By Kavitha Kolla, MS, MPH, CGC
The Thelma D. Jones Breast Cancer Fund’s (TDJBCF) virtual Support Group celebration back in January focused on genetic counseling and breast cancer genetics. During the event, I had the pleasure of discussing genetic counseling and genetic testing, and this article seeks to expand on that theme.
Approximately 10% of breast cancers are due to a genetic risk factor that we can identify through genetic testing. We all have genes in our bodies that help prevent cancer from forming. If one of these genes has a harmful genetic change (or mutation), that can increase the risk of developing cancer. Genetic counseling can help you learn if your personal or family history of cancer is suggestive of a genetic factor increasing the risk for cancer, whether genetic testing is recommended, and how you and your family can be proactive about your health.
There are some features that are suggestive of a genetic risk factor and these are reasons to consider genetic testing. These include a personal or family history of breast cancer diagnosed before age 50, ovarian cancer, pancreatic cancer, male breast cancer, aggressive or metastatic prostate cancer, or multiple relatives on the same side of the family diagnosed with breast cancer. This is not a complete list of reasons to consider genetic cancer testing, and meeting with a genetic counselor can help you understand your risk factors.
If genetic testing is appropriate, speaking with a genetic counselor before and after testing can be beneficial in many ways. Before testing, the genetic counselor provides an overview of how genetic testing works, the pros and cons, the type of information it can provide you and your family, and discussing whether it is the right time to pursue genetic testing. Genetic testing provides valuable information about whether there is a genetic risk factor increasing your cancer risk and informs whether there are proactive steps you and your family can take for screening or to reduce the risk of developing cancer. As this can be a lot of information to process, the genetic counseling appointment provides a space for you to address any questions or concerns before deciding whether you want genetic testing.
Genetic counselors also go over insurance coverage and the cost of testing during the appointment. The cost of genetic testing has gone down in recent years and there are many ways to cover the costs of this care, sometimes resulting in no out-of-pocket costs to the patient. Genetic testing labs offer options to get an estimate of the out-of-pocket cost early in the testing process or before genetic testing, and many labs have patient assistance programs to help make genetic testing affordable.
After test results are available, the genetic counselor discusses the results with you and explains how those results may change any medical recommendations for you and your family. For example, genetic counseling and genetic testing can help inform if additional cancer screenings or risk reducing options would be beneficial.
If you are interested in learning if genetic testing is indicated for your personal or family history of cancer, talk to your healthcare provider or a genetic counselor. To learn more about genetic counselors or to find a local or telemedicine genetic counselor, please visit www.aboutgeneticcounselors.org.
Kavitha Kolla is a certified genetic counselor at the Lombardi Comprehensive Cancer Center at MedStar Georgetown University Hospital who provides patients with cancer risk assessment and counseling for hereditary cancer predisposition syndromes.