The state is encouraging Michigan health plans to provide genetic counseling and testing for some types of breast cancer.
Breast and ovarian cancer can run in families. Sometimes it's caused by an underlying genetic change passed from parent to child.
Jenna McLosky, who's the cancer genomics education coordinator for the Michigan Department of Community Health, says women who have a family history of breast cancer should consider tests for a change in the BRCA 1 or BRCA 2 genes.
"A lot of times they're not aware. They say, 'Oh, cancer runs in my family. I know I might get it in my lifetime,' but they don't know that there's an actual genetic change that's causing the cancer," McLosky says. "Both of those genes are related to about a 60 to 80 percent lifetime risk of breast cancer, and up to about a 40 percent lifetime risk for ovarian cancer."
McLosky says genetic screening can lead to earlier intervention and more treatment options, including removing breast or ovarian tissue before cancer occurs.
"Once we have this information, it really allows us to start screening much earlier than in the general population, where you'd start breast cancer screening at age 40," McLosky says. "For women who have a significant family history or one of these genetic changes, you might start mammogram screening at 25."
The National Comprehensive Cancer Network clinical guidelines say that genetic testing and counseling should be considered standard of care for women with a known BRCA mutation.
McLosky says the standards save lives and make good business sense for health insurance providers.
"We try to focus on the human element. Of course we want to catch cancers early, but from the business side of things it is much cheaper to treat a stage 1 cancer than stage 4 disease, so it is economical as well," McClosky says.
She says Blue Cross Blue Shield of Michigan and Blue Care Network offer good models in their policies for clinical services for BRCA-positive women.