reported thar nationally known company to our state commissioner. Easy on line form.

    In addition, don’t be too invested in the term “preventative” or prophylactic. The best way to describe these procedures and imaging options is as ‘risk reducing’. You probably realize that mammograms do not prevent cancer however lots of women actually think that is true. A retired pharmacist, I tend to be sensitive to details in order to avoid confusion.

  • zen1028
    zen1028 Member Posts: 25

    Thank you the insight vinrph. I hope I don't have to go thru what you listed above with my insurance. Dana Farber has started the paperwork on the pre-authorization already. Fingers crossed. I actually do believe mammograms prevent in a way. It does not prevent in the same definition as like a vaccine. But it can be a prevention for something to become more serious. Mine was discovered during my annual mammogram, stage 1 non-aggressive. It was sooo small it can't be felt on manual exam and a radioactive seed had to go in prior to surgery so the surgeon can find it. I am advocating to all the women around me. One friend is around my age but her doctors suggested every 2 years. Not sure why but if insurance is paying for a mammogram annually as "preventative" with no out of pocket expense, why not do it. I do hope I get the MRI approved. I do hope that researchers can include cancer survivors are part of the high risk group to getting cancer again.

  • zen1028
    zen1028 Member Posts: 25

    Just updating on the Survivorship Program. Soooo not sure if this is different elsewhere, but the one near me, this program is more for folks that have gone thru the "treatment". Meaning done with the 5 yr of hormone, chemo, surgery, radiation. It was not the "coordinator" of care that I was looking for upon completion of radiation. I feel that there should be a navigator/coordinator of care, not social work, but one to help cancer patients navigate all of the types of care at every stage. Maybe not a specific individual but a department. I feel it has been confusing on what is next after radiation, whom do I go for things that I feel were a result of the treatments, etc. Venting.