About Genetic Counseling

The Risk Assessment and Prevention Program

The Risk Assessment and Prevention Program (RAPP) at Invision Sally Jobe provides patients with a personalized assessment of their risk for various types of cancer.  Every patient who comes to Invision Sally Jobe for any type of breast imaging exam receives this initial assessment. After the exam, any relevant recommendations are communicated to their referring doctor(s) as part of the imaging report, as well as to the patient directly in a separate letter. Patients who have already had breast cancer are evaluated as well, to determine whether their cancer might have been caused by a hereditary breast cancer syndrome.

The RAPP program is overseen by a board-certified cancer genetic counselor that is available for consultation with patients, either in person or via telephone.


Should you consider Genetic Counseling?

Genetic Counseling for breast cancer risk is recommended when one or more of the following apply:

  1. A person is diagnosed with breast cancer under the age of 45
  2. Breast cancer occurs in someone in the family prior to age 45
  3. Breast cancer occurs in more than one person in the family
  4. Breast cancer is associated with other cancers in the family, such as ovarian, pancreatic, uterine or thyroid
  5. Breast cancer is associated with Ashkenazi Jewish ancestry (Jewish with ancestors from Eastern Europe, usually Germany, Poland, Lithuania, Ukraine and Russia)
  6. Breast cancer occurs in a male person in the family

About 5 to 10% of breast cancer is hereditary and passed through families.  A Genetic Counselor can closely examine your personal and family history.

After reviewing this history, the genetic counselor may recommend genetic testing for one or more cancer predisposition syndromes, such as Hereditary Breast and Ovarian Cancer Syndrome (caused by mutations in the BRCA 1/2 genes). If you are found to carry a mutation in a gene associated with a cancer predisposition syndrome, you and your medical team can work together to form a more personalized treatment and management plan.

How would carrying a gene mutation change my treatment and management?

Individuals who test positive for certain genetic mutations can take preventive actions to reduce their risk of developing cancer, in some cases by as much as 90%.  These actions include more aggressive screening beginning at younger ages, preventative surgeries and chemoprevention (taking drugs known to reduce the risk of developing cancer). For women who are fighting breast cancer or who have survived the disease, genetic test results may change their treatment options and/or their post-treatment screening recommendations, for not only breast cancer, but possibly other cancers as well.

What would this mean for my family members?

Mutations in genes associated with cancer predisposition syndromes are passed through families. Most of the time, if you are positive for a genetic mutation, your first-degree family members (mother, father, sisters, brothers and/or children) have a 50% chance of also carrying this mutation. If you are found to be positive for a mutation, a genetic counselor can help you inform your family members about their risk of developing certain cancers.

Does insurance cover the cost of genetic counseling and genetic testing?

At Invision Sally Jobe, genetic counseling visits are most often covered by insurance. When a genetic counselor or other medical professional recommends genetic testing, insurance covers it in most cases. A genetic counselor and the laboratory conducting the testing can help you find out if genetic testing is covered by your specific insurance plan and what the out-of-pocket cost would be to you. If you would like to contact your insurance company to check on your coverage for genetic counseling and/or testing, please contact us for the relevant billing code(s).

If I test positive for a genetic predisposition syndrome, could this affect the insurability of my children and/or other relatives?

Genetic information cannot be accessed by anyone, except you and people you authorize to view this information. Furthermore, the Genetic Information and Discrimination Act of 2008 (alsoknown as “GINA”), is a federal law that prohibits insurance companies and employers from discriminating against someone because of their genetic information. Additionally, Colorado law (S.B. 94-058) states that health insurance, group disability and long-term insurance coverage cannot be denied based on genetic information.

How do I schedule an appointment?

To schedule an appointment with a genetic counselor at Invision Sally Jobe, simply contact the scheduling department at 720-493-3700. If you have further questions regarding genetic counseling before scheduling your appointment, please contact the genetic counselor at 720-493-3229 or email to [email protected]


 

Resources

GINA : Genetic Information Nondiscrimination Act

National Society of Genetic Counselors

Bright Pink – The only national non-profit organization focusing on the risk reduction and early detection of breast and ovarian cancer in young women while providing support for high risk individuals.

FORCE: Facing Our Risk of Cancer Empowered – A non-profit organization for women whose family history or genetic status puts them at high risk of getting ovarian and/or breast cancer, and for members of families in which this risk is present.

Sharsheret – An organization that supports young Jewish women and families facing breast cancer and ovarian cancer at every stage — before, during, and after diagnosis.

Know:BRCA – An educational website from the Centers for Disease Control and Prevention designed to build awareness about how BRCA gene mutation affect risk for breast and ovarian cancer.

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