Genetic Testing For Breast Cancer: 7 Common Questions Answered

Sarah Ruppert, MS, CGC, is a certified genetic counselor.

Genetic testing has become an important part of medicine, and new tests for cancer-related genes are developed every year. If you’re wondering whether you should get tested, the answers to these common questions might help.

1. What can a genetic test tell me?

Genetic testing isn’t a crystal ball. It can’t tell you if or when you’ll develop cancer. What it can do is tell you whether you have a version of a gene that increases your risk of developing cancer. Changes in some genes are associated with a high risk of breast cancer, and others are associated with a more moderately elevated risk. We can test for 20 to 30 genes in a single test.

2. Who should be tested for genes related to breast cancer?

Typically, we recommend testing only for people who have certain risk factors for breast cancer. Ideally, genetic testing should start with someone in the family who has had breast or a related cancer. However, this is not always possible.

For women, we may recommend testing if you have either a personal or family history of:

• Breast cancer diagnosed at or before age 45
• More than one separate breast cancer in the same person, especially if the first was diagnosed at or before age 50
• Breast cancer in two or more relatives on the same side of the family, especially if one was diagnosed at or before age 50
• A combination of breast, ovarian, pancreatic and/or aggressive prostate cancers in the family, especially if any of the cancers were diagnosed at or before age 50
• Ovarian cancer diagnosed at any age
• A family history of male breast cancer diagnosed at any age
• Ashkenazi Jewish descent with any personal or family history of breast cancer, ovarian cancer, pancreatic cancer or aggressive prostate cancer

3. I’m interested in genetic testing. What should I do?

Meeting with a genetic counselor is the best first step. Genetic counselors are trained to help you understand your testing options and prepare for the results.

If you and your genetic counselor agree to move forward with testing, we can gather a saliva sample during the initial visit.

4. What if I test positive?

If there’s a positive test result, your genetic counselor will help you understand the results and review your best options for detecting a cancer early – or preventing it altogether. We can also put you in touch with the doctors who can help you finalize a personalized plan for managing your risk.

5. Will health insurance cover the test?

Most insurance companies do cover genetic testing for breast cancer, though sometimes there’s an out-of-pocket cost for the patient. The lab can confirm if the test is covered by insurance.

6. Will my health insurance raise my rates if I test positive?

Fortunately, we haven’t seen health insurance companies drop patients or raise their rates after a positive genetic test, and there are federal laws to prevent that from happening. Some laws provide protection only for those who do not have a personal history of cancer at the time of testing. 

7. Should I have a genetic test?

Genetic testing isn’t for everyone, and a genetic counselor can help you decide if it’s the right choice for you. For many women, however, genetic testing can help guide medical decisions to minimize the chance you’ll be diagnosed with breast cancer.

For more information, learn about Inova’s Cancer Genetics Program.