Hellobee Boards

My mom had breast cancer and it was super aggressive and some other markers that make me very nervous, so this is something I’ve brought up at my last 2 annual appointments. My PCP has referred me this year (I’m 36) to a breast care center/specialists; which I’m meeting with next month. My PCP was hesitant (well, basically refused) to schedule any mammograms before 40 because 1) unlikely insurance would cover and 2) chance of false positive due to denser breast tissue.

I asked my PCP about BRCA screening and she told me to have my mother do it vs. me doing it, since my mother was the one confirmed with cancer and that my insurance would likely only cover my test if hers was positive.

Hope this helps. FWIW, I've brought up breast cancer concerns with both my OB and my PCP (and I really like both doctors) and both took the same position that it was early for me to do anything, absent additional close family connections (and connections who had breast cancer pre-menopause). I have good insurance and neither provider thought it was likely insurance would cover much, if anything, right now. So, you may want to do as much family history trackdown before your appointment as you can.

With only one second degree relative with breast cancer, it is highly unlikely that your provider would recommend additional screening or testing. If you're determined to be tested, then I would count on paying out of pocket.

I would like to point out, however, that even if you do get testing, and the testing is negative, that doesn't mean that you would never develop breast cancer. It sounds like you are looking for a way to determine if you are at risk for ever getting breast cancer, but the answer is most likely that modern medicine can't give you that answer. Current screening guidelines are very effective for the majority of the population and are most likely what your doctor will recommend for you.

ETA: Nearly all cervical cancers are caused by HPV. BRCA links breast and ovarian cancers, but is not linked to cervical cancer.

@yoursilverlining: Same experience.

I did not have the BRCA screening, but just went through this with my family. Piggy backing on what PP said (such good info, btw!), your insurance will most likely consider it elective. If you do not have a direct line with someone who had a positive test, they usually don't cover it as the current recommendation is against screening unless you have someone with a known genetic mutation (aka test positive for BRCA). Technically your dad could be tested for the gene and determine if it made sense for you. I actually think that makes more sense as it would address if your sister needed to be concerned as well.

We were also told that just because you screen negative by no means indicates that it's not potentially genetic (or that you can just toss the worry aside). They are still researching and isolating strands constantly. They said the #1 thing you can do is be proactive about screening. Also having the gene doesn't mean it will manifest -- my family member's doctor actually said the most beneficial things the gene does is (a) encourage those with it to take screening seriously (which it sounds like you already do) and (b) certain chemos are most responsive when there is a genetic component.

FWIW, I think most people who have experienced cancer have a "gut feeling" it will impact them. I'm not discounting your feeling, I just wanted to provide some comfort. My family member was 100% positive it would be genetic and actually had a genetic line that indicated it might be - but it wasn't.

ETA: I have a similar link as @yoursilverlining and I'm not pursuing testing.

FYI, I’m pretty sure you can figure out BRCA if you do 23&Me (which is much cheaper). My mom was tested since we have a family history, but she didn’t have it.

Insurance will not cover it if your grandma is the only one who has had it (unless she was very young when diagnosed I believe). My mom had breast cancer (only one in my family) and insurance won’t cover it for me. I’m not pursuing it on my own as it’s very expensive. I will start having mammograms at 35.

I have already had cancer and am at risk for breast cancer.

I brought up the test with my Dr and she is in support of me taking the test- however she suggested that I wait until I am done having children and breastfeeding since I may pursue a more aggressive treatment and she’s concerned I’ll feel like a ticking time bomb if you will. So I’m taking her advice and waiting.

I didn't read all the comments, but I had the BRCA screening done before ttc because my mother and my paternal grandmother both had breast cancer, and so it is on both sides of my family (and my mom was only 40 when diagnosed). My ob/gyn at the time is the one who suggested it and referred me to a genetic counselor. I didn't actually have the gene they tested for, and it was about 8 years ago so I don't remember if insurance covered it...

Even though I didn't have that particular gene, my dr still wants to be proactive about screening. You can't get a mammogram while pregnant/nursing, but I had one + a breast u/s and mri done at 29 before I got pregnant w lo1 (actually I was preggers at the mri but didn't know yet, whoops...) and I'll get a repeat test done when I'm done nursing lo2

@ElbieKay: I just saw your question. This will not come up on your full fertility screen. I had one done and this was not something they tested for.

Didn't fully read the other responses - my mother had breast cancer and was diagnosed at age 51. She had BRCA screening done and was negative, so my doctor did not recommend for me to have BRCA screening because of that. They told me they usually recommend that you begin getting mammograms when you're 10 years younger than your first-degree relative was diagnosed (i.e., if your mother was diagnosed at 35, they would recommend you get mammos starting at 25). Since my mom was diagnosed after age 50 and the recommending starting age for mammograms is 40, that is likely when I'll start, although I may start doing them sooner for my own peace of mind.

My family history is grandma, Mom, and aunt. The first person in a family who is screened has the whole gene (plus some others related) screened. Since my mom came back with a mutation, they only tested my sister and I for that specific mutation. It was covered for both of us. My aunt is also positive for the mutation but my cousin is negative. So 3/4 people for us, but my mom and aunt have both survived their cancers, my grandma did not, but also had lung cancer...

The test brought great piece of mind for my sister and myself since now we know doctors will take our risk seriously and we qualify for extra screening. (We rotate mammogram and breast mri every 6 months.) We have both chosen no prophylactic surgeries at this point but I have met with all of the appropriate surgeons and doctors for when I decide to go that route.

I’m not sure I would do it with just one family member having cancer though since only a fraction of breast cancer cases are from the gene mutations carriers...

@Mrs D: My mom got aggressive breast cancer at 31, and when I started getting screened at 21 one of the conversations I had with the doctor was about genetic screening. The challenge is if you don't know the status of your family member who got it a your result is called an "uninformed positive/negative" and it's less predictive of future development of the disease. Unless you're interested in prophylactic surgery, each of the three providers I've worked with over the past 10 years has said an uninformed positive wouldn't change my screening plan, so I've chosen not to get tested. I do have a fairly aggressive screening plan, though, so it may be different for you. All this is to say, though, think about whether the result would change anything for you. If the answer is no it might not be worth it. For me it felt like a positive would add stress without changing what we are doing in terms of prevention, but a negative wouldn't relieve stress because there's no way to know whether my mom had it or not.