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Policy History & Impact

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 breast 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:


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.

For more information on the EARLY Act and Tigerlily’s work, please click HERE.

To read the EARLY Act text, click HERE.


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.