Questions About the BRCA Genes Answered

7:49 AM, May 31, 2013   |    comments
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Since actress Angelina Jolie revealed she had a double mastectomy to lower her risk of getting breast cancer, many people now have questions about the genetic testing which determined she carries the BRCA1 gene.

BRCA1 and BRCA2 are the names given to the breast cancer susceptibility genes. The mutated genes, linked to the development of certain types of cancers, appear in less than one-percent of the population. But, if you've already had breast cancer, your chance of having one of the mutated genes goes up to five to ten-percent. Your risk also goes up if multiple family members have had breast or ovarian cancer.

So how do you know if you should get the test?

"A lot of that is discussions that you'll have with your doctor, your surgeon, your primary care doctor, your gynecologist. Most people in the medical field are aware of guidelines, so there's really no set criteria of who should have genetic testing," says Dr. Shicha Kumar with the Roswell Park Cancer Institute.

Since Jolie revealed she had a double mastectomy, Dr. Kumar says more people are calling with questions about the genetic testing for the BRCA genes.

BlueCross BlueShield tells us the tests are covered by insurance, but are "prior authorized."

"What that means is when a physician is considering doing that testing, they need to contact the insurance company for authorization, prior to doing the testing and we then have evidence based protocols that we use to make sure the testing is appropriate," says Karen Blount with BCBS of WNY.

The co-pay depends on your plan, and surgery is covered if medically necessary.

"Plans don't make medical decisions for their physicians or their patients," says Blount.

So what happens if you have the BRCA gene?

"It doesn't necessarily mean that you have to do anything different. It's really a heightened awareness of that increased risk. And, that's why it's so important for people to have genetic counseling before they undergo any testing because those questions, what if I test positive, are really important ones to consider even before the test is done," says Dr. Kumar.

Kumar says testing positive means you can consider having both breasts removed as a preventative measure decreasing your risk of developing breast cancer by more than 95-percent. Men are also at risk.

"The BRCA2 mutation can not only include a higher risk of breast and ovarian cancer, but also a higher risk of other cancers such as prostate cancer, some skin cancers, pancreatic cancer, and a host of others," she says. "It's actually a very important topic and hopefully it'll gain more attention because this is now been in the media for a few days."

This is a very expensive test. According to the website cancer.gov it usually ranges from several hundred to several thousand dollars. Dr. Kumar says if you do not have insurance, but your team of doctors thinks you would benefit from the test, there are some options to help get it covered for you so you don't have to pay the entire cost out of pocket.

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