Shannen Doherty’s Cancer May’ve Been Missed Due to Lapse in Insurance

Breast cancer is the second most common cancer among women in the United States, according to the Centers for Disease Control and Prevention.

In 2021, around 272,000 women in the United States are diagnosed with breast cancer, and around 42,000 women die from breast cancer, the CDC reports.

Detecting breast cancer at an early stage, when it is easier to treat, can improve the chances of long-term survival.

“A screening mammogram is probably the best tool we have at improving survival for breast cancer,” said Dr. Christopher McGreevy, MD, a breast cancer surgeon at Hackensack University Medical Center.

“It’s been shown in numerous studies that screening mammograms increase the chance of a woman surviving breast cancer,” he told Healthline.

The 5-year survival rate for stage 1 breast cancer — cancer that has not spread beyond the initial site — is over 99%, according to the National Cancer Institute. The survival rate drops to 32% once the cancer has spread to distant parts of the body.

People whose breast cancer is detected earlier “may also potentially avoid additional treatments such as chemotherapy, and they generally have more options for surgery,” said McGreevy.

Dr. Monica M. Yepes, MD, associate director of breast imaging at the Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, said most guidelines recommend that females with average breast cancer risk get a screening mammogram every year starting at age 40.

One exception is the U.S. Preventive Services Task Force (USPSTF), which recommends screening mammograms every other year starting at age 40.

However, “we know that two years is too long, especially in the 40 to 50-year age group, because the younger patients are the ones that have the more aggressive cancers,” Yepes told Healthline.

When should people who are at an increased risk of breast cancer start screening? It depends on their specific situation.

“If their risk is based off of a genetic mutation, then we would definitely start screening earlier,” said McGreevy, “and their screening would involve a little bit more, such as including additional things such as MRIs.”

“For women whose increased risk is solely based off of family history, when they should start their screening depends upon the age at which their family members were diagnosed with breast cancer,” he said.

Yepes said many patients don’t know they have a higher risk of breast cancer until they start screening mammograms at age 40.

That’s why “the American College of Radiology recommends that every woman should identify their risk factors and their lifetime risk of developing breast cancer as early as age 25,” she said. “So if they do need to start early screening, they’re prepared for it.”

Risk assessments can be done with a primary care doctor, an OB-GYN, or through a referral to a specialist.

Doctors use risk assessment tools to determine a person’s breast cancer risk based on their personal medical and reproductive history, as well as their family history of breast cancer.

In addition, “genetic testing allows us to identify mutations in genes,” said Tran Ho, DO, a breast surgical oncologist at El Camino Health in the San Francisco Bay Area. “Most commonly, you may hear about BRCA1 and BRCA2, genes which can have mutations linked to an increased risk of breast cancer.”

While many physicians will discuss breast cancer risk with patients in their 20s, Ho encourages women to be proactive about their health.

“If patients find that their physician isn’t bringing it up, they should feel empowered to mention it to their doctor,” she told Healthline. “This might even mean asking their doctor to refer them to someone who would be able to review their history and calculate their breast cancer risk.”

Yepes said certain groups have a higher risk of having breast cancer and of having very aggressive breast cancers.

For example, “there is a subtype of breast cancer called a triple-negative breast cancer that is very common in African American women,” she said.

Yepes also pointed out that minority females dying of breast cancer have a 127% higher risk of dying before the age of 50 compared to their white counterparts.

In addition, people without health insurance and certain racial and ethnic groups are much less likely to be up to date with recommended screenings, according to the 2024 AACR Cancer Disparities Progress Report released in May.

In 2021, 53% of American Indian and Alaska Native women and 67% of Asian women were up to date with breast cancer screening, compared to 76% of non-Hispanic white women, the report showed.

The report also found that women under age 65 without health insurance were half as likely to be up to date with breast cancer screening compared to women under age 65 who had private insurance.

Yepes said these disparities are due to a number of factors, including a higher genetic risk of having cancer or a more aggressive cancer, socioeconomic factors and a lack of knowledge about the importance of breast cancer screening.

Lack of access to the healthcare system can also prevent women from being up to date with screenings. This includes living in areas without adequate healthcare, not having insurance or being underinsured, lack of transportation, being unable to take time off from work, and other barriers.

Since 2010, the Affordable Care Act has required most private health insurance plans to cover the cost of women’s preventive healthcare, including mammograms.

If you don’t have insurance or your insurance doesn’t cover breast cancer screening, the National Breast and Cervical Cancer Early Detection Program provides access to breast cancer screening for low-income, uninsured, and underinsured women ages 40-64.

Actor Shannen Doherty died July 13 at age 53. Her cause of death was breast cancer.

The “Charmed” and “Beverly Hills, 90210” star was first diagnosed with breast cancer in 2015. Two years later, she announced her cancer was in remission, but it returned later as stage 4 cancer.

In a lawsuit against her former business management firm, Doherty said a lapse in her health insurance delayed doctors diagnosing her breast cancer. She accused the firm of failing to pay her medical insurance premiums.

A screening mammogram can detect breast cancer at an earlier stage when it is easier to treat.

In the United States, women with an average breast cancer risk have the option of starting screening mammography at age 40.