"You only test for these genes that we know of today," he said, "but there are genes that can increase the risk for that patient to develop cancer that we don't know about but we will in the years to come."
Most health insurance plans will pay part of the cost for genetic testing and mastectomy, Kusminsky said. By law, health insurance companies cannot discriminate against customers based on genetic testing, but life insurance companies are not bound by the same law.
He tells patients, "If you are planning to get life insurance, get it now or you will be compromised because of the results of this test."
Hereditary cancers are rare, but the chances of getting breast cancer can increase dramatically for someone with the faulty gene. A patient with the gene mutation has a chance of breast cancer that's as high as 87 percent, he said.
Medication can cut a patient's chances of cancer by up to 50 percent, he said, while a double mastectomy can cut those chances by 90 percent.
For the women who opt to have a preventative mastectomy, breast-reconstruction surgery has come a long way in the past few decades, said Dr. Abdalla Bandak, a Charleston plastic surgeon. Reconstruction can be done at the same time the patient has the mastectomy.
In the 1970s, when surgeons did mastectomies, they would not immediately do the reconstructions, Bandak said. The thinking was that women wouldn't be pleased with the results of reconstruction and that if they saw themselves after their mastectomies, but before reconstruction, they would be more satisfied with the reconstruction, he said.
Today, surgeons performing mastectomies can save the skin, Bandak said. Women can opt to get implants or use tissue from cadavers or from elsewhere on their bodies to fill in the breasts.
Bandak said he has practiced plastic surgery for 18 years. In his roughly seven years in West Virginia, he's probably done reconstructions for preventative double mastectomy twice in patients that didn't have cancer. He said he also performed the surgery twice in Virginia, when he practiced there.
The procedures women choose to have can determine what their bodies look like after surgery, he said. Most women look better if they keep their own skin and if they use their own tissue, rather than implants, he said.
"It seems to be that women are getting more educated, they have more access to the Internet," Bandak said. "They see what's available and ask their surgeons for that procedure."
Reach Lori Kersey at lori.ker...@wvgazette.com or 304-348-1240.