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Petitioning Virginia State Bureau of Insurances Medical Directors of Insurance Companies

Cover MBI/BSGI as a diagnostic test for women with dense breast tissue and inconclusive mammograms.

MBI/BSGI can detect cancerous lesions that are missed by other imaging technologies such as Mammogram, Ultrasound and MRI. Mammography is a good tool for the early detection of breast cancer, but it can miss cancers, especially in women with dense breast tissue. Molecular Breast Imaging (also called scintimammography or breast-specific gamma imaging in the medical literature) is a breast-imaging test that has shown the ability to find cancers in women with normal or inconclusive mammograms. Despite the availability of hundreds of published studies supporting its use, several insurance companies continue to deny patients coverage for this procedure and as a result many women are denied access to this life-saving technology.
Imagine finding cancer before it spreads. I had breast cancer that was not detected by the mammogram or the ultrasound. Fortunately, my doctor did not feel comfortable with the negative results and she sent me to a cancer center that has a Molecular Breast Imaging machine that was developed by Dilon Technologies. With this technology, the radiologist was able to get a better image of the masses and found that I had a 1.5 cm tumor that was hidden in dense breast tissue. This tumor, which was reported to be normal in the mammogram and ultrasound, turned out to be both ductal and invasive. Because of the MBI procedure, my cancer was found so early that it had not spread to my lymph nodes and I did not even need chemo. I was able to go back to teaching and taking care of my family in no time! I attribute my success story to the doctor that would not settle for less than Molecular Breast Imaging.
After everything settled down, I did some research and was amazed to find that the company that developed this amazing technology was only 20 miles away from my house. I contacted them to thank them and to share my experience. During my research, I found that there are only 120 of these life-saving machines in the United States—I was shocked. It turns out that the lack of availability is because many insurance carriers have labeled this procedure as experimental and have denied claims. Medical facilities cannot afford to purchase machines for a procedure that is not covered by insurance. This does not make sense to me. If I had been told to come back in 6 months and have another mammogram I may not be here today. What would have happened to my husband, my children, and my students if I had not had a MBI. This procedure clearly detected my tumor even though the mammogram and the ultrasound missed it due to the density of my breast tissue. I am thankful that my doctor pushed for additional imaging; however, many people do not question the insurance companies and would come back in 6 months for another mammogram only to find out that their cancer is now not so easily managed. MBI is a relatively inexpensive procedure, much less than an MRI and should be used in cases where the mammogram is inconclusive. There should be no questions about it!
All of this brings me to this conclusion: we need more of these machines available and more medical facilities and professionals using these machines. My goal is to get insurance companies to recognize the importance of this procedure and to stop turning down pre-authorizations and denying claims. By solving the reimbursement issue more facilities will be able to obtain the machine which will make the test more readily available to women in the United States. Please help me get this machine into the diagnostic centers and medical facilities and to revolutionize how women are screened for breast cancer. Let’s make the Molecular Breast Imaging machine the new “Gold Standard” for the 21st Century and then we won’t have to imagine a world where people survive breast cancer, we will see it.
Join me in petitioning the insurance companies to change their medical policy to cover MBI as a diagnostic test for women who have unresolved issues after mammography. Don’t ever accept “we will monitor you” as an answer because it could be too late. Be a part of revolutionizing the way breast cancer is detected and don’t let insurance companies make the decisions for your family and friends.

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  • Virginia State Bureau of Insurances
    Medical Directors of Insurance Companies

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