PEWAUKEE — Doctors and patients in Pewaukee are reacting after Gail’s Law was signed earlier this month, expanding insurance coverage for additional breast cancer screenings.
The law, known as Gail’s Law, is named after Wisconsin mother Gail Zemear, who died two years ago after being diagnosed with advanced breast cancer in 2016.
She was diligent about getting her yearly screenings, but she did not know at the time that she was at a higher risk and needed additional screening.
The new law requires insurance companies to cover medically necessary supplemental breast cancer screenings for women with dense breast tissue or other high-risk factors.
Doctors at ProHealth Pewaukee Cancer Center say the change could impact about 14,000 women in the ProHealth network who are eligible for supplemental screening.
A screening that made the difference
For Pewaukee resident Carey Zigler, additional screening made a life-changing difference.
Zigler said she went in for a routine mammogram in 2019 and was later asked to get an ultrasound.
Both tests came back normal, but because of her family history and because she knew she had dense breast tissue, she asked for a screening MRI and paid for it herself.
“With a normal mammogram and a normal ultrasound, it was just caught on the screening MRI, and I was very lucky it was stage zero,” Zigler said.
Years later, in 2025, another screening MRI found breast cancer again, this time at stage one.
“Right now, going through the treatments, I’m stage one, so it really saved me from more advanced chemotherapy. Still very tough, but I’m going to be okay,” she said.
Zigler said the additional screening — which she paid for out of pocket — may have made the difference, and hopes the new law will help other women avoid the same financial barriers.
“So many women don’t know these screenings are out there. Yes, they’re expensive, but they can make such a huge difference,” she said.
“Everyone should know their breast tissue.”
Why additional screening matters
Doctors say the issue is especially important for women with dense breast tissue.
Dense breast tissue can both increase the risk of breast cancer and make tumors harder to detect on a traditional mammogram.
“The mammogram can hide or mask cancer behind dense tissue, and just by having dense tissue, it increases your risk of cancer,” said Dr. Jennifer Bergin, a radiologist with ProHealth Care.
Because of that, some women are recommended to get additional screening, such as an MRI or automated breast ultrasound, to detect cancer earlier.
ProHealth Care uses supplemental screening technology, including automated breast ultrasound systems developed by GE HealthCare, which are designed to help detect cancers that may not appear on a mammogram in women with dense breast tissue, according to information provided about the technology.
Until now, those additional screenings often came with significant out-of-pocket costs, sometimes several hundred dollars per exam, which created a barrier for many patients.
“We’ve always been conflicted giving recommendations because we know they create stress and anxiety, because they’re being asked to choose between an expensive extra test or spending that money on family needs,” Bergin said.
She said the new law will help remove that barrier and expand access to screening.
“This will alleviate that and broaden access to women who need it,” Bergin said.
Looking ahead
Supporters say Gail’s Law is ultimately about early detection and saving lives.
For Zigler, the law is personal, and she hopes it will help other women catch cancer earlier.
“That’s why this law is so important because it would have made such a difference for so many women,” she said.
Insurance plans will have until Jan. 1, 2027, to comply with the new coverage requirements under Gail’s Law.
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