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Maryann Gromisch RN Guide

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ask: Next steps for BRCA1 and BRCA2 genetic testing?

By Shana O'Connor
 
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I have a strong family history of breast cancer and have always worried about my chances. The past 3 generations of women on my Dad's side have had breast cancer and just last week, a close family friend was diagnosed with stage 3 breast cancer. So naturally this has been on my mind a lot recently. 

I am 28 years-old and diligently schedule my yearly well-woman exam to stay proactive, however I want to do more and to truly advocate for my health. I have inquired about getting screened for a mammogram, but fear being exposed to the radiation too young and am uncertain if my insurance would cover it. 

Not all organizations agree on mammogram guidelines, but the recommended age is around 40-50 years old. The U.S. Preventive Services Task Force mammogram guidelines recommend women begin screening at age 50 and repeat the test every two years, while The American Cancer Society and other organizations recommend screening begin at 40 and continue annually. 

How can I learn more about genetic testing for BRCA1 and BRCA2? I have some specific questions:

  1. Is there a age restriction or recommendation? 
  2. Should I contact my insurance company or physician? 
  3. How much does the testing typically cost (both covered and not)?
  4. Where do they perform the tests? 
  5. What is involved in the testing and how long does it take?
  6. When can I expect results? 

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Maryann Gromisch RN Guide

Hello Shana,

It is understandable that you are concerned about your risk for developing breast cancer.

You can learn more about BRCA1 and BRCA2 by visiting the National Cancer Institute at the National Institutes of Health website, www.cancer.gov.

The BRCA1 and BRCA2: Cancer Risk and Genetic Testing is very informative.
http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA

To answer your questions:

Genetic testing is recommended for individuals with a family history that suggests harmful mutation in BRCA1 and BRCA2. It is not recommended for children, even those with a family history that suggests mutation of BRCA1 and BRCA2, "because no risk-reduction strategies exist for children, and children's risks of developing a cancer type associated with a BRCA1 or BRCA2 mutation are extremely low. After children with a family history suggestive of a harmful BRCA1 or BRCA2 mutation become adults, however, they may want to obtain genetic counseling about whether or not to undergoing genetic testing."

Consult your physician to schedule a BRCA1 and BRCA2 genetic test. Check with your insurance provider to see if your policy covers this test.

"The cost for BRCA1 and BRCA2 mutation testing usually ranges from several hundred to several thousand dollars. Insurance policies vary with regard to whether or not the cost is covered. People considering BRCA1 and BRCA2 mutation testing may want to find out about their insurance coverage for genetic tests before having the test.

Some of the genetic testing companies that offer testing for BRCA1 and BRCA2 mutations may offer testing at no charge to patients who lack insurance and meet specific financial and medical criteria."

The BRCA gene test is a blood test. The blood sample is sent to a lab for DNA analysis. It can take several weeks before test results are available.

The first step in the gene testing process is to meet with a genetic counselor.

Have I answered your questions adequately?

Regards,
Maryann

May 29, 2014 - 4:09pm
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