Questions About Mastectomies and the BRCA Test Answered by Our Expert

Following Angelina Jolie's announcement via a New York Times op-ed that she underwent a double mastectomy after learning of her increased risk for breast cancer, women have had questions about what Jolie's experience and the BRCA gene test could mean for their lives.

We turned to our women's health expert, Dr. Roshini Rajapaksa, for more information on the BRCA gene blood test and insurance coverage as it relates to breast cancer.

Mastectomies, breast reconstruction, and breast cancer treatment are covered by insurance.

The BRCA blood test, which looks for gene mutations, might not be covered by insurance.

"BRCA coverage is variable depending on the insurance plan, and the patient's medical and family history," Dr. Raj says. "Someone who is not at increased risk for breast cancer would never be able to have a BRCA test covered by insurance."

A preventive mastectomy, without a BRCA test, is sometimes covered by insurance.

"For example, they may cover it if the woman has other strong risk factors for breast cancer like abnormal (pre-cancerous) cells in the breast, chest radiation exposure, or a strong family history of breast cancer," Dr. Raj says.

If a woman has the risk factors for a mutated BRCA gene - if she's had breast cancer before age 50, if she has a family history of both breast and ovarian cancer, or if she has close relatives with breast cancer - insurance might cover the test.

"Generally if a woman meets the qualifications, then it becomes a personal choice, and if she wants to do it, her doctor can try to advocate to get the insurance company to cover it," Dr. Raj says.

If a woman fits the BRCA mutation profile, it is probably smart to have the test if she is in a financial position to do so.

"I am always a big believer in prevention, but not knowing someone's financial circumstances, I can't say if it is worth it," Dr. Raj says. "If they can afford it, then yes, I think they should do it."

Sexual attractiveness and beauty do not hinge on whether a woman has her breasts.

"I am happy a female icon like Angelina Jolie has spoken so honestly about her experience," Dr. Raj says. "Not only does she raise awareness about this all too common killer of women, but she also lets women who have undergone mastectomies know that they are not alone, and can still feel gorgeous and sexy."

Follow Dr. Raj on Twitter at @DrRoshiniRaj and on Facebook.

Dr. Raj

Dr. Roshini Raj appeared on "Bethenny" in summer 2012 answering your health questions. She is a board certified gastroenterologist and internist with a medical degree from New York University School of Medicine and an undergraduate degree from Harvard College. Currently, Dr. Raj is an attending physician at NYU Medical Center/Tisch Hospital in New York City, where she was the first female gastroenterologist to join the faculty. She also serves as an Assistant Professor of Medicine at the NYU School of Medicine. Dr. Raj has a special interest in women's health and cancer screening and has published several research articles on colon cancer screening.

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