WASHINGTON, DC (WUSA9) -- Angelina Jolie probably didn't worry about the costs of testing or surgery. But many women do.
The prices for preventive mastectomy are all over the place. Several local hospitals declined to even answer questions about the costs.
But if you have insurance, the good news is more and more plans are covering both genetic testing and preventative surgery for women at high risk of breast cancer.
"It's not as scary as being diagnosed with breast cancer," says Beth Peshkin, who has counseled scores of women with the defective BRCA1 gene at Georgetown- Lombardi Comprehensive Cancer Center. "The testing is not cheap. And as many people have heard, there is one lab (Myriad Genetics) in Salt Lake City that holds the patent, and they control the price."
For a comprehensive BRCA analysis, that price is $3,340. But if you have a family history, that narrows the search and lowers the price to $475.
The Affordable Care Act now requires insurance companies to pay for testing for high risk patients. But you have to have insurance -- and risk factors. "It's not a guarantee that if someone wants testing that they'll be able to access it," says Peshkin.
Then if women make the same decision as Jolie and decide on prophylactic mastectomy, there's the cost of surgery. At breastcancer.org, women complain that the cost can run from $14,000 to $100,000 with reconstruction to $300,000 with complications. And even women with insurance said their co-pays and deductables cost them tens of thousands.
"And it's also the time away from work, childcare expenses, rehabilitation. So it is not a simple proposition," says genetics counselor Peshkin.
There all all kinds of choices here. Test or no test. Mastectomy or intensive screening, MRI, risk-reducing meds like Tamoxifen.
But Jolie has helped start a national dialogue -- and empowered people to decide the best course for them.