Genetic Testing, Cancer Risk, and Angelina Jolie’s Choice

Actress Angelina Jolie is no stranger to the headlines, but she stunned the world with her Op-Ed in The New York Times, in which she shared her very private decision to have a preventive double mastectomy after testing positive for the BRCA1 gene mutation. “I hope that other women can benefit from my experience,” wrote Jolie. “Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness.” But for Jolie, and many others, getting genetic testing and taking action may offer control and comfort.

How do you know if genetic testing is right for you? Judy Garber, MD, MPH, is director of the Center for Cancer Genetics and Prevention at Dana-Farber Cancer Institute, and one of the leaders of the Institute’s Susan F. Smith Center for Women’s Cancers. She talks about the BRCA test, family history and cancer risk, and preventive options for breast and ovarian cancer.

The Dana-Farber Cancer Genetics and Prevention Program offers advanced genetic tests to determine risk, as well as counseling and education, once the results are determined.

If you have a question about genetic factors that increase cancer risk, you can ask the Dana-Farber cancer genetics team.

5 thoughts on “Genetic Testing, Cancer Risk, and Angelina Jolie’s Choice”

  1. What you didn’t give information about (and something that Angelina Jolie brought up in her op ed piece) is the cost of
    genetic testing and counseling.

    Also, does health insurance (in my case medicare) pay for genetic testing? Don’t the health insurance companies treat this as a “choice” and not a necessity?

  2. Thanks for bringing up a good question. The cost of the test can vary but in the United States, it typically costs about $3,000 – $4,000. In many cases, it’s covered by insurance, even Medicare and Medicaid, but you may want to check with your insurance provider first. This page in our Health Library, talks in more detail about insurance coverage for genetic testing.–insurance-coverage.aspx

  3. I’ve been told that since my Mother has passed that it is not possible for me to have the genetic testing as she is not here to test as the “source” and also that private health insurance won’t cover the cost. Is that accurate?

  4. Hi Margaret:

    Thanks for the comment. We checked in with Elaine Hiller, one of our expert genetic counselors on this. Here’s what she said.

    We are assuming from what you wrote that your mother had cancer but you don’t. It is true that, ideally, genetic testing for hereditary cancer predisposition or risk should first be done for a family member who has had cancer. This gives us the highest chance of finding a specific genetic change (‘mutation’) responsible for the family history. If we find a mutation, then the testing of other family members is targeted, completely informative, and quite inexpensive. And if a mutation is not found for the relative with cancer, then there would not currently be helpful genetic testing to offer for other family members.

    Unfortunately, as in your situation, this approach is not always possible. When relatives with cancer have passed away, it is certainly still possible to have genetic testing. It’s just important to know that it may not be as helpful, and that interpreting the results can be much more challenging. Perhaps there is a relative other than your mother who has had cancer and might be interested in genetic testing? If so, then this could be another possibility for your family.

    Genetic testing is not appropriate for everyone, so it’s important to have an expert assessment of the family history. Insurance coverage varies, and many insurers do have specific criteria for coverage. Genetic testing laboratories pre-verify insurance coverage before beginning the test. All of these issues are discussed during a visit to the Cancer Genetics and Prevention Center here at Dana-Farber.

    We hope that’s helpful.

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