Q: How is BRCA tested for?
It’s a blood test that uses DNA analysis to identify mutations in the BRCA genes. The initial step is for you to meet with a genetic counselor who will take a detailed medical and family history and assess your risk for breast and ovarian cancer. Your counselor will discuss the implications of a positive, negative, and uninformative test result. You will also review options for surveillance – ways to detect cancer early, chemoprevention (taking medications), and risk-reducing surgery. Possible psychological, emotional and familial implications of test results are also discussed.
Q: How much does BRCA testing cost?
The BRCA testing and genetic counseling should be covered by any plan started after March 23, 2010, as Health and Human Services has found this to be one of the mandatory free preventative care measures covered under the Affordable Care Act (Obamacare). Preventive actions taken as a result of testing, are expensive. If you are considering testing, find out about your insurance company’s policies regarding coverage of preventative surgeries.
Q: What surveillance is needed for women who are BRCA positive?
Breast surveillance includes twice yearly breast exams by your doctor and annual mammogram and MRI no later than age 25. Surveillance for the ovaries includes having semi-annual pelvic exams, annual transvaginal ultrasound imaging and blood tests to measure the cancer antigen 125 levels.
Q: What are risk-reducing strategies for BRCA positive women?
There are two options: chemoprevention versus surgery. Tamoxifen has been shown to reduce risk of breast cancer by 50% in pre- and postmenopausal women. Another FDA approved drug called Raloxifene has also been shown to reduce breast cancer risk-but only in postmenopausal women. Bilateral salphingo-oophorectomy (removal of both ovaries and fallopian tubes) reduces ovarian cancer by 90% and breast cancer by 50%. This should be offered by age 40 or when childbearing is complete. Bilateral mastectomy (removal of healthy breasts) reduces breast cancer risk by 90%.
Visit the BlackDoctor.org Breast Cancer center for more helpful articles and tips.
Dr. Draion M. Burch, DO (Dr. Drai) is among the country’s most well-known and respected OB/GYN physicians and surgeons. Dr. Drai is a practicing physician and teaching faculty member at Magee-Womens Hospital of The University of Pittsburgh Medical Center, one of the nation’s top five hospitals specializing in obstetrical and gynecological care. Dr. Drai is also the founder and Chief Medical Advisor of DrDrai.com, where he discusses actionable ideas and real-world strategies to help women take control of their health.