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Removing Cost as a Barrier for Breast Cancer Screening

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Michele Sensenig faithfully follows the recommendations of her health care team, whether that involves brushing her teeth twice a day, getting regular exercise or scheduling her annual breast cancer screening.

Yearly mammograms are especially important to Sensenig, 54, whose risk for breast cancer is elevated due to family history and her own recent scare. But because she and her husband are self-employed with expensive yet limited insurance coverage that only pays for serious accidents or major hospital stays, they must pay the full cost of her screenings.

“I always get my mammogram, no matter how much it costs,” she said. “Sometimes we have to make a payment plan. We do whatever we need to do.”

2020 was an especially difficult year for the Sensenigs, who own a plumbing and electric business. In addition, five of the couple’s six young adult children are currently living at home due to the COVID-19 pandemic.

In 2018, Sensenig’s mammogram detected a breast abnormality that required surgery. While it proved to be benign, the experience reinforced the importance of regular screenings. So even though her family’s budget was tighter than usual in 2020, she never considered skipping her annual mammogram.

She scheduled an appointment and planned to put the cost on her credit card.

Fortunately, Penn Medicine Lancaster General Health has a new resource that ensures access to breast cancer screening and diagnostic services for women like Sensenig, who may be facing financial hardships. The Suzanne H. Arnold Center for Breast Health Endowment has already reached well over $1.2 million and continues to grow with additional gifts from the community.

Jennifer Groff, executive director of the Lancaster General Health Foundation, which supports philanthropic efforts throughout the health system, said an increasing number of women are experiencing financial barriers to accessing breast cancer screening services. While some other resources are available to support these patients, not all women qualify.

“We know early detection saves lives,” Groff said. “Unfortunately some women are slipping through the cracks. We don’t want any woman to not have access to critical diagnostic services because of inability to pay. We’re so grateful to the donors who stepped up with support to help fill this gap in care.”

Access to lifesaving technology

In recent years, mammography technology has evolved from film to digital images, with tomosynthesis (3D) screening mammograms increasingly becoming the standard of care. This advanced technology comes at a higher cost, which some insurance plans may not cover.

Nitin K. Tanna, MD, chief of Mammography and Breast Imaging Services at LG Health, said about 10 percent of screening mammograms show an abnormal finding that requires additional testing. Though insurers typically will cover the costs of follow-up diagnostic mammograms, and if necessary, biopsies, deductibles and co-pays may apply.

Access to these services is vitally important, regardless of cost, Tanna said. Without regular mammography screenings, malignancies remain undetected and continue to grow. As a result, a woman’s treatment options may be limited once the cancer is discovered.

“Research shows that detecting cancer at an earlier stage offers women much broader and more conservative treatment options,” he said. “Treatment becomes much more complicated later in the cancer journey.”

For example, cancer detected at an earlier stage can be more successfully treated with a lumpectomy or radiation. Larger cancers that are discovered at a later stage potentially require more invasive treatments, such as chemotherapy or mastectomy.

Fortunately, some resources are available for women who may be unable to pay for regular screenings. This includes the Penn Medicine Breast Health Initiative, which offers free screening and diagnostic services, as well as support services, to women who are uninsured or underinsured. The program is available to patients at locations throughout the health system.

However, in the past few years, some other longstanding sources of funding these services for women in need have dwindled, leaving a huge void, Tanna said.

“In addition, the pandemic has intensified financial needs for many women, including lost jobs and insurance coverage,” he said. “We really need these additional resources to increase access to lifesaving screenings.”

Tanna supported the Foundation’s efforts to create the endowment, which is off to a strong start thanks to the generosity of two leadership donors who wish to remain anonymous. The endowment will provide an ongoing source of funding to meet patients’ needs well into the future.

Just months after its initiation, it’s already helping grateful patients like Michele Sensenig.

‘It’s nice to get good news once in a while’

The pandemic forced Sensenig to postpone her regular 2020 mammogram for about six months, until the fall. She worried about the delay, and after a tough year for her family, she found herself bracing for more bad news. Sensenig’s doctor recommends the 3D mammogram due to her family history and breast density.

Sensenig heard about the endowment while checking in at LG Health’s Suzanne H. Arnold Center for Breast Health, when she inquired about the possibility of a payment plan or a discount. After following up the next day, she was thrilled to learn that she qualified for funding.

She ended up paying nothing for her mammogram, saving her family about $700. She soon received even better news when her mammogram came back clear.

“Having the cost of my mammogram covered was so unexpected, and such a huge blessing,” she said. “It’s nice to get good news once in a while.”

To contribute to the endowment, click here. Under Fund Designation, click Suzanne H. Arnold Center for Breast Health, and write in “Breast Health Endowment” under Payment Details.

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