What does being "High Risk" for breast cancer mean?

There are many reasons why a person may be considered "high risk" for breast cancer. Here are some of them:

• Personal history of breast cancer
• Previous breast biopsies that revealed atypical cells
• Family History of breast cancer
• History of Chest Wall Radiation Therapy
• Late age of first birth or not having children

How do I know if my family history is concerning for a genetic mutation?

Here are some of the criteria:

• First degree relative with breast cancer under the age of 50
• Relative(s) diagnosed with both breast and ovarian cancer
• Relative diagnosed with breast cancer in both breasts
• Any men in your family diagnosed with breast cancer
• Any of your family members ever been told they are positive for the breast cancer gene
• Ashkenazi (eastern European) Jewish descent with any family history of breast or ovarian cancer

Do I need a referral to the clinic?

If your insurance company requires referrals you will need to obtain one prior to the visit.

If you are undergoing genetic counseling there should actually be two referrals. One for genetic counseling with the High Risk Clinic and Tracey Hall, NP and one for genetic testing with Myriad genetics for BRCA1 and BRCA2.  The Genetic Testing CPT codes are: 83891, 83898, 83904, 83894, 83912.

If I choose to undergo genetic testing will my insurance company cover it?

Many insurance companies do cover this. More than 90% of the tests submitted have greater than 90% coverage.  After the counseling visit, if you choose to be tested we will submit a test requisition form to your insurance company to determine if they will pay for this.  If you have specific questions for the company before the visit please call 1-800-469-7423.  You can also find additional information on their website www.myriadtests.com

If I choose to have genetic counseling or testing should I be concerned about being discriminated against? 

State and federal laws protect against health insurance discrimination based on genetic information.  To date, there have been no documented cases of health insurance discrimination as a result of testing for hereditary breast and ovarian cancers.
Life insurance is a separate issue and is not protected by any laws.

What is involved in a "high risk" appointment?

Depending on your risk factors you may either meet with the nurse practitioner or physician to discuss your risk of breast cancer.  For some patients we will review all the risk factors for breast cancer, specific ways to reduce your risk and how you should best be screened for breast cancer. This part of the visit usually takes about 30 minutes and a breast exam is done.  This visit is usually with the physician. 

If your family is very strong and you would like to be counseled regarding a genetic mutation this process takes about 45 minutes and usually involves an in-depth evaluation of your family history of cancer.  This visit is done with the nurse practitioner.

Some people choose to do one or both parts of this visit.