MIR-2006-11AB, November 2006

Breast Cancer Awareness

The Centers for Medicare & Medicaid Services (CMS) would like to invite you to join with us in helping to promote increased awareness of the importance of early detection of breast cancer, and ensure that all eligible women with Medicare know that Medicare provides coverage of screening mammograms and clinical breast exams for the early detection of breast cancer.

Next to skin cancer, breast cancer is the most common form of cancer diagnosed in women in the U.S., and it is the second leading cause of cancer death in women. According to the American Cancer Society, in 2006 about 212,920 women in the U.S. will be found to have invasive breast cancer, and about 40,970 will die from the disease. The earlier breast cancer is detected, the better the treatment outcome. Regular screening mammograms can help women detect breast cancer early.

Although screening mammograms and clinical breast exams are services covered by Medicare, the data indicates that these services are being underutilized. There are eligible women with Medicare who have never taken advantage of these preventive benefits and others who do not get screening mammograms and/or clinical breast exams at regular intervals.

Barriers to Getting Mammograms*

The top four barriers, in women’s words, are:

• “I don’t need a mammogram because my doctor has never recommended I have one.”
• “I’ve never thought about it.”
• “I have no breast problems, so mammography isn’t necessary.”
• “I don’t have enough time.”

Other barriers include:

• Fear about pain from the procedure.
• Fear of a diagnosis of breast cancer.
• Concerns about screening costs.
• Living a distance from the screening site.

* Source: The Manual of Intervention Strategies to Increase Mammography Rates, Centers for Disease Control and Prevention with the Prudential Center for Health Care Research.

Medicare Coverage
The good news is that mammography rates for women aged 50 and older are increasing, and breast cancer deaths are in decline. The U.S. Preventive Services Task Force (USPSTF) recommends screening mammography, with or without clinical breast examination, every 1-2 years for women aged 40 and older.

Medicare provides coverage of an annual screening mammogram for all female beneficiaries aged 40 and older. Medicare also provides coverage of clinical breast exams (The clinical breast exam is a Medicare-covered service which is included as part of the pelvic screening exam.) every 12 or 24 months, depending on risk level for the disease.

How Can You Help?
As a trusted source, your recommendation is the most important factor in increasing utilization of breast cancer screening services among eligible women with Medicare. CMS needs your help to ensure that all women with Medicare take full advantage of the preventive services and screenings for which they may be eligible. These services could save their lives.

• Help your patients understand the nature of breast cancer, benefits of breast cancer screening, and encourage them to get screening mammograms at regular intervals.
• Encourage your patients to talk about any barriers that may keep them from obtaining mammography services on a routine basis and help them overcome those barriers.

For More Information

• For more information about Medicare’s coverage of screening mammography, visit the CMS Web site: www.cms.hhs.gov/Mammography/ .
• CMS has also developed a variety of educational products and resources to help health care professionals and their staff become familiar with coverage, coding, billing, and reimbursement for all preventive services covered by Medicare.

§ The MLN Preventive Services Educational Products Web Page ~ provides descriptions and ordering information for all provider-specific educational products related to preventive services. The page is located at http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp on the CMS Web site.

§ The CMS Web site provides information for each preventive service covered by Medicare. Click on www.cms.hhs.gov , select “Medicare,” and scroll down to “Prevention.”

• For products to share with your Medicare patients, visit www.medicare.gov on the Web.
• For more information about NBCAM, please visit www.nbcam.org .

Thank you for joining with CMS to promote increased awareness of early breast cancer detection and mammography and clinical breast exam services covered by Medicare.

CMS Learn Resource 200610-02