Requires biopsy 6 Known biopsy-proven malignancy (cancer) Biopsy confirms presence of cancer before treatment begins BI-RADS also includes four categories of breast density that may be reported. The radiologist who reads the mammogram chooses the category that best describes the level of breast density seen on the mammogram film. The categories, from the least amount of breast density to the highest, are as follows: The breasts are almost entirely fatty There are scattered areas of dense glandular tissue and fibrous connective tissue (together known as fibroglandular density)
The breasts are heterogeneously dense, which means they have more of these areas of fibroglandular density. This may make it hard to see small masses in the breast tissue on a mammogram. The breasts are extremely dense, which makes it hard to see tumors in the breast tissue on a mammogram. Many states in the U.S. Exit Disclaimer have enacted laws requiring mammography providers to tell women if they have dense breasts (i.e., breasts that are heterogeneously or extremely dense on a mammogram) and to inform them of risks associated with having dense breasts. In addition to making mammograms harder to read, dense breasts are a risk factor for breast cancer. How much does a mammogram cost? Insurance plans governed by the federal Affordable Care Act must cover screening mammography as a preventive benefit every 1–2 years for women age 40 and over without requiring copayments, coinsurance, or deductibles. In addition, many states require that Medicaid and public employee health plans cover screening mammography. Women should contact their mammography facility or health insurance company for confirmation of the cost and coverage. Medicare pays for annual screening mammograms for all female Medicare beneficiaries who are age 40 or older. Medicare will also pay for one baseline mammogram for female beneficiaries between the ages of 35 and 39. There is no deductible requirement for this benefit. Information about coverage of mammograms is available on the Medicare website or through the Medicare Hotline at 1–800– MEDICARE (1–800–633–4227). For the hearing impaired, the telephone number is 1–877–486–2048. Women who need a diagnostic mammogram should check with their health insurance provider about coverage. How can uninsured or low-income women obtain a free or low-cost screening mammogram?
Some state and local health programs and employers provide mammograms free or at low cost. For example, the Centers for Disease Control and Prevention (CDC) coordinates the National Breast and Cervical Cancer Early Detection Program. This program provides screening services, including clinical breast exams and mammograms, to low-income, uninsured women throughout the United States and in several U.S. territories. Contact information for local programs is available on the CDC website or by calling 1–800–CDC–INFO (1–800– 232–4636).
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- Fall '19