Who should consider genetic testing?
Testing is recommended only after discussion of the benefits, risks, limits, and potential outcomes of genetic testing. Common characteristics of hereditary cancer families include:
- Someone in your family has a known genetic mutation
- Cancer that occurs at an early age (50 or younger)
- Two or more close relatives who have the same type of cancer or related cancers
- Cancer that occurred in more than one generation
- One family member has two or more cancers
- A rare cancer or tumor, such as sarcoma or male breast cancer
- Cancer that develops in both breasts, both ovaries, both kidneys, etc.
- Any person concerned about developing cancer because of their family history
What happens at a genetic counseling appointment?
Risk Assessment: The genetic counselor will take a complete family history and medical history. During the risk assessment, the patient will learn more about their cancer risk and potential risk to other family members.
Education: Includes learning about the genetics of hereditary cancer, genetic testing options, and other screening, management and treatment options.
Testing: If indicated, genetic testing is offered, but only after the benefits, risk and limits of each test are carefully considered. Deciding whether or not to have genetic testing is a personal choice.
Results: Individuals receive their test result from the genetic counselor. A discussion follows regarding how the result affects cancer screening, treatment, and management, as well as the testing recommendations for other relatives.
Specific Examples of Hereditary Cancer Concerns
Breast and Ovarian Cancer
- You or a close relative had breast cancer at an early age (50 or younger)
- You had breast cancer at any age and a close relative had breast cancer earlier than age 50
- You had a “triple negative” breast cancer
- You had ovarian cancer at any age
- You or a close relative had bilateral breast cancer
- You or a close relative had breast and ovarian cancer
- There are 3 close relatives on the same side of the family with either breast, ovarian, or pancreatic cancers diagnosed at any age
- You have Ashkenazi Jewish heritage and were diagnosed with breast cancer at any age
- Any male with breast cancer or a close relative of a male with breast cancer
- Your close relative carries a BRCA1 or BRCA2 gene mutation
Colon and uterine cancer
- You had colon or uterine cancer diagnosed at age 50 or younger
- You had 2 colon cancers, or colon AND uterine cancer at any age
- You had 2 close relatives with colon cancer; one diagnosed at 55 years or younger
- You had 3 close relatives with colorectal and/or uterine cancer at any age
- You or a close relative had 10 or more total colon polyps
- You or a relative had abnormal tumor screening results
Does Insurance Cover Genetic Testing?
Many insurance plans cover genetic testing. Most testing labs will obtain pre-authorization from your insurance carrier prior to testing. Should there be high out-of-pocket expenses the lab will contact you for approval before beginning the test. The genetic counselor can help you find out what your insurance will pay for.