by Chris Bavender
It’s estimated there will be 246,660 new cases of breast cancer in 2016, according to the National Cancer Institute. An estimated 40,290 people will die of the disease. That’s why organizations such as Planned Parenthood stress the importance of breast cancer screenings.
During Breast Cancer Awareness Month in October, the emphasis is on getting word out that every woman should start scheduling breast cancer screenings at age 21.
“The screening is a physical breast exam done by a nurse practitioner or physician,” said Judi Morrison, vice president of marketing and education for Planned Parenthood of Indiana and Kentucky (PPINK). “Breast exams are encouraged every one to three years as part of an annual well woman visit for average risk patients between the ages of 21 and 39. Women age 40 and over should have an annual screening mammogram in addition to a clinical breast exam. We do not provide mammography but provide referrals for this service.”
PPINK operates the Midtown Health Center at 3750 N. Meridian St., and has offered breast cancer screenings since the American Congress of Obstetricians and Gynecologists identified them as an “appropriate component of routine reproductive health care.”
The breast cancer screening process is simple. “When the patient checks in she is asked to complete minimal paperwork to be entered into our electronic health record system. A health center assistant will take her to an exam room to complete a medical history and document any concerns she may have about breast health and provide education about breast self-exams,” Morrison said. “The nurse practitioner will then see the patient to complete the exam, educate and encourage breast self-awareness, and document the findings of the visit.”
Patients are advised to allow about 45 minutes for an appointment, including time spent with the health care provider. The result of the physical exam is reviewed with the patient at the time of the exam. If an issue is detected, the patient is given a written referral to a breast specialist for follow-up care. That could be a “diagnostic mammogram, an ultrasound, or other care based on the problem that was identified,” Morrison said. “In addition, any concerns about cost would be taken into consideration and the patient would be referred to programs that provide services to uninsured or underinsured patients.” A visit for a breast cancer screening at Planned Parenthood is typically $50 for those paying out of pocket, according to Morrison.
According to the World Health Organization, early detection of breast cancer “greatly increases the chance for successful treatment.” But once treatment is started, it can often be difficult to find the energy for even the smallest task—and sometimes it’s difficult to find the money to help offset everyday living expenses. That’s where the Indiana Women In Need Foundation (I.W.I.N.) can help. The statewide organization with headquarters in Broad Ripple helps fit the “critical gap in the breast cancer support system.”
“We are the middle person and try to keep women in treatments and take some of that everyday stuff off them,” said Nancy Shepard, I.W.I.N. founder and executive director, and a registered nurse. “Whether they just had surgery or are fatigued from treatment or tight on money for meds, we try to help with the journey so they can concentrate on staying in the fight.”
I.W.I.N. does that by providing personal grants: $250 for those undergoing short-term treatment, and $500 for those on a longer treatment plan. “Maybe the recipient really needs the lawn mowed every three weeks,” Shepard said. “We collaborate on that and then pay after the services are done.”
The 501(c)(3) organization was founded in 2000 when one of Shepard’s friends—a nurse who was 36 and had two small children—went through surgery for breast cancer.
“I saw the emotional toll but also the physical toll it took on her. At that time there wasn’t any organization that provided comprehensive services,” Shepard said. “Initially I was going to raise money for a cure, but then I learned from a survivor that there is all this money that goes to focusing on the cure but women are having a really difficult time getting through the journey.”
Shepard’s research found there was nothing else like I.W.I.N. in Indiana so she decided to make it a statewide organization. “The main focus is to keep women in treatment so they get on that road to survivorship,” she said. “They can get overwhelmed and say they can’t afford treatment—maybe can’t afford the gas to go for treatment if they live in a rural area. And if you can’t get to treatment, you can’t get to a cure. So we want to lessen the issues of life—lessen the physical, mental and financial issues they face and give women strength to endure treatment.”
An online application is available for a grant, but Shepard said the majority of applicants come to I.W.I.N. from collaboration with partners such as nurse navigators and social workers. “Sometimes it’s as simple as someone being in chemo and sitting next to someone and talking to them and telling them they should call I.W.I.N.,” she said.
More than 500 women are served a year. There are currently five men in the program as well. “We are getting requests for 40 to 50 grants a month. Word has gotten out without us really marketing this,” Shepard said. “We are on a big mission to reach out to people and corporations to become impact partners for us.”
I.W.I.N. also gets money through corporate and individual support, and from grants. Money for the grants comes from a variety of sources. A complete list of October fund-raising events are posted at the group’s website. The annual signature fundraiser, however, is the Pink Pajama Party in February. Next year’s event is set for Feb. 17. “More than 300 women from around the state come and spend the night, and we have dinner and dancing and spa services all night and breakfast in morning,” Shepard said. “They learn what we do and how they can help.”
- Coverage of mammograms for breast cancer screening is mandated by the Affordable Care Act, which provides that these be given without a co-pay or deductible in plans that started after August 1, 2012. “Grandfathered” plans—those that existed before the Affordable Care Act was passed—are exempt from this requirement.
- As a part of the Affordable Care Act, the full cost of a screening mammogram is covered once every 12 months for all women with Medicare aged 40 and over. Diagnostic mammograms are covered with a 20% copay after the part B deductible is met. Medicare also pays for a clinical breast exam when it is done for screening or prevention.
- Indiana requires private insurers to cover annual mammograms for women age 40 and older.
- Indiana covers screening mammograms for Medicaid recipients. Women in medically underserved communities may also be eligible for treatment coverage through Medicaid.
Sources: National Women’s Law Center (hrc.nwlc.org) and American Cancer Society (cancer.org)