A better form of mammography ”” seeing in three dimensions ”” is now available, but not to all. As with many new technologies, the insurance industry lags behind the medical community in its enthusiasm for the procedure. Radiologist Gioia Riccio is a proponent and practitioner of 3-D mammography. She answered questions on the topic for the Business Journal.
Is 3-D mammography something all women should know about? Is there a subset of the population that should be more concerned then another subset?
Dr. Riccio: 3-D mammography has proven invaluable for all women. Studies have shown both a decrease in callback rate and increase in cancer detection across the board. Findings are irrespective of breast-tissue density.
You provide 3-D exams at no extra cost to patients whose insurance does not cover the procedure or to those who are uninsured? Is cost the biggest obstacle?
Dr. Riccio: The issue of cost twofold. The major cost obstacle is acquiring the 3-D unit itself as it is an expensive technology, though well worth it. Additionally, as you know, medical procedures are costly and the additional cost may discourage a patient from having the exam, thereby completely defeating the purpose. That is why 3D mammograms need to be covered by insurance. Insurance companies are required to cover annual mammograms for women, without any out-of-pocket costs, beginning at age 40. Given that 3D mammograms are a mammography service, it is critical that insurance companies and Medicare cover the service because all women deserve access to the most accurate and effective mammogram technology.
What is the difference between 2-D and 3-D? Why is it preferable?
Dr. Riccio: 2-D mammography is the current gold standard. It is however, a 2-D picture of a 3-D structure, the breast. 3-D mammography is a more detailed and comprehensive evaluation of the breast tissue made by taking sequential focused pictures for sections of the breast. It eliminates overlapping tissue and highlights abnormalities making it preferable to 2D.
Is extra training required to read the results and are the reading as (or less) accurate?
Dr. Riccio: Yes, there is extra training required to learn to interpret 3D images. It also takes the radiologist longer to read the films, but, I”™m sure any radiologist would agree, it is completely worth it. There is increased accuracy on the part of the radiologist and thereby improved benefit to the patient.
Federal regulations mandate mammography reimbursement, but 3-D mammography isn”™t covered. Buying into the assumption it is a male-dominated world, is gender bias at work? And when might the procedure be covered?
Dr. Riccio: I do not think there is gender bias. There”™s no valid reason not to cover to this procedure. We hope to see reimbursement any day and we are encouraging women to reach out to their insurers and Congress to make it happen as soon as possible.
Gioia Riccio is a radiologist specializing in diagnostic radiology and licensed to practice in Connecticut, Massachusetts, New York, New Hampshire and Rhode Island. She practices diagnostic radiology at Robert D. Russo M.D. & Associates, 425 Post Rd., Fairfield; 2660 Main St., Suite 103, Bridgeport; and 4699 Main St., Suite 108, Bridgeport.
