It was by chance that Katherine Gorski discovered she had breast cancer.
The Lemont resident was scratching an itch when she felt a bump.
Gorski scheduled a mammogram, but the test showed nothing. A subsequent ultrasound showed the mass, at the time about the size of a pencil eraser.
"It was Oct. 8, 2010," said her husband, Paul Gorski. "Oct. 9 was our 10-year anniversary. You're trying to have dinner and you're trying not to break down. It was a nightmare."
Katherine Gorski, 39 at the time, underwent chemotherapy and radiation. Three years later, she is cancer-free.
Or at least the couple thinks so.
In late October, Cigna sent Gorski a letter denying the doctor's request. The letter, dated Oct. 21, said the MRI is not covered by her insurance policy, citing "MedSolutions Chest Imaging Guidelines."
It said an MRI of the breast would only be approved when dense breasts or extensive scar tissue prohibit a doctor from interpreting a mammogram, "or when a suspicious breast lesion cannot be palpated or biopsied using mammogram."
The letter also said Cigna would approve an MRI for screening "when there is a 20-25 percent or greater risk of developing breast cancer as determined by family history or clinical risk models."
The Gorskis were floored.
Gorski had undergone treatment for a tumor that was not detected by a mammogram in 2010, and although her doctors did not put her risk of recurrence above 20 percent, they did put it close — at 15 percent.
Upset by Cigna's decision not to pay for an MRI, Paul Gorski emailed What's Your Problem?
He said tumors in younger women tend to be more aggressive. Catching them early is crucial, he said.
"As a husband with a wife I adore, with two young children, her health and the health of my children are the greatest importance to me," he said. "If I could take her cancer and transfer it to me and relieve her of this burden, I would do it in a second. And fighting with an insurance company just adds to the already high levels of stress and frustration."
Gorski said that if Cigna does not reverse its decision and agree to pay for the MRI, the couple would schedule one anyway and pay for it out of pocket. If not covered by insurance, it could cost them thousands of dollars, he said.
"My hope, of course, is they would cover it not just for my wife, but for all the others who fit into that situation," Gorski said.
The Problem Solver contacted Gloria Barone Rosanio, a spokeswoman for Cigna, and forwarded Katherine Gorski's information.
On Friday, Cigna reversed course and agreed to pay for the MRI.
"Cigna's clinical team requested more medical information and had what is called a 'peer to peer' consultation with the doctor who is treating the patient," Rosanio said in an email. "With the additional medical information and the conversation between the doctors, the MRI was approved. If it hadn't been approved, the customer would then have had the right to a formal appeal process."
Rosanio said 99 percent of Cigna's customer claims are approved.
Gorski said he learned of Cigna's decision late Friday.
"The clinic called and said a miracle happened," he said. "We had a very, very good weekend."
His wife plans to have the MRI this week.
"Thank God," Paul Gorski said. "If it comes back negative, then we can all take a deep breath."