Doc critical of genetic testing without counseling

Tracy said some patients with no known risk factors for breast cancer are asking her to test them for mutations in two genes that have been tied to a greater risk of breast and ovarian cancers. Testing for the BRCA1 and BRCA2 mutations, which account for about 5 percent of breast cancers, is considered appropriate for women with a strong family history of breast or ovarian cancer.

Tracy links the rise in concern to a marketing campaign that Myriad Genetics launched in September in Boston, Hartford, Providence and New York. The company makes a blood test called BRACAnalysis that detects the two mutations. She worries that women without the risk factors that make testing feasible are using time with her that could be better spent.

"We spend a lot of time talking about why a test is not appropriate, when I should be talking about quitting smoking or eating a healthy diet," she said.

A spokesman for Myriad disagreed with Tracy on two points. First, William A. Hockett III said, Tracy has confused what his company does with test kits that people can order over the Internet.

"The difference between the types of genetic testing that Tracy is concerned with and what we do is that those tests are offered directly to the consumer and the consumer can receive literature and test kits at home and send it in and get results back," he said. "That is not the case with BRCA 1 or BRCA 2 (testing). It has to be provided by a physican and the patient’s blood is drawn in the physician’s office and the test is sent in by a physician. It requires that informed consent has been performed by the physician or office."

He also said there has been no change in the percentage of negative test results during the campaign.

"If inappropriate patients were being tested, you would expect that rate to go down and fewer patients would be found positive," Hockett said. "We think we are testing appropriately and the percentage of positive tests has not changed during this campaign."