To BRCA or not to BRCA

It’s been over a week now since my gynecological oncologist convinced me that that a BRCA genetic test would be a good idea for me. This test analyzes DNA to identify mutations in either one of the two breast cancer susceptibility genes. These are called BRCA1 and BRCA2 and they are fairly rare. Women who have the mutation are at much greater risk for recurrence and for ovarian cancer. Since I no longer have my ovaries, that is not a concern for me. However, since my cancer is Type 3 aggressive and triple negative, my options if I do have a recurrence are severely limited.

I found out on Monday that my insurance had denied authorization for the test. This was based on a lack of family history. They require two family relatives with breast or ovarian cancer before they will approve the test. So far as I know, I don’t have any relatives with either cancer. If we were to pay for the test ourselves, it would cost $3,120.00. The representative who called me said they could hold the test for a week to give me time to decide what I want to do.

If I did find that I had the BRCA mutation, I could opt for a double mastectomy and reduce my odds of recurrence to some degree. When I factor in the surgical risks, I’m not sure of the statistical benefit of doing that. In addition, for women with the defect, cancer usually occurs at around 35 years of age. I am far past that landmark.

I talked to my primary oncologist, Dr. Cho, before my chemo treatment on Thursday and he supported my inclination to forego the test unless I get more information about relatives on my father’s side that did have high incidences of breast or ovarian cancers. I don’t really expect that to happen and am content with my decision. The representative at Myriad Labs said I could always opt to have the test at a later time.

I am so fortunate to be blessed with a husband who supports me whether I get the test or opt not to have it. It’s a great comfort to know that so far as he is concerned it’s all about me and what will give me the most peace of mind. We should all have the luxury of that kind of support in our lives.

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