BOISE, Idaho — In August, Boise Rep. Brooke Green announced she would be stepping back from public life after a diagnosis of invasive breast cancer.
“It was crushing. It was a crushing blow because, you know, not only am I now a cancer patient with breast cancer, I've also lost the opportunity to carry a baby through through IVF. And so it's like, which one's worse, right? Getting cancer and not being able to continue to grow my family and have to rely on surrogacy,” Green said.
Green was hoping to use IVF to expand her family, but her attention was quickly forced in a new direction.
“I had a clear scan last year. I didn't have cancer on my scans last year. My cancer appeared within nine months,” Green said.
Green was able to quickly get into Lyra Total Breast Health in Meridian for more scans and care. A doctor there pointed out something pretty interesting.
“She goes. Let me show you something. And she shows me my imaging and she goes, here's your cancer on 2D imaging and here's your cancer in 3D. Just I can't see it with 2D imaging,” Green said.
She was able to work with Dr. Barbara White, a radiologist and co-founder of Lyra Total Breast Health
“On the 2D. You cannot see her cancer. There is no doubt. I cannot see it, even in retrospect. Going back to the images,” White said.
Through her work, Dr. White has found a major gap in breast cancer care in Idaho.
“A lot of women in Idaho are just given the option of having a 2D, and then if they want to have the 3D, then they have to sign paper that said they're going to, potentially pay more if their insurance doesn't cover it. And what happens is a lot of women opt out of doing that and only get the 2D image. And so with that, they, they often don't have breast cancers diagnosed in a timely manner,” White said.
It varies from carrier to carrier, but people like Dr. White found insurance just doesn’t cover beyond a 2D scan.
“So what we're trying to do is get all coverage for all imaging for breast health in Idaho,” White said.
There are tools like contrast scans that can yield quick and crucial results. Especially in patients with dense breast tissue.
“What happens when you have dense breast tissue is the cancer is white, but so is the normal tissue is white. And so it's really hard. It's really difficult to determine. Is there something going on. And when I do the 3D and I can scan through it on this and the one millimeter slices, I can actually see this breast cancer here. But again it's pretty subtle,” White said. “There's no doubt in my mind that there is an enhancing mass there.”
Green quickly found something she needed to learn more about.
“Through this process, I found out oftentimes insurers don't cover it if it's in diagnostic. And I'm like, wait, you mean to tell me when somebody actually finds a lump and they go in to get additional, you know, imaging it's not covered,” Green said.
That coverage could very literally be the difference between life and death, Dr. Rhiana Menen, the medical director of Mountain State Breast and General Surgery, agrees.
“Representative Green story is so impactful because we can see it right in front of us. So had she not had the best available initial screening, she would have had a diagnosis of cancer mid to late pregnancy and that might have cost her life,” Menen said.
She, too, is advocating for expanded insurance coverage in Idaho.
“Covered access to all the best technologies that are available throughout the country. So what we want is contrast enhanced mammography, MRI, 3D mammograms. We want all of these approaches that are just standard to be covered by insurance,” Menen said.
As Brooke Green dove into the topic, it became apparent that Idaho women were faced with a cost barrier to coverage. Coverage that is life altering.
“So are we going to choose between better imaging and enhanced prognosis? No. Better prognosis? Or are we going to choose food? And so, you know, the conversations I've started with insurance companies. This is you know, what does the coverage look like for your insurer. And how can we expand that in preparation for you know, the legislate session, which is right around the corner,” Green said.
Green is using her experience to try and push for change.
“It would ensure that 3D imaging is covered and ensures the other diagnostic tools are also covered, and not just for preventative insurance. Like we're doing this right, we're doing it for preventative. And then I ask, well, what about diagnostic? And they're like, oh, let me get back to you. Well, the reality is is diagnostic needs some things. They are,” Green said.
For now though, Green and her family are focused on her health. A bittersweet reality that includes reflection on what could have been but in the context of a crucial catch.
“Cancer sucks. It's like slaps you in the face. One day in 24 hours, your life changes. In our case, it was our family. You know, that was probably the hardest hit. Once I realized I was gonna be okay. We realized, like, oh, how big of a deal this is going to be. So it's hard, but it's also therapeutic. You know, if we can work to make good, positive teams and then helping somebody else,” Green said.
Rep. Green said she will miss an early portion of the Idaho Legislative session for continued care and surgery. She hopes to return during the session to push for change. In the meantime, she continues to talk with insurance companies about what is on the table in Idaho.
Green and her medical team have a direct message to all Idaho women: get checked, get scanned, get invested into your health.