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I am a 31 year old I have a 1 year old child and recently just found out I have a brac2 gene problem.  I have went through 1 round of breast cancer and would rather not fo through another!!!  I was wondering if insurance co. pay for double mastectomy and reconstruction???
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25201 tn?1255584436
This is an issue you need to take up with your Insurance Company. Only they would be able to answer questions as to what they will pay for and what they won't. This would also involve statements from your Physicians as to the necessity of this procedure.  Regards ....
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739091 tn?1300669627
Here is some information for you to use. If you have not seen a genetic counselor this is the time to do it. In the US, if an insurance company pays for a mastectomy it must also pay for reconstruction and if they say they don't/won't, fight them with information.

What are the similarities and differences between  BRCA1 and BRCA2 mutations?
A. When working properly, both BRCA genes help to keep our bodies healthy by repairing cellular damage that accumulates throughout life from many different influences.  Mutations in either BRCA1 or BRCA2 can be passed from parent to child and can cause cancer to run in families. As research unfolds, we are learning more about these two genes, how they affect cancer risk, the types of cancer they cause, and how effective treatment and prevention may be for each.
Cancer risks
• These mutations lead to increased risks for breast, ovarian, fallopian tube, and primary peritoneal cancer; these risks are much higher than risks for people in the general population.  
• Lifetime risks for breast cancer are similar for both mutations
o BRCA1 and BRCA2 risk is estimated to be 50-85%
o The average age at cancer diagnosis for people with either mutation is earlier than in peoplein the general population.
• Lifetime risks for ovarian/fallopian tube cancers are different for people with a BRCA1 vs. BRCA2 mutation
o BRCA1 risk is estimated to be 40-60%
o BRCA2 risk is estimated to be 10-20%.
• People with either BRCA mutation may also have an increased risk for the following cancers (although not as high as for breast/ovarian cancer):
o Pancreatic cancer
o Prostate cancer
o Male breast cancer
o Although both mutations are associated with an increased risk for the above cancers compared to the general population, BRCA2 mutations are linked to a higher lifetime risk for all three cancers compared to BRCA1 mutations.  Prostate cancers do not occur at younger ages, but are often more aggressive.  The risk of pancreatic cancer is no more than 5% in BRCA2 mutation carriers, but more research is needed to identify which BRCA mutation carriers are at elevated pancreatic cancer risk.    
o BRCA2 mutations are also associated with elevated risk for melanoma, which has not been shown for BRCA1 mutation                                                      
Types of breast cancer
• BRCA1 mutations are most commonly associated with a type of breast cancer that does not express estrogen or progesterone receptors and does not overexpress a protein called “Her2neu.” This “triple-negative” breast cancer is usually treated with chemotherapy, and not with hormonal medications or drugs like Herceptin that target the HER2 protein.
• BRCA2 mutations are most commonly associated with a type of breast cancer that expresses estrogen and progesterone receptors and does not overexpress the Her2neu protein. These cancers are often treated with drugs that block or interfere with hormones.  Some may also required chemotherapy.  
Risk management differences
• Salpingo-oophorectomy (removal of the ovaries and fallopian tubes) is recommended for women with a BRCA1 or BRCA2 mutation. This surgery substantially lowers the risk for ovarian and fallopian tube cancer. When performed before menopause, the surgery also lowers the risk for breast cancer: the resulting reduction in may be greater for women with a BRCA2 mutation than those who have a BRCA1 mutation. Read more about the research that came to this conclusion in our Joining FORCEs Spring 2008 newsletter (pdf).
• Tamoxifen and Raloxifene are Selective Estrogen Receptor Modulators (SERMS), medications that are used to lower the risk for breast cancer in high risk women.  There have been some studies on SERMs in women with BRCA mutations, and they have been shown to reduce breast cancer risk, but information is limited.
Q. Can someone inherit mutations in both genes? If so, what are their risks for cancer?
A.  Although uncommon, it is possible for someone to inherit a mutation in both the BRCA1 and BRCA2 genes. Because it is unusual, there is little research on the related cancer risks. Experts will often use the higher risk estimates for each cancer. For ovarian cancer experts may use risk estimates similar to estimates for people with a BRCA1 mutation and for pancreatic cancer, prostate cancer, and melanoma, experts may use estimates similar to those for people with a BRCA2 mutation.
Q.  My doctor recommended that I have BRCA genetic testing.  I'm not sure that I want to have genetic testing, but I do want to understand more about the cancer in my family.  If I do decide to have testing, how can I go about getting the test?
A. Before taking a hereditary cancer genetic test such as a BRCA test, it is recommended that you speak with an expert who specializes in cancer genetics.  They will evaluate your family medical history and assure the proper test is ordered and results are interpreted correctly.  Sometimes genetic testing is more informative if someone else in the family tests first before you.  A genetic counselor will be able to determine the best person in your family to have testing.  It is difficult to make an informed decision about genetic testing unless you receive up-to-date and credible information from an expert.  A genetic expert will not try to talk you into or out of genetic testing but will look at your family history and educate you about your cancer risk and risk-management options.  Once you understand your risks and options, the decision to undergo genetic testing is up to you.
You can get this. You can find more information readily available at www.facingourrisk.org which is all about hereditary cancer and BRCA mutations. They have enough info to push your case. Seriously though, if you haven't seen the counselor you really need to. You're so young and some of the risk management options for you would not be wise. Let the experts help you when you need it most.

Please let us know how you're doing. Best wishes.
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