Policy History & Impact

In 2009, the United States Preventative Services Task Force (USPSTF) updated its guidelines to recommend against routine screening mammography for women between ages 40 to 49 and to recommend biennial (every other year), instead of annual (every year), screening mammography for most women between ages 50 to 74. Previously, from 2002–2009, USPSTF guidelines recommended routine screening mammography at least every two years for women aged 40–49 and annual mammography for women 50 years and older.

This change in guidelines was and continues to be very controversial and Tigerlily is especially concerned about the barriers to accessing screening (and thus diagnostic and treatment services) for young women already facing additional barriers and potentially contributing to furthering disparities for patients of color as well as potentially delaying treatment contributing to later-stage diagnoses/progression to metastatic breast cancer. Committed to our mission to educate, advocate for, empower and support young women before, during and after cancer and further our vision to end disparities of age, stage and color, Tigerlily turned to public policy to protect patients. Here is a snapshot of the history of our policy work and the impact of our advocacy:

EARLY Act

In 2009, Tigerlily worked with Congresswoman Debbie Wasserman Schultz to develop the Breast Cancer Education and Awareness Requires Learning Young (EARLY) Act. The EARLY Act provides: (1) campaigns to educate the public and health care professionals about young women’s breast health, (2) research into prevention of breast cancer in young women, and (3) support for young women with breast cancer.

The EARLY Act was reauthorized in 2020 which continued the education campaigns, research and support at an increased funding level of $9 million annually from 2022 through 2026.

The EARLY Act has driven national progress in breast cancer awareness and prevention. Its three core programs include:

The Bring Your Brave campaign, which uses real stories to increase awareness among women aged 18–44 about breast cancer risk factors, symptoms, and early detection.
The Young Breast Cancer Survivors Program, which supports nonprofit organizations providing services to young patients and survivors.
Continuing medical education (CME) for health care providers to improve early detection and care for young women at increased risk.

In July of 2025, Tigerlily was proud to once again support the Education and Awareness Requires Learning Young (EARLY) Act with its reauthorization! The EARLY Act is a critical lifeline for young and high-risk women and their providers. When we first championed this legislation in 2009, we knew it would save lives—and it has. The EARLY Act’s education campaigns, provider training, and grant programs have empowered women with knowledge and tools to advocate for their breast health, while equipping clinicians to better serve them. But our work isn’t done. With disparities persisting—especially for young, Black and other underserved women—we must ensure this vital legislation continues to bridge gaps in awareness, access, and care.

To read the EARLY Act text, click HERE.

To read the EARLY Act re-authorization, click here for the House bill and here for the Senate bill.

PALS Act

In 2014, Tigerlily worked with Congresswoman Debbie Wasserman-Schultz and Susan Brooks to collaborate on the Protecting Access to Lifesaving Screenings (PALS) Act. The PALS Act was designed to ensure that women ages 40-49 continue to have access to annual screening mammography. In 2015, through the appropriations process via the PALS Act, a three-year moratorium was placed on implementing the updated USPSTF breast screening guidelines. The moratorium was subsequently renewed until January 1, 2020 and the Protecting Access to Lifesaving Screenings (PALS) Act of 2021 was introduced in the Senate in July of 2021 to extend the moratorium once again.

The PALS Act requires that any provision of law referring to the current USPSTF breast screening recommendations be administered as if (1) it is referred to USPSTF recommendations issued before 2009 (routine screening mammography at least every two years for women aged 40–49 and annual mammography for women 50 years and older); and (2) those recommendations applied to any screening mammography modality would including any digital modality.

Access to regular, preventative breast screenings for high-risk young women is essential in our effort to eradicate barriers and disparities. And this issue has not dissipated in the years since the USPSTF guidelines update in 2009. In recent years there has been a significant decline in breast cancer screening due to the Coronavirus pandemic. As we try to return to our regular healthcare after the decline since 2020, the PALS Act will assist in removing access and cost barriers for young women needing preventative services.

To read the bill text, click HERE.

Young Women’s Breast Health Day on the Hill

In 2009, Tigerlily Foundation worked with Representative Debbie Wasserman Schultz to develop the Breast Cancer Education and Awareness Requires Learning Young (EARLY) Act. With $9 million per year in proposed funding for five years, the EARLY Act calls for a national education campaign about the risks that young adult women (under 45) face from breast cancer. The bill also provides assistance to young women who have the disease.

Inspired by the EARLY Act, Tigerlily Foundation hosted the first Young Women’s Breast Health Day on the Hill. This event on Capitol Hill brought together researchers, legislators, advocates, breast cancer survivors, physicians, healthcare professionals and more to learn about, advocate for and ask for better resources, support, funding and improved quality of care for young women – before, during and after breast cancer.

With Tigerlily Foundation’s 4th Annual Young Women’s Breast Health Day on the Hill, the event has transitioned into a Lobby Day for young women, if effort to make a bigger impact in the nation’s capitol and beyond.

In 2023, Tigerlily Foundation expanded our mission from breast cancer to include women’s health and oncology. Our legacy event, now known as Tigerlily’s Young Women’s Health Day on the Hill under the Tigerlily HEAL Policy Center of Excellence continues to empower and engage young women in policy advocacy work.