BRCA testing: any changes due to the Supreme Court decision?

The supereme court decision will have no affect on past tests performed.  It will allow competition via other labs and thus may bring the cost down in the future.

Medical providers can charge whatever the market will bear.  If covered by insurance, they may/may not contract with the insurance carrier for a certain fee.  If there was pre-authorization or not will affect your insurance carrier's refusal to pay. Good for you for appealing.

Frankly, I have a question or thought that is slightly off here.  If I have already been diagnosed with Breast Cancer, why would "I" need BRCA testing?.  Shouldn't it be my children, if I already have them.  It would seem to me that, if I were young and had no children, I would want to know if I had the BRCA mutations to help aid in my choice of whether or not to have children and likely pass on that gene mutation.  However, if I already have the cancer, and I already have my children, why would I need the test? 

I want my 15 y/o daughter to be covered for the test, so that she can make informed decisions about her life. I think her medical insurance should pay for it. SHE is the one at risk.

If you test positive for a deleterious BRCA mutation when you already have a breast cancer diagnosis, a genetic counselor would inform you about your risk for developing additional or contralateral cancers and as well as future radiation-induced cancers should you choose lumpectomy. So if you've already had breast cancer and had a BMX, what would the usefulness of the test be? You would be advised of your risk of developing ovarian cancer so you could contemplate prophylactic oophrectomy or at least follow additional screening guidelines. You would also learn about any additional cancer risks your particular mutation has shown - some that are actionable (annual skin checks for melanoma) and some that aren't (no screening for pancreatic). You could inform blood relatives (including your daughter) of your mutation so they could consider testing (testing for a known mutation is much cheaper than the full sequencing/BART). If you are still in treatment, you could be offered certain chemos that have shown greater efficacy in BRCA cancers.



In other words, BRCA testing can inform a lot of decisions beyond pre-conception considerations (I'm sure I missed some). And as SpecialK mentioned, it is usually preferred to run any kind of genetic test on a proband (affected individual) rather than an unaffected relative.

Not only your daughter at a reduced charge but other blood relatives. Also if you have more than one child it is much less expensive for one parent then all the kids to go get tested especially if the parent is negative. We were advises in this course. At 27 if I tested positive after DX to have my parents/not siblings tested first. That way if they both tested negative we wouldn't worry about my siblings. Also we would know which side of the family to inform if we tested positive. I can't imagine not sharing the info and watching my cousins end up getting sick. Also for insurance to pay generally you have to have 1 1st relative test positive or two second degree relatives. There are a lot of reasons to test. Prophy measures for yourself. Even after my BC DX I will never go to 1 yr tests and scans. I have a variety of scans 2x per year. But for me getting tested was to enable my family to have the choices I did have. My gene is from my maternal line. I have 6 aunts/ uncles on that side that's a lot of cousins and family to watch having to go through 300,000 dollars worth of treatment over skipping a $3000 test. Also brca does have implications for males. They can be at higher risk for other cancers and breast cancer! I don't mean this to be confrontational in any way I just wanted to share my experience.