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" \n Angelina Jolie didn&amp;#039;t have to share the story of her preventative double mastectomy. Unbelievable as it may seem, the woman whose every move is tracked by the paparazzi managed to keep her medical procedures under wraps. But as she writes in her brave New York Times op-ed, &amp;quot;I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested.&amp;quot; Leave it to Angelina to raise awareness\u2014and plenty of questions\u2014instantaneously: Who should get tested for the &amp;quot;breast cancer genes&amp;quot; BRCA1 and BRCA2, and when? And does the test really cost $3,000? We consulted Dr. Mark Robson, Clinic Director of the Clinical Genetics Service at Memorial Sloan-Kettering Cancer Center in New York, whose practice is weighted on women with hereditary breast cancer, and Cosmo Radio women&amp;#039;s health expert Dr. Jennifer Wider, for answers. Should you get tested for BRCA1 and BRCA2? If you have a first-degree relative (mother, daughter, or sister) who developed breast cancer before the age of 50\u2014yes. You should also get tested if you have two or more second-degree relatives (like your grandma or aunt) diagnosed with breast cancer, or a combination of first and second degree relatives who have had breast and ovarian cancer. Ashkenazi Jewish women have an increased risk, and should get tested for BRCA1 and BRCA2 if they have a first-degree relative with breast or ovarian cancer. Statistically speaking, the majority of breast cancer cases are actually not genetic. &amp;quot;People who have these mutations are quite rare,&amp;quot; Dr. Robson said. An estimated 1 in 500 people will carry a breast cancer gene. Most women who get breast cancer don&amp;#039;t inherit it from their families, so every woman should be vigilant about screenings via their annual gynecological exam, self breast exams, and starting mammograms at age 40. What if you have no family history of breast cancer or ovarian cancer\u2014can you still get tested for BRCA1 and 2?  No. Doctors won&amp;#039;t test you for the breast cancer genes if you don&amp;#039;t have cancer in your family tree. &amp;quot;They&amp;#039;re not going to indiscriminately test you, because it costs a lot of money to do so,&amp;quot; Dr. Wider said. Speaking of which, does the test really cost $3,000 like Angelina Jolie mentioned? Without insurance, the test could indeed cost up to $3,000. A company called Myriad Genetics currently has exclusive rights to test for the gene, driving up the cost of testing. But &amp;quot;if you have a history of early on-set breast cancer or ovarian cancer in close relatives, then the test is pretty routinely covered by insurance,&amp;quot; Dr. Robson notes. What does the test entail? Testing for BRCA1 and BRCA2 requires a blood sample and genetic counseling. If you test negative, does it mean you won&amp;#039;t get breast cancer? Unfortunately, you are still at risk. &amp;quot;BRCA1 and 2 are two isolated genetic mutations. There are a host of others, so if you get tested and you don&amp;#039;t have these two genes, it doesn&amp;#039;t mean you&amp;#039;re in the clear,&amp;quot; Dr. Wider says. If you test positive, what does it mean for your breast cancer risk? Testing positive means, based on study results, that you have an estimated 65 to 87 percent chance of getting breast cancer. Angelina Jolie writes about about her &amp;quot;personal risk factor&amp;quot; for breast cancer as being 87 percent. How does a woman figure out her personal risk factor? &amp;quot;It&amp;#039;s hard to comment on individual risk,&amp;quot; Dr. Wider said. Some families carry a higher risk than others, and Dr. Robson believes the 87 percent cited by Jolie as her risk factor is based on the positive result from Myriad Genetics, which reports that if you are BRCA positive, your risk could be as high as 87 percent. If you test positive for BRCA1 or 2, do doctors advise following Angelina&amp;#039;s lead and getting a preventative mastectomy? &amp;quot;It&amp;#039;s a complex decision and it&amp;#039;s not an easy one. One of my big concerns is that I find women don&amp;#039;t want to be tested because they feel like [mastectomy] is the only thing that&amp;#039;s available to them, and so they don&amp;#039;t want to look,&amp;quot; Dr. Robson said. The alternative, he says, is to set on a course of increased screening, including MRIs and ultrasounds\u2014like one Cosmopolitan staffer has been doing for the last 13 years. She tested positive for BRCA1 at age 25, after her mom was diagnosed with breast cancer at age 50. Now 38 and a mom of two, she did not opt for a preventative double mastectomy, but she sees a breast specialist three times a year and an OB/GYN specialist who conducts blood tests and ultrasounds twice a year, among other advanced screenings. She says: &amp;quot;Knowledge is power.&amp;quot; How does a preventative mastectomy affect your cancer risk? The surgery dramatically reduces the risk of cancer, but it doesn&amp;#039;t mean post-op patients have a zero percent chance. Dr. Wider cites the case of a patient who had a preventative double mastectomy only to develop breast cancer in her chest walls. Jolie writes that her risk has been lowered to under 5 percent. Are preventative mastectomies becoming more common? &amp;quot;My impression is that the number of women choosing to do it is increasing,&amp;quot; Dr. Robson said. Though there&amp;#039;s no new medical info urging women to opt for preventative mastectomies, Dr. Robson says there is a &amp;quot;social network effect&amp;quot; at work thanks to high-profile cases like those of Angelina and Christina Applegate, who battled breast cancer with a preventative double mastectomy. &amp;quot;When someone like Angelina Jolie makes this choice and makes it very publicly, it becomes increasingly difficult for women to make an alternative choice,&amp;quot; he said. &amp;quot;It starts to look like this is the norm.&amp;quot; But he stresses that there are alternatives for women with an increased genetic risk, including the aforementioned advanced annual screenings. &amp;quot;It&amp;#039;s a choice that is faced by many women who find out they have these sort of genetic dispositions,&amp;quot; he said, praising Jolie. &amp;quot;I think she was pretty articulate in terms of describing the choice and why she made the decision that she did.&amp;quot; Photo Credit: Getty Images For more from Michelle, follow her on Twitter @michelleruiz "^^<http://www.w3.org/2001/XMLSchema#string>
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