Genetic counselor weighs in...........

I met with perky Lisa, one of the genetic counselors at my Gyn/Oncologist's group, this AM. She ran down all the FAQs of BRCA testing. In a nutshell:

OVCA is not a common cancer, so if you have it, you should consider genetic testing if there is ANY type of female cancer in your family's medical history. If you have a family history of OVCA or BC, even a third degree instance (great aunt, for example, or first cousin), you should definitely think about genetic testing, and most insurance carriers will, in that instance, pay for it. Medicare will pay 100% if you have OVCA and a single case of ovarian or breast cancer before the age of 50 in your family, and you don't have to document it, either. It's an honor system. (I had a great aunt who had both breasts removed back in the 1940's or 50's. She is long dead (not from BC, however) and there is no way to check, but I think she was under 50 at diagnosis. My insurance company is paying 100% for the test, based on this information.)

If you are positive, they recommend an MRI of your breasts every six months. That's if you don't elect to have them removed. BRCA positive women have an 87% chance of contracting breast cancer. Usually, the BC presents first (before OVCA), in which case they recommend a total hysterectomy for women who do not want to have children. In my case - OVCA confirmed - they would not discourage me from having a preventative double mastectomy, and I definitely would. The genetic counselor said she has seen every reaction in the book, from "No way are they taking off my boobs," to "How soon can we schedule the surgery?" She does not hard-sell any particular route, but she will tell you that she had a BC patient recently (BRCA positive) whose daughter (in her 30's) was tested and found to be positive, as well. She elected to have her breasts removed, even after a "clean" diagnostic mammogram. There was a tiny, malignant tumor in one of her breasts.

Also, if you are positive, you need to educate your family members (males, too) and if you provide your genetic test info, they can have a single strand (much less expensive) test done to determine their status. BRCA gene mutation is related to male BC and prostate cancer.

My results will be back in one-two weeks. There is also something called "Lynch Syndrome" - a link between colon cancer and OVCA. A history of polyps on your colonoscopy alerts them to this and they do further genetic testing if you have had 20 or more polyps over your lifetime. I am close, if not already up to 20, and I have only had about 4 colonoscopies. She is sending for the reports to check that out. Oh, joy....more blood work.