A study published today (Monday, Dec 10th) in the Journal of Clinical Oncology has found that the current guidelines for genetic testing of breast cancer patients, limits the number of women (and men) who can get tested and because of those restrictions, the tests miss as many patients with hereditary cancers as they find.
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Dr. Peter Beitsch, co-author of the study and a cancer surgeon practicing in Texas noted that with insurance companies paying attention to those guidelines, “patients without genetic test results might not receive the appropriate treatment for their cancer, which could be a matter of life or death.” 1 (Roughly 330,000 patients are diagnosed with breast cancer every year in the US and it’s estimated that 10% are due to hereditary causes.)
“The guidelines for the genetic testing of breast cancer patients were established about 20 years ago by the National Comprehensive Cancer Network, a nonprofit alliance of 28 cancer centers dedicated to improving patient care, explained Beitsch, who is a co-founder of the TME Breast Care Network, a nonprofit focused exclusively on advancing treatment for breast cancer patients.”2
Beitsch said that back then they only tested for BRCA1 and BRCA 2 and the testing was difficult and expensive. Today, genetic testing is easier to do and far less expensive; it used to be about $5,000 to test two genes and now the cost is about $250 to test 80 genes.
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We also now know that there are actually 11 major gene mutations, two of which are BRCA 1 and BRCA 2 (tumor suppressor genes that everyone has; if a defect or mutation occurs in one or both of these genes, the likelihood of breast cancer is increased 3), that can cause breast cancer and 25 or 30 other genetic variants linked to the disease. But, while the guidelines evolved, Beitsch says they got too complicated. Hence, the need for the study.
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Looking at nearly a thousand female breast cancer patients (half who met the National Comprehensive Cancer Network guidelines and half who did not), 959 study participants underwent a full panel of DNA testing for hereditary breast cancer:
“The results showed that 83 women or 8.65% of the total participants, had breast cancer-linked genetic defects. Of these, 45 women met the National Comprehensive Cancer Network’s criteria for testing, while 38 women did not. Ordinarily, then, these 38 women would not have been tested.”4
A survey in 2016 suggested that 56% of American adults would take a genetic test that indicated the likelihood of their developing cancer and yet, insurance plans do not routinely cover the expense of medical genetic testing. According to Beitsch, because genetic tests are now fairly inexpensive, and because we know more people should be tested, the reason for creating an “economic roadblock” no longer exists. It’s time for the guidelines to totally change. Beitsch hopes his study will catch the attention of the National Comprehensive Cancer Network who will change the guidelines.
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In fact, based on his new research, Beitsch believes that all people need to be tested.
What do you think? Would you get tested if your insurance paid for it?
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