As reported by the Boston Globe, January 9, 2005.

Advocates Say Rell Diagnosis May Help Breast Cancer Legislation

By Noreen Gillespie

HARTFORD, Conn. -- Gov. M. Jodi Rell's public battle with breast cancer will likely reverberate throughout the 2005 General Assembly.

Two breast cancer bills were introduced in the first week of the session. And advocates say the public attention to Rell's diagnosis is creating a climate to talk about everything from more money for breast cancer research, expanding insurance coverage for screening and expanding treatment available for low-income women.

"Her strength in talking about her own private disease has brought this issue to the forefront," said Susan Davis, president of the Connecticut Breast Cancer Coalition and Foundation.

Rell couldn't hide her emotion during her first State of the State address on Wednesday. She thanked the state for the support she received as she struggled through her diagnosis and surgery.

Many lawmakers wore tiny pink ribbons and some were near tears during Rell's speech, which was just nine days after her mastectomy and reconstructive surgery. Many legislators said Rell inspired them.

Both breast cancer bills filed last week seek to expand the type of screenings insurance companies are required to cover. Under one proposal, insurers would be required to offer women with fatty breast tissue the opportunity to get either a mammogram or ultrasound, which research indicates can be a more effective test for the disease in some women.

Under another bill, women with a genetic risk for developing breast cancer would be able to opt for either a mammogram or magnetic resonance imaging, or MRI, to detect cancer. Some research has shown that an MRI is more effective in detecting cancer in young women who are at high risk for developing breast cancer.

Sen. Joseph Crisco, D-Woodbridge, said he was considering the bills before the governor's diagnosis. Though mammograms are required to be covered, he said constituents told him there are inconsistencies about when insurance companies cover MRIs or ultrasound tests, and they often require prior approval.

"I'm hoping to clarify the issue so there's no inconsistency," said Crisco, who heads the Insurance and Real Estate Committee.

Both bills are in their early stages and will likely be revised. The Insurance and Real Estate Committee plans to discuss breast cancer when it meets next week, so more bills could surface.

Dr. Kristen Zarfos, medical director of the UConn Medical Center's specialty health program for women, said lawmakers should work closely with breast cancer specialists as they consider the bills.

Both MRIs and ultrasounds are options that physicians use to individualize care for patients, Zarfos said, but only in some cases. Mammograms are still often the best option, she said.

"Any legislation should be able to have physicians give individual, personal care to patients," she said.

Advocates are also hoping for help for treatment programs. Many would like to see funding increased for a program that helps low-income women get screened and treated for breast and cervical cancer.

"It's one thing to be screened, but what do you do with the women who were screened and need treatment?" Davis said.

A longtime advocate of early detection, Rell followed her own advice and got a routine mammogram. It was after a biopsy that a doctor discovered the cancer, which was in the earliest stage. Following her mastectomy and breast reconstruction surgery, some state hospitals began reporting a surge in women calling for mammograms.

Lawmakers considering the bills may be responsive because of the interest women have taken in the disease since Rell's diagnosis, said Mary Ann Henry, executive director of the Breast Cancer Alliance in Greenwich.

"They're not just reading about it and admiring her. They're doing something about it," Henry said. "When legislators see people acting on their own behalf, that certainly translates into what they feel is important, and people vote on what they feel is important."

Pauline Keezer, former secretary of the state and now the president of the Susan G. Komen Breast Cancer Foundation of Connecticut, was at Rell's speech last week handing out pink ribbons. Not only did the ribbons disappear quickly, but people began telling stories about their struggle with the disease, or the struggle of their loved ones.

"I think these bills will have a little bit of an edge, because it's something people are talking about," said Keezer.

Connecticut has already passed legislation in recent years related to breast cancer, much of which was boosted by Rell's advocacy efforts. The state created a checkoff system on the state income tax return to raise money for research and prevention efforts, and created a license plate to raise money for the cause.

Legislation to end "drive-thru mastectomies" required insurers to cover a 48-hour stay in the hospital after the surgery was also successful. Last year, legislation to cover wigs for patients undergoing chemotherapy was approved.

House Speaker James Amann, D-Milford, said he has often emphasized that by giving people proper testing, more money can be saved in the long run because people will be healthier.

A cancer survivor himself, he predicted lawmakers' reaction to Rell this week signals that breast cancer will be an issue.

"We believe it's a highlighted issue and should be through the whole General Assembly," he said.

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