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high risk for these cancers more tools and more information about how to make a decision about how to handle their health,” Mitchell says. But genetic testing is not recommended for all patients, cautions Dr. Valeria Brutus, a breast surgeon at Albany Medical Center and assistant professor of surgery at Albany Medical College. “Only 5 percent of breast cancer is genetic,” she says. “Women can always have this discussion with their providers and they can go this extra step, but it’s very rare.” Jones’ risk factors made her a good candidate for testing. But because most of the risk was on her father’s side, she saw the test as a precaution, something to cross off her to-do list. “I would get a negative result and be done with it,” she says. “I was not at all nervous because I was so sure it would be negative.”
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THE TEST
Most testing for BRCA1 and BRCA2 mutations is done at a doctor’s office or medical lab via a blood test or by swabbing the inside of the cheek. The test can cost up to $4,000, but is often covered by insurance, particularly for women with a family history of early onset bilateral breast cancer or ovarian cancer, early onset of menstruation and Ashkenazi Jewish heritage. Jones paid about $400 out of pocket when she was tested, she says. In addition to determining if testing is warranted, genetic counselors help clients make sense of their results, which often include a detailed analysis of the patient’s calibrated future risk by age, says Bonnie Liebers, a genetic counselor based in Schenectady. “Mutation carriers should receive their testing information in the context of an appointment that includes genetic counseling with a medical professional who has expertise in genetic test interpretation,” Liebers says, noting that it is easy for a lay person to misinterpret her test results, by, for example, mistaking a benign mutation for a cancer risk. Says Jones: “You get a whole report that gives you all these staggering numbers, which puts it in scary blackand-white terms.” Jones’ test results put her risk of getting breast cancer by the time she is 50 at 50 percent, and her risk for ovarian cancer by the same age at 27 percent. “I’m 42, so 50 is right around the corner,” she says. Further, her results assessed her risk of contracting breast cancer by age 70 at 87 percent and her risk for ovarian cancer by age 70 at 44 percent. These are not numbers Jones felt she could live with, particularly her risk for ovarian cancer, which is harder to detect than breast cancer and more likely to be fatal. For Jones the
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