The Power of Prevention: How Breast Imaging Can Detect Cancer Early and Changes with Medicare

Did you know that breast cancer is the most common cancer found in women worldwide? The majority of women diagnosed with breast cancer do not have special identifiable risk factors. Therefore, screening all women is vital to catching breast cancer in its earliest stages, when treatment is more effective with less harmful side effects. In fact, studies consistently demonstrate 40% fewer deaths due to breast cancer among women screened with mammography than among those who do not undergo screening. Prioritizing breast health promotes physical well-being, peace of mind, and the ability to make informed choices. 

A screening mammogram is an exam recommended for women on an annual basis beginning at age 40. Some women who are at increased risk of breast cancer are recommended to begin screening earlier. All patients are recommended to discuss their personal risk of breast cancer with their providers to identify if earlier screening or screening with additional imaging exams, such as an MRI, may be needed. Screening mammography is used to check for breast cancer in people who do not have any breast symptoms. Screening mammograms help detect cancers that may be too small to feel, allowing for earlier and more effective treatments. 

At Weill Cornell Imaging at NewYork-Presbyterian, our standard of care utilizes the latest technology of 3D mammography, also known as breast tomosynthesis. During 3D mammograms, the X-ray arm sweeps in a slight arc over the breast and takes multiple images in just seconds. These images are then combined to compose a 3D picture of the breast, which has been shown to increase detection of breast cancer and decrease the need for additional workups. All mammograms at Weill Cornell Imaging at NewYork-Presbyterian are read by our specialized breast radiologists—physicians with expertise in the diagnosis of breast cancer. 

While screening mammograms are effective in detecting many cancers, there are instances where additional imaging is helpful. For example, women with dense breasts are at a slightly increased risk of developing breast cancer and the denser tissue may make it more difficult to detect breast cancer 

What are dense breasts?  

Having dense breasts refers to the composition of breast tissue. Breasts are primarily made up of the following tissues: 

  • Fatty tissue. 

  • Fibrous tissue. 

  • Glandular tissue. 

Dense breasts have more fibrous and glandular tissue. This is completely normal and is seen in approximately half of all women

How do you know if you have dense breasts 

Mammography is the primary way to determine breast density and this information will always be included on all radiology reports and the letters to patients.  

What can I do if I have dense breasts 

While mammography with breast tomosynthesis is still the best test proven to decrease mortality from breast cancer, patients with dense breast tissue may benefit from additional screening exams such as breast ultrasound or breast MRI. These tests can help detect cancers that may not be seen on the mammogram.  These additional screening tests do not replace mammography. 

What happens if I am referred for additional imaging? 

If a patient’s mammogram shows that they have dense breasts, other additional imaging tests, including breast ultrasound or breast MRI may be recommended. However, these additional screening exams may not be paid for by insurance or may result in patients needing to pay out of pocket for deductibles, copayments, and/or co-insurance. Patients should speak with their provider about additional imaging or our Radiology Consultation Services team 646-962-2273 (option 3) to determine if further imaging is necessary. 

Medicare Coverage Changes 

In January 2024, Medicare shared an announcement that breast ultrasounds done just for additional screening because of dense breast will not be covered. Medicare patients who choose to proceed with one of these additional screening exams will be expected to pay at the time of their visit. 

Medicare will continue to pay for breast ultrasounds when there is a specific symptom or concerning areas in the breast. For example, assessment of a lump discovered during physical exam, or a possible cancer found by mammography. Medicare will also cover ultrasounds for patients with a history of breast cancer.  

We understand this is a substantial change that alters the routine care our patients have been receiving for years. We want to ensure any questions are answered before their appointment with us. Our staff is fully equipped to answer questions and address any concerns that our patients may have. 

How we can help 

Our dedicated breast imaging specialists are available to speak with patients and providers regarding any questions about what tests are best for a patient. Please contact Radiology Consultation Services at 646-962-2273, option 3. 

For questions around insurance coverage, please contact our Insurance and Financial Clearance team at 212-746-6000, option 2.