The Susan G. Komen for the Cure® Advocacy Alliance takes a stand on issues of importance to cancer survivors, advocates, and others involved in the movement. Primarily, our positions relate to breast cancer research, early detection, and access to high-quality care. From time to time, we may also comment on other health-related topics and sign onto letters published by other organizations, which we feel may have an impact on the breast cancer community.

National Breast and Cervical Cancer Early Detection Program

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast cancer screening, outreach and case management services for low income, uninsured and underinsured women who do not qualify for Medicaid. The program is a joint partnership between the Centers for Disease Control and Prevention (CDC) and state health departments and operates in all 50 states. Since 1991, NBCCEDP has served more than 3.9 million women, provided more than 9.8 million breast and cervical cancer screenings, and diagnosed more than 52,000 cases of breast cancer.

In program year 2010, NBCCEDP provided screenings to over 325,000 women nationwide and diagnosed 5,500 cases of cancer, many in early stages when treatment is the most effective. Without the assistance of NBCCEDP, many women would delay or completely forego recommended screenings, leading to later stage diagnosis, larger tumors, and fewer, more costly treatment options.

Early detection is a key to survival. When breast cancer is detected early, before it spreads beyond the breast, the 5-year survival rate is 98 percent. Once the cancer spreads to other parts of the body, survival rates plummet to just 23 percent. If access for underserved women is reduced, women who have cancer will eventually have to be treated for late-stage cancers that are deadlier and much more expensive to treat — putting an even greater strain on the health system and on state budgets. Breast cancer can be five times more expensive to treat when it has spread to other parts of the body.

The Komen Advocacy Alliance works with Komen’s 122 Affiliates across the country to ensure that funding for the program is maintained and preserved at the state and federal level.

Affordable Care Act

Throughout the health care reform implementation process, the Komen Advocacy Alliance will continue to focus on patient protections -- the aspects of the health care system that directly affect women with breast cancer or women who may develop breast cancer.
The Komen Advocacy Alliance seeks to ensure that:

1. All women have access to breast health care services that may save her life
2. Breast cancer survivors have access to affordable health insurance
3. Women are empowered with information, so they know what to look for, when to see a doctor, and what to ask them

The Komen Advocacy Alliance is committed to advancing our mission by:

1. Making sure that throughout every step of any future transition to new coverage options, such as the Health Insurance Exchanges and the Expansion of Medicaid, breast cancer patients have access to coverage as favorable as the current programs available to them.
2. Reducing barriers to utilization by advocating for an essential health benefits package that provides coverage for the entire continuum of evidence based breast health, cancer, and survivorship care recommended by the patient’s health care providers.
3. Ensuring that preventive services required to be covered by the ACA include mammograms and all other evidence-based screening, counseling and early detection services needed for early diagnosis and treatment.
4. Reducing health care disparities and promoting education and outreach that will ensure that breast cancer patients understand and can experience any benefits of health care reform that apply to them.
   
    

Breast Cancer Research Stamp

The Breast Cancer Research Stamp (BCRS) is a special “semi-postal” stamp issues by the U.S. Postal Service that allows breast cancer advocates to demonstrate their support for the fight against breast cancer and to personally invest in the search for a cure. The stamp is a public/private partnership that generates private dollars to further the impact of the public dollars.

Since 1998, when the stamp was first issues, the U.S. Postal Service has sold more the 903 million breast cancer stamps and has raised $72 million for breast cancer research. The stamp costs 55 cents and is deemed valid as a 44-cent first-class stamp – the additional 11 cents from each stamp sold is invested in breast cancer research. 70 percent of the research funds generated by the stamp are directed to breast cancer research at the National Institutes of Health – the remaining 30 percent is directed to the Department of Defense’s Congressionally Directed Medical Research Program (CDMRP) for breast cancer.

Since 1998, legislation to reauthorize the stamp has been passed five times; late in 2007, the stamp was reauthorized through the end of 2011. Congressional reauthorization is needed by December 31, 2011 to ensure the continued availability of this popular stamp.

The Komen Advocacy Alliance is calling on all Members of Congress to cosponsor and pass the Breast Cancer Research Stamp Reauthorization Act (S. 348/H.R. 466) to ensure that this important source of revenue for breast cancer research is still available.

Oral Chemotherapy Parity

Oral chemotherapy is the use of oral anti-cancer medications that kill or disable cancer cells. Chemotherapy is traditionally administered intravenously in a hospital or physician’s office. However, oral chemotherapy is quickly emerging as an attractive option for patients needing more flexibility with their treatment options. Unfortunately, health insurance practices lag behind the state of the science. Intravenous therapies are traditionally covered under a medical benefit, under which most patients are simply required to cover an office co-payment and are not required to pay a separate fee for the intravenous drug. By contrast, oral chemotherapy is generally covered under a prescription drug benefit, in which patients are required to pay for the cost of the drug out-of-pocket, which is typically at a much higher rate than generic medications. Some patients are faced with out-of-pocket costs of hundreds or even thousands of dollars a month.

The Komen Advocacy Alliance believes health decisions should be made between a patient and their doctor. Treatment decisions should not be constrained by financial factors. People who are fighting cancer should be protected from high out-of-pocket medical costs that could lead to financial hardship and even bankruptcy.

The Komen Advocacy Alliance supports efforts at the state and federal level to require group and individual health insurance coverage and group health plans to provide coverage for oral chemotherapy drugs on terms no less favorable than the coverage provided for intravenously-administered chemotherapy. At the same time, we must ensure that in adopting oral chemotherapy parity, health insurers are not allowed to reduce the coverage of intravenous therapies.

Breast Density

Breast density is a way to describe the composition of a woman’s breast. This measure compares the area of breast and connective tissue seen on a mammogram to the area of breast fat. Breast and connective tissue are denser than fat and this difference shows up on a mammogram.

• High breast density means there is a greater amount of breast and connective tissue compared to fat
• Low breast density means there is a greater amount of fat compared to breast and connective tissue

On a mammogram, fat in the breast looks dark and the denser breast and connective tissues look light gray or white. Because cancer can also appear white on a mammogram, it is harder to interpret mammograms in women with dense breasts.

High breast density, as seen on a mammogram, is linked to an increased risk of breast cancer. At this time, we don’t understand why breast density is related to breast cancer. Researchers are looking into many possible mechanisms in the body that might explain this relationship.

Many factors related to breast density are also related to breast cancer. Learning more about these factors may help explain how breast density increases breast cancer risk. It may also provide clues for ways to lower breast cancer risk in women with dense breasts.

There are no special breast cancer screening tests recommended for women with dense breasts. However, if you have dense breasts, talk to your health care provider about which breast cancer screening tests are right for you.