News > Beyond the headlines: Finances and disparities in breast cancer

Beyond the headlines: Finances and disparities in breast cancer

LBBC’s views on breast cancer news

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Spring is in bloom at our home office outside Philadelphia, and the rising temperatures and longer days fuel the energy we need to track the news we bring you this month.

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Attendees of the 2017 Conference on Metastatic Breast Cancer hold up signs saying, "Count me"
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With Thriving Together: 2023 Conference on Metastatic Breast Cancer right around the corner, we’ve been discussing policies that positively impact people with stage IV breast cancer, including the Metastatic Breast Cancer Access to Care Act. Our April issue covers this legislation as well as health inequities in screening, for older adults, and Black people. There’s also promising news for CDK inhibitors in early breast cancer and a celebration of our LBBC Leadership Volunteers who continue to inspire the next generation of advocates.

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Financial toxicity from breast cancer

Pressure is mounting for policy makers to address concerns about the financial impacts of breast cancer. In March, the Metastatic Breast Cancer Access to Care Act was re-introduced to both the U.S. House and Senate. This legislation, which LBBC supports, would waive the 5-month and 24-month waiting periods for eligible people with stage IV breast cancer to access Social Security Disability Insurance and Medicare benefits. But Medicare coverage alone won’t solve the problem: one study showed that older adults who had comprehensive Medicare plans still struggled to afford breast cancer care and depended on financial assistance for access.

Our CEO Jean Sachs continues to speak publicly about financial toxicity as an equity issue; our local NPR station recently interviewed her about coding changes in breast reconstruction that puts the cost of DIEP flap surgery out of reach for some people. Our advocacy is making a difference – we just learned that Cigna, one of the largest U.S. health insurance companies, agreed to delay changing its coding policy for tissue-based breast reconstruction and will remedy member payments for DIEP flap surgeries that have been performed since March 12, 2023.

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The coding change is certainly making a really good option not accessible to everybody.

Jean Sachs, CEO of LBBC, on WHYY

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A healthcare provider assists an older woman with her mammogram
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Make dense breast screening affordable

It’s good policy to make women aware of their breast density. It’s a better policy to ensure they can afford to monitor it. A recent analysis compared past medical records of more than 1 million women who had either traditional two-dimensional or 3D mammograms and found the newer technology more effective at detecting cancers. Though this study showed no differences in detection between dense and non-dense breasts, other research shows 3D to be more effective for young women and those with high breast density. Now that mammographers are required to inform about breast density, LBBC will advocate for health insurance to cover the costs of additional screening recommended by doctors to ensure cancers are found when they are more easily treated.

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Breast cancer detection is becoming an individualized experience and each patient in conjunction with their personal physician and radiologist may benefit from adjunct screening tools–such as ultrasound screening and Breast MRI.

Paul Friedman, DO, in Medical News Today

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Racial disparities in health outcomes

We believe overcoming racial disparities requires commitment to change at every level of health care, from medical training to clinical research to treatment delivery. That view is supported by a remarkable analysis showing that in U.S. counties with more Black primary care doctors, Black people lived longer and had lower death rates overall—even if there was only a single Black doctor. Those same counties also saw smaller disparities in health outcomes between Black and white residents. A much smaller, interview-based study showed differences between the way white and Black women view risks for breast cancer and found Black women were more likely to rely on primary care doctors for prevention advice. LBBC will continue to elevate the voices of Black doctors throughout LBBC’s programs to support the delivery of more equitable care for all Americans.

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A Black female physician reviews medical info with an elderly patient

Community involvement and advocacy by Black physicians may change the social drivers of health for the populations most vulnerable to their health effects.

Monica E. Peek, MD, MPH, MSc, in JAMA Network Open

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Kisqali in early HR+ breast cancer

Between 20% and 30% of early breast cancers can recur, or metastasize, years after treatment. Finding methods to prevent metastases is a priority in all forms of breast cancer, including hormone receptor-positive, HER2-negative, the most common diagnosis. Early results from the NATALEE clinical trial showed adding the CDK 4/6 inhibitor ribociclib (Kisqali) to anti-estrogen therapy prevented more recurrences than giving hormonal therapy alone. That finding was consistent, even when cancer was in the lymph nodes. We’ll learn more once the study is published, but these results suggest Kisqali could be a new CDKi option for early-stage disease, alongside abemaciclib (Verzenio). Novartis, the manufacturer of ribociclib, plans to apply soon for FDA approval.

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Jenny Burkholder
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(Our) people are talking

This National Poetry Month, we’re celebrating LBBC Hear My Voice graduate Jenny Burkholder (above), who was recently named Poet Laureate for Montgomery County, Pennsylvania. Her application included works about her breast cancer experience. Meanwhile on SHARE’s Our MBC Life podcast, Abigail Johnson, Janice Cowden, Stephanie Walker, Lesley Glenn, and Miranda Gonzales, all graduates of LBBC programs, explored their paths to advocacy. Also in that episode: our colleague Catherine Ormerod shared what drove her to establish the Hear My Voice Metastatic Advocacy program in 2015. Over on YouTube LBBC board member and co-founder of For the Breast of Us Marissa Thomas launched her Love & Cancer series to uncover how thrivers navigate post-breast cancer relationships.

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I thought, let’s try offering a program for the metastatic community. We found people were hungry to find their own voice, to contribute, and to come together as a community.

Catherine Ormerod, LBBC, in Our MBC Life

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Kudos to two members of our medical advisory board: Karen Winkfield, MD, PhD, appointed by President Biden to NCI’s National Cancer Advisory Board, and Angela DeMichele, MD, MSCE, who will receive the Gianni Bonadonna Breast Cancer Award at the 2023 ASCO meeting for her practice-changing research.

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A grateful thank you to consulting medical editor Claire Nixon for lending her expertise to this month’s column.

Please send us items for the May issue at online@lbbc.org.

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Glossary
About LBBC

Janine E. Guglielmino, MA

  • Worked at LBBC 2001-2023
  • Believes in the power of shared stories to build connection and illuminate the realities of complex life experiences
  • Is an empath, writer, and cancer and mental health advocate who gains strength from the natural world

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Living Beyond Breast Cancer is a national nonprofit organization that seeks to create a world that understands there is more than one way to have breast cancer. To fulfill its mission of providing trusted information and a community of support to those impacted by the disease, Living Beyond Breast Cancer offers on-demand emotional, practical, and evidence-based content. For over 30 years, the organization has remained committed to creating a culture of acceptance — where sharing the diversity of the lived experience of breast cancer fosters self-advocacy and hope. For more information, learn more about our programs and services.