Anyone in Canada Have A Voluntary Mastectomy Covered by OHIP?

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GoldenGirls
GoldenGirls Member Posts: 608
edited June 2014 in High Risk for Breast Cancer

With my mother's cancer diagnosis I am becoming more and more worried about my own risk and am fully willing to have a voluntary mastectomy (with reconstruction) as well as ovary removal (likely hysterectomy because of many fibroids and cysts anyway). I touched on this briefly with her oncologist who informed me that I may not be deemed as high risk by the government. My mom was diagnosed originally at 51 (and recently stage IV) and was only menopausal because of a previous hysterectomy for cysts and fibroids like I have. She had an aunt who also died of what was thought to be ovarian cancer (little village in Europe many, many years ago when cancer wasn't mentioned and people just said she "died from cysts on her ovaries").

I am wondering if anyone else has been through something similar? Any other Canadian women who chose a mastectomy for prevention and managed to have it covered by OHIP?

I am sick of living with this constant fear.

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  • rozem
    rozem Member Posts: 1,375
    edited February 2013

    hi there

    i had cancer and double msx - but i know thats different bc of my diagnosis

    what i can share with you is that the first step would be to have genetic counselling/testing.  Any of the major cancer ctrs have a genetics dept.  They will go through you family history and tell you what your risks are.  Having a mother diagnosed pre-menopausally, before the age of 50 does put you at a higher risk (you seem to be boarder line).  Any history of ovarian cancer also puts you at higher risk. If you do end up being brac1/2 then you would have a good case to have a preventative msx.  I am not sure if OHIP would cover without a firm brac1/2 diagnosis - (my guess is they would not).  I went to genetics counselling at Sunnybrooke but I know PMH has a great center aswell


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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2013

    canadagirl, has your mother had the BRCA test, and if so, was she positive?  If she is, then you should be tested.... you would have a 50/50 chance of being positive too if she is.  In that situation, I'm pretty sure that there would be no issue with OHIP paying for the operation. 

    I think that is the best first step if a PBMX is something you are considering.  I understand your fear, but what's important to know is that even if your mother is BRCA positive, you might not be.... this is a gene that we inherit either from our mother or from our father. So even if the 'breast cancer gene' is in your mother's family, there's only a 50% chance that you would have it. You might have inherited this particular gene from your father, and in that case, your risk would not be increased at all. 

    If you mother does not carry the BRCA mutation, then it becomes more complicated to show that you are high risk. There might be another as yet undiscovered gene that is driving the cancer in her family. Talking to a genetic counsellor, which is the first step to getting the BRCA test, would be helpful in that regard.  There may be enough family history to position you as being high risk, and in that case, I believe OHIP would pay for the operation.  

    Just going for the operation without this background work to provide evidence that you are high risk probably would not be successful, in terms of getting OHIP to pay. That's just my guess however it sounds like that's consistent with what your mother's oncologist was saying. 

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  • rozem
    rozem Member Posts: 1,375
    edited February 2013

    try posting this on the canadian forum aswell

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