Closing the Gap in Breast Cancer Care: The Fight for the ABCD Act. Isabela Butler, Gonzaga University.
The event centered on the Access to Breast Cancer Diagnosis (ABCD) Act, a bipartisan bill designed to make diagnostic imaging more affordable and accessible for all women. By addressing financial barriers and insurance gaps, the act aims to ensure that no one delays or skips critical follow-up testing simply because of cost.
Black women face the highest breast cancer mortality rates of any racial group in the U.S. They are 40% more likely to die from the disease and often receive diagnoses at younger ages and later stages. Similarly, Hispanic women and those with annual incomes below $35,000 are more likely to miss follow-up screenings because of cost barriers.
The ABCD Act would close these gaps by mandating insurance coverage not only for screening mammograms but also for follow-up diagnostic imaging such as MRIs, ultrasounds, or biopsies.
Van Duyne provided a candid look at why passing even bipartisan legislation can be so challenging. Each congressional session sees roughly 10,000 bills introduced, and only a fraction make it onto the legislative calendar. With Congress in session just two full days per week, securing attention from committee chairs and leadership is an uphill climb.“The system is set up to move slowly,” Van Duyne explained. “That’s why advocacy groups do so much of the heavy lifting.”
Despite these hurdles, Dingell remains cautiously optimistic about progress. She highlighted that breast cancer is a growing cause of concern for Black men and reaffirmed her commitment through efforts like the Prevent Cancer Caucus. However, both congresswomen acknowledged that momentum may be slowed by the ongoing government shutdown and competing legislative priorities.
Van Duyne also called for harnessing technology to bridge healthcare gaps, especially in rural areas where access to imaging centers is limited. She proposed expanding telehealth coverage and the importance of technology fairs to use the newest technology to help constituents.
“Healthcare insurance is not the same as healthcare,” she reminded attendees. Her message underscored a larger point: improving access requires not just expanding coverage but ensuring that coverage translates into meaningful, timely care. She also advocated for giving doctors more authority in hospital decision-making to ensure that patient needs remain central.
Katie Mazuk, Chief Patient Experience Officer at Novartis US, offered an industry perspective, noting that while there’s tremendous innovation in breast cancer treatment, early detection remains uneven. “There’s a lot of progress,” she said, “but only one in two women eligible for a mammogram actually receive one.”
Mazuk discussed the Breast Health Index, which helps track and improve diagnostic outcomes. Still, she emphasized that technology and innovation only matter if they reach the patients who need them most.
A panel featuring Ricki Fairley, Molly Guthrie, JoAnn Pushkin, and Dr. Christine Edmonds drove home the human and systemic factors behind these statistics and the urgent need for change.
Ricki Fairley, Co-Founder and CEO of TOUCH: The Black Breast Cancer Alliance, began with a striking reality: Black women are three times more likely to be diagnosed with triple-negative breast cancer (TNBC), which is an aggressive subtype of cancer with limited treatment options and no existing drug to prevent recurrence.
She added that half of Black women with breast cancer are diagnosed with de novo (advanced) disease, meaning their cancer has already spread by the time it’s detected. Fairley called for earlier and more frequent diagnostic screening, as well as targeted outreach to ensure that Black women receive equitable, timely care.
JoAnn Pushkin, Executive Director of DenseBreast-info Inc., addressed one of the lesser-known barriers to detection: breast density. About 60% of Black women have dense breast tissue, which can make mammograms less effective at detecting tumors. Pushkin helped push for the FDA requirement that women be informed about their breast density, a milestone that empowers patients to pursue additional imaging when necessary.
Dr. Christine Edmonds, Associate Professor of Radiology at the University of Pennsylvania Health System, provided a scientific perspective on imaging accuracy. MRIs are more sensitive than mammograms or ultrasounds, she explained, but they are also more costly and less widely available. Ultrasounds can catch additional cancers but produce more false positives, which can cause anxiety and additional costs. Edmonds emphasized the need for personalized screening, where women’s risk factors such as age, density, and family history, can guide which imaging methods are used.
Molly Guthrie, VP of Policy & Advocacy at Susan G. Komen, connected these medical insights to advocacy efforts. She noted that only about 30 states currently provide coverage for follow-up imaging after an abnormal mammogram. The ABCD Act, she explained, would ensure nationwide coverage consistency and reduce out-of-pocket costs. Her team is focused on ensuring that federal health plans also include these protections. “Where you live shouldn’t determine whether you can afford a test that could save your life,” Guthrie said.
Together, the panelists and lawmakers painted a picture of what equitable breast cancer care could look like: accessible imaging, early detection, community engagement, and strong policy support. But they also made it clear that progress will take persistence from advocates, doctors, and patients alike.
The ABCD Act has now been introduced five times, but with continued advocacy and growing awareness, the push for early detection and equity in care is only gaining strength.