While many US insurance companies will pay for BRCA 1 or BRCA 2 testing in a patient with a family history of breast or ovarian cancer, NPR's Shots blog reports that insurers often "balk at providing coverage" for tests examining other mutations linked to breast or ovarian cancer.
Mutations in BRCA 1 and BRCA 2, NPR notes, are behind about 5 percent to 10 percent of breast cancers and 15 percent of ovarian cancers, and under the Affordable Care Act, insurers will be required to cover such testing. But many more mutations have been implicated in the diseases.
Mary Daly from Fox Chase Cancer Center adds that TP53 mutations can lead to Li-Fraumeni syndrome, which also increases the risk of breast and other cancers, and PTEN mutations also increase disease risk. There are, Daly says, test available for these other, rarer breast cancer mutations but "they often aren't covered by insurance."