State doctors praise mammogram law

FAYETTEVILLE — A new state law requiring health insurance companies to cover breast ultrasounds and 3-D mammograms will save lives, medical experts say.

“This test has been proven in many, many studies to be a superior mammogram,” Dr. Kelly Pierce at The Breast Center of Northwest Arkansas said of the 3-D mammogram.

Mammography is the most widely used cancer screening tool for women between the ages of 40 and 74, according to the National Cancer Institute, a federal agency for cancer research and training.

Arkansas is taking a step forward by requiring insurance to cover the more advanced screenings as part of regular checkups, state Rep. Greg Leding, D-Fayetteville, said. Leding sponsored the legislation that took effect Aug. 1.

Act 708 says an insurer cannot impose a co-payment or a deductible for breast ultrasounds and screening mammograms. The law does not require coverage for more than one mammogram if a patient has to have additional tests.

The 3-D mammography technique, also called tomosynthesis, uses multiple X-ray images taken in an arc around the breast, while conventional mammograms use a two-dimensional image. Ultrasounds use harmless, high-frequency sound waves to produce an image.

A 2014 study in the Journal of the American Medical Association found that screenings that use

both conventional and 3-D mammography detected 41 percent more invasive cancers and reduced false positive findings by 14 percent. However, the National Cancer Institute’s website shows those findings are not yet conclusive.

The U.S. Food and Drug Administration has approved the 3-D mammogram, but it is not considered standard care, according to breastcancer.org, a nonprofit organization that seeks to provide up-to-date information on breast cancer.

Not everyone agrees that 3-D mammograms or breast ultrasounds are the best way to go. Supplemental ultrasounds for women with dense breasts would substantially increase costs with little improvement in overall lifespans, according to a 2014 report from the Annals of Internal Medicine.

Leding said insurance premiums are not expected to rise because of the law. Insurance companies may actually save money because of lower treatment costs by catching the disease early, he said.

A spokesman for the insurance company QualChoice said Friday that the company couldn’t immediately answer questions about the change. An Arkansas Blue Cross and Blue Shield spokesman did not return a phone message or email last week.

Patients should save money, Leding said.

A 3-D mammogram costs $400, and a breast ultrasound costs $275 at the The Breast Center, Pierce said. Some patients were paying those costs out of pocket before the legislation took effect, she said.

While 3-D mammograms are not yet offered at all clinics in Arkansas, the technology has proved extremely effective, said Lisa Nims, the radiologic technologist mammography supervisor at the Northwest Breast Imaging Center at Willow Creek in Springdale.

“We can look through the whole breast. [3-D] is like having a book, and we get to see each layer,” Nims said.

The Willow Creek center gives about 40 mammograms a day and has offered 3-D mammograms since 2012.

The Breast Center did about 20,000 mammograms last year. The 3-D mammogram has been offered for about a year and represents about 40 percent of those mammograms, Pierce said.

The center plans to switch to 3-D mammograms for all its patients, Pierce said. The technology helps speed up treatment for patients through better and earlier diagnosis, Nims and Pierce said.

In 2014, Arkansas was among 11 states with the highest cancer death rates among women, according to a study by the Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control.

The breast cancer death rate in women in Arkansas is 23 per 100,000 women, according to the CDC.

Leding said he hopes the new law will lower that rate by giving more women access to the best technology.