Whether you like Angelina Jolie or not, most women desire to have something that she has. Maybe you want to have arms like her, with or without the tattoos. Maybe you want her fortune and fame. Or maybe you want to be married to Brad Pitt. All of those are desirable attributes of Angelina Jolie. There is one thing she has that most women do NOT want to have and that is her genes, her DNA, not her 7 For All Mankind jeans.
Many actresses have put a face to breast cancer diagnoses at a young age, for example:
- Cynthia Nixon (diagnosed at 40yo)
- Sheryl Crow (diagnosed at 44yo)
- Edie Falco (diagnosed at 40yo)
- Kylie Minogue (diagnosed at 36yo)
- Christina Applegate (diagnosed at 36yo)
- Melissa Etheridge (diagnosed at 43yo)
Angelina Jolie is the first actress to put a face to prophylactic approaches to breast and ovarian cancers. She publicly announced that she has already undergone a bilateral mastectomy and reconstruction to reduce her chances of actually getting breast cancer and plans to undergo an oophorectomy (removal of the ovaries) in the near future to prevent ovarian cancer. She has made these drastic decisions based on her genetic risk of developing these cancers.
Most women, if not previously to Angelina’s announcement, are aware of the possibility of genetic cancer risks being identified through testing. There is a simple blood test that can tell you if you are a carrier of these genes and therefore have an increased risk well above the average female.
Family history plays a significant role in disease prevention and detection. However not all patients with a family member diagnosed with breast cancer are at the same risk as Angelina Jolie. Actually only about 10 % of the population carries this genetic mutation. So this information is helpful in determining the appropriate surveillance and risk reduction approaches for those men and women identified as carriers.
It is also important to know that genetic mutations are inherited from both the maternal and paternal side. A grandmother on your dad’s side with a history of breast cancer is just as important and a grandmother on your mom’s side with the same history. If you are a carrier of this genetic mutation then your family members (parents, siblings, and children) have a 50% chance of having the same mutation, therefore it is important for them to be tested as well.
Patients often have many concerns associated with genetic testing. How much does it cost? Will testing be covered for me? Do I qualify for testing? Will my insurance drop me if I am a positive carrier? These are all valid questions and now that testing has been available for so long we have those answers.
The best way to see if you qualify for testing is to go online to www.hereditarycancerquiz.com. This is a free, confidential, user friendly website that asks a few questions about your personal and family history and determines whether you are a candidate for testing. If you are a candidate, all you need to do from that point on is call the office to schedule an appointment for testing.
The Genetic Information Non-Discrimination Act (GINA) was put into effect November 2010. This act makes it illegal for insurance companies to deny coverage based on genetic mutations, therefore eliminating the concern of future insurance coverage denial if you are determined to be a carrier.
Cost is also a concern for patients regarding this test. When it was first released the cost was a couple of thousand dollars. These days insurance companies are recognizing the importance of the test so 70% of patients do not have any out of pocket costs. Of the 30% of patients that do have out of pocket costs the average cost is $100. Myriad will process any test that is less than $375 and will call to set up a payment plan for those with costs greater than $375.
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