If Not Essential, Does It Matter?

This article originally appeared as a post on LinkedIn.

In today’s world, the word "essential" has become more common than ever. You hear about essential workers and essential businesses every day. The word ‘essential’ instantly sparks an understanding of the importance and need for these things, even when the world is uncertain.

When you’re buying a car, you’re offered many supplemental features like a sunroof or heated seats, but it’s the essential features like the power steering and seat belts you expect to be in each option because they help keep you safe.

It was the word "essential" that caught my eye in a recent opinion article, Language matters when screening women with dense breastsfrom Andrea Wolf, CEO of the Brem Foundation.

In the article, Andrea discusses how we often refer to additional screenings for women with dense breasts as "supplemental screenings." But for the over 40 percent of women in the U.S. with dense breasts, these screenings drastically improve their chances of catching cancer earlier, and in turn, save lives.[1]

In fact, mammograms miss over one-third of cancers in dense breast tissue.[2] But, when women with dense tissue are screened with a mammogram plus another technology, such as ultrasound, detection rates go up by over 25 percent.[3] Thus, these screenings are not supplemental at all.

As Andrea puts it: Changing language will make a big difference. And it will lead to other changes. And it is free. And you can start today.

To dive into this deeper, I had the chance to speak with Andrea herself on the topic. Here’s what she had to say:

Why do you think these lifesaving exams for women with dense breasts deemed supplemental in the first place?

Mammography was the first technology shown to result in definitive mortality reduction from breast cancer and is considered the accepted standard of care for breast screening. However, untold numbers of women have died from delayed detection and research is growing to support breast screenings beyond mammograms. Unfortunately, we speak about these effective secondary exams as “supplemental” not “essential.” What we need now is a large-scale cultural change around how we describe screenings. The term “supplemental” makes people think these tests are extra or nice to have rather than the fact they are filling the shortcomings of our standard of care today.

What are some reasons that women are not getting essential breast screenings they need to find cancers earlier?

It’s simple, really. There are two reasons: 1. lack of education and 2. cost. Education comes first. If women (and physicians) do not realize that these tests are absolutely needed, they won’t ask for them. We need to launch a campaign to educate physicians, medical professionals, and patients on this critical issue. The second barrier of cost related to co-pays and deductibles inhibit women from taking advantage of these lifesaving, essential test.

What could be the potential impact if we shift in this direction?

When people start to talk about these exams as essential it will save lives. More laws will be enacted to make these tests affordable. More people will have access to essential exams and women will have more years with loved ones.  Moreover, covering these essential tests will save the whole healthcare system a lot of money. In fact, early stage breast cancers cost 154% less to treat than later breast cancers.

How can I help?

You can start helping today by changing your vernacular to lifesaving, essential breast screening when discussing screenings for women with dense breasts. Spread the word by encouraging women you know to get properly screened based on their risk factors. Finally, make a difference. Visit and urge your legislators to remove access barriers to women receiving essential breast screening by amending or sponsoring legislation that mandates density inform laws and full coverage.

To learn more about these efforts and how you can also be an advocate for these essential screenings, click here.

[1] Accessed on 10/6/2020:

[2] Mandelson et al. J Natl Cancer Inst 2000; 92:1081–1087.

[3] Tagliafico, Massimo Calabrese et al, Journal of Clinical Oncology 2016 34:16, 1882-1888.