Should I have genetic counseling?
The choice to have genetic counseling and proceed with genetic testing is one to be taken seriously and with some caution. Though it can sound simple to be tested, there are many things to consider before making this decision. Our physicians and nurses will help guide you through the entire process so you understand the pros and cons of genetic testing. If you or your family is interested, you should go to a facility that has many years of experience with genetic counseling and testing for breast cancer.
How do I initiate the process of testing?
If you have a significant family history of breast and/or ovarian cancer and you’re interested in genetic testing, it is recommended that a relative who has had breast or ovarian cancer be tested first. If your family member with cancer is tested and found to have an abnormality in one of these genes, other relatives with or without cancer may be tested for that specific genetic mutation.
If you then test negative for the genetic mutation that is known to be present in the family, your chance of developing breast or ovarian cancer is probably no higher than the risk faced by an individual without a significant family history. If you test positive, your risk for developing breast or ovarian cancer is substantially increased, but not 100 percent.
What are the risks of genetic testing?
There are certain risks associated with genetic testing for cancer susceptibility, including the possibility of insurance or employment discrimination. There are some federal and state laws designed to lower the risk of insurance discrimination, but they only pertain to specific types of insurance. Other risks of genetic testing are adverse psychological reactions and disrupted family relationships. An individual who tests positive may experience anxiety, guilt, depression or fear. Family members may have similar feelings, which could cause strain between relatives.
What if I don’t have a family history of breast cancer? Should I be tested anyway?
In general, those without a family history should not be tested. Individuals who might consider genetic testing include:
- Women with breast cancer before menopause who have had a family member diagnosed with pre-menopausal breast cancer or ovarian cancer at any age
- Women diagnosed with both breast and ovarian cancer
- Women with pre-menopausal breast cancer or ovarian cancer who are of Ashkenazi Jewish descent
- Men with a personal history of breast cancer
- Someone with a relative who has a BRCA1 or BRCA2 mutation
What does genetic testing cost?
Genetic testing tends to be quite expensive, and usually costs $3,400 for the first family member tested. If a mutation is identified, testing of other family members for the identified mutation is approximately $500. For Ashkenazi Jewish individuals, testing is more straightforward, and typically costs $500-600. Many insurance companies cover the cost of genetic testing, though most companies require that the family history meet specific requirements.
What is the connection between breast and ovarian cancer?
Studies suggest that there may be a strong link between breast cancer and ovarian cancer. Women who have an altered BRCA1 gene have a 40 to 60 percent risk of developing ovarian cancer by age 85. Studies suggest that ovarian cancer risk is 16 to 27 percent in women with an altered BRCA2 gene.
Removal of the ovaries (prophylactic oophorectomy) is considered for patients with certain inherited syndromes. Learn more about ovarian cancer.