CHEYENNE – Women in Wyoming seeking genetic testing for hereditary breast cancer face significant barriers in a state where screening rates lag far behind the national average.
More than 60% of women who inherit harmful changes in BRCA1 or BRCA2 genes will develop breast cancer during their lifetime, compared to about 13% of women in the general population, according to the National Cancer Institute.
“People know they need to get their screenings, but the hospital may be a hundred miles away. That’s a big deterrent,” said Kelly Morgan, executive director of the Wyoming Breast Cancer Initiative.
Wyoming currently ranks last among all states when it comes to breast cancer screening rates for women over 50, Morgan said.
Mammography prevalence ranges from less than 60% in Wyoming to at least 75% in Massachusetts, Connecticut, Louisiana and Rhode Island, according to the American Cancer Society’s 2024 breast cancer statistics report.
The low screening rates pose particular concerns for genetic testing access. The Wyoming Cancer Program considers women with known BRCA1 or BRCA2 mutations as high-risk and eligible for breast cancer screenings starting at age 18, according to the state Department of Health eligibility guidelines.
Wyoming Medicaid covers BRCA testing when criteria are met, including personal or family history of breast cancer associated with young age of onset, according to state policy documents. The program allows up to 90 minutes of genetic counseling in conjunction with medically necessary BRCA testing.
However, genetic counseling services may only be billed by physicians when the genetic counselor is under physician supervision and is an employee of the physician, as services provided by independent genetic counselors are not a benefit of Wyoming Medicaid.
Women with BRCA mutations face cancer risks far exceeding the general population, with 39% to 58% developing ovarian cancer if they inherit harmful BRCA1 changes and 13% to 29% if they inherit harmful BRCA2 changes, the National Cancer Institute reports.
The 2025 National Comprehensive Cancer Network guidelines recommend genetic testing for anyone diagnosed with breast cancer at age 50 or younger, according to Breastcancer.org. The American Society of Clinical Oncology and the Society of Surgical Oncology issued recommendations in 2024 saying anyone newly diagnosed with breast cancer who is age 65 or younger should be offered BRCA1 and BRCA2 testing.
The Wyoming Breast Cancer Initiative has contributed a million dollars in grant funding over the last eight years to support screenings and awareness events across all 23 counties, Morgan said. The organization partners with the Wyoming Cancer Program to provide a consolidated application for breast cancer screening services.
In 2025, approximately 316,950 women will be diagnosed with invasive breast cancer nationwide, according to breast cancer statistics. About 16% of women with breast cancer are younger than 50 years of age.
Men with harmful inherited changes in BRCA genes should also discuss screening options with their health care providers, the National Cancer Institute advises.
Morgan said her organization hopes to eventually acquire a mobile mammography van to reach people in more rural parts of the state where access remains limited.
