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Should I test my breasts?

  • Story Highlights
  • Genetic tests can tell you whether your risk for breast cancer is greater than average
  • Screening not for everybody; can sometimes create more questions than answers
  • Genetic counselor can analyze family history, recommend or discourage testing
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By Elizabeth Cohen
CNN
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Empowered Patient, a regular feature from CNN Medical News correspondent Elizabeth Cohen, helps put you in the driver's seat when it comes to health care.

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Self-exams and mammograms are vital, but what about genetic tests for breast cancer?

ATLANTA, Georgia (CNN) -- So you're scared of breast cancer. Smart lady. Nearly 200,000 women will learn they have breast cancer this year, and you don't want to be one of them. You're doing everything you can to make sure you're not next -- doing breast exams, getting mammograms -- but you think it would be great if you could get a test to see if you'll develop breast cancer.

There is indeed a test to see whether you have genes that make it likely you'll get breast cancer. Sounds like a no-brainer, right? If you test positive, you can actually do something -- get extra tests, or take drugs that will make it less likely you'll get breast cancer. There are even advertisements on television for the tests, telling women to "be ready against cancer."

But be careful.

"The 'bring it on, the more information the better' attitude we have about genetic testing could really come back to bite us," says Ellen Matloff, director of cancer genetic counseling at the Yale Cancer Center.

Genetic counseling, she explains, while invaluable for some, can be detrimental for others. Here, from her and other breast cancer authorities, are the do's and don'ts of genetic testing.

DON'T get tested just because you're worried

Perhaps you have a friend with breast cancer, or maybe all those pink ribbons and 5K races are freaking you out, and you want a test. Bad decision, Matloff says.

Breast cancer tests aren't like tests for strep throat or pregnancy that have a very clear "yes" or "no" answer. If you don't have a family history of breast cancer, the test results many times are ambiguous. "At the end of the testing process, you've paid $3,200 out of pocket, and you're likely to end up with more questions than answers," Matloff says.

DO consider testing if you have a family history of breast cancer

The U.S. Preventive Services Task Force recommends that women be referred for genetic evaluation only if they have a family history of breast cancer. Click here to see how they define "family history."

DON'T think the BRCA test covers everything

Some 10 genes are connected to breast cancer -- the often-cited BRCA1 and BRCA2 are just two of them. This means a test showing you're "BRCA-free" doesn't mean you're off the hook.

This is one reason groups such as the American Cancer Society urge genetic counseling. A genetic counselor can analyze your family history of cancer and see whether you should be tested for any of the other genes related to breast cancer.

By the way, being tested for all the genes is impractical. "It would cost tens of thousands of dollars, and you'd have to go to labs all over the world," Matloff says.

DO think about locking in insurance before testing

While no one officially tells women this, that's the advice of Tammy Kimball, who had genetic testing only after she made sure her life insurance was a sure thing.

Health Library

  • MayoClinic.com: Breast cancer

"In case the result was positive, I didn't want them to deny me insurance or increase my premiums," says Kimball, whose three older sisters had breast cancer.

As for health insurance, results of genetic tests can cause problems if you get health insurance on your own instead of through your employer, Matloff says.

In the end, genetic testing can be invaluable for some, like Kimball, who decided to have her breasts removed so she wouldn't suffer the same fate as her sisters. But for others, the "should I get tested" question isn't nearly as clear. E-mail to a friend E-mail to a friend

Elizabeth Cohen is a correspondent with CNN Medical News. Associate producer Sabriya Rice contributed to this report.

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