Genetic Testing for Women at Risk of Cancer In her thoughtful article about her choice to undergo a double mastectomy, Angelina Jolie said the cost of genetic testing for BRCA1 and BRCA2 mutations "remains an obstacle for many women" ("My Medical Choice," Op-Ed, May 14). Our BRACAnalysis test has been used by more than a million women to assess their risk of hereditary breast and ovarian cancer. The test remains widely reimbursed by insurance companies, with more than 95 percent of at-risk women covered and with an average out-of-pocket cost of about $100. And, thanks to preventive care provisions in the Affordable Care Act, many patients can receive BRACAnalysis testing with no out-of-pocket costs. For patients in need, Myriad offers a patient assistance program that offers testing at reduced costs or free of charge. PETER MELDRUM President and Chief Executive Myriad Genetics Salt Lake City, May 16, 2013 "Jolie's Disclosure of Preventive Mastectomy Highlights Dilemma" (front page, May 15) discusses Angelina Jolie's decision to undergo prophylactic surgery after testing positive for a BRCA1 mutation. It should be noted that not all hereditary breast and ovarian cancer is attributable to mutations in BRCA1 and BRCA2. An alternative dilemma exists when a patient has a very strong family history of breast and ovarian cancer, especially diagnosed at young ages, and the BRCA test is negative. The patient is left wondering what to do next. These patients should consider a new method of testing for multiple genetic mutations via next-generation sequencing, which can often be ordered as part of a research protocol in academic centers. The writer, a clinical geneticist, is director of reproductive genetics at Montefiore Medical Center and an associate professor at Albert Einstein College of Medicine.