Breast Cancer Genetic Testing Useful For Preventative Care

PJ Hamel Health Guide
  • OK, take your choice: Have breast cancer, go through treatment, and spend the rest of your life wondering if it’s going to come back. Or never have breast cancer.

    Simple, right? Although ultimately the experience of breast cancer can be both positive and enlightening, I think the vast majority of us survivors would prefer not to have ever had breast cancer. It wrecks a significant piece of your body. It can wreak havoc with your entire system. It can leave you with long-lasting side effects. And though the cancer cells disappear (where did they go?), the memory of their visit (where are they?) remains with you forever (are they coming back?)
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    Sadly, breast-cancer prevention is something that we, as a society, simply don’t take seriously. Aside from a major reduction in prescriptions for hormone replacement therapy drugs–once those drugs were proven to cause breast cancer–there’s not much that women have done to try to avoid this deadly disease, the #3 killer of American women, after heart disease and lung cancer.

    One step in the right direction would be genetic testing for those women who appear to be at increased risk: women with a strong family history of breast cancer. Breast cancer that “runs” in a family is often the result of mutations in two genes, BRCA1 and BRCA2. When genetic testing identifies women with these mutations, preventive measures against breast cancer can be taken. But unless and until women at risk have access to genetic testing, prevention will never happen.

    And what’s preventing that access? First, lack of knowledge. Dr. Funmi Olopade, the Walter L. Palmer Distinguished Service professor of medicine and director of the Cancer Risk Clinic at the University of Chicago Medical Center, spoke on breast cancer prevention at this weekend’s annual meeting of the American Association for the Advancement of Science (AAAS) in Boston. Dr. Olopade’s take on it? Let’s start by educating primary care physicians on the genetics of breast cancer. Our PCPs need to be able to determine which of their patients might be at increased risk, and advise those patients about genetic testing and risk-reduction strategies. "A growing body of evidence has documented the benefits of preventive measures for high-risk women, including those with mutations in the BRCA1 and BRCA2 genes," noted Dr. Olopade. "Our goal is to make this knowledge more and more available to patients, and that has to begin in the primary care setting.”

    Unfortunately, though, no matter how well versed our PCPs become in breast cancer genetics, most insurance companies still won’t pay for genetic testing, which can run upwards of $3,500. And many lag in fully covering the cost of mammograms, which are the best tool for early detection. Why are insurance companies willing to pay for breast cancer treatment, but not for the simple tests that might help prevent it (or catch it early, when it’s much easier and less expensive to treat)?  

    Does any of this make sense? What can YOU do about it? How about this: find out which of the Presidential candidates will work to force the insurance industry to cover the basic tests we, as women, need for breast cancer prevention and early detection. You’ll find answers at HealthCare ’08.  Remember, change has to start somewhere; this November, let it begin with us.  
Published On: February 16, 2008