Interview with Dr. Gina Campbell, Board-Certified OB/GYN and Myriad Genetics Leader

Dr. Thais Aliabadi and Mary Alice Haney sat down with Dr. Gina Campbell to unpack something many of us know by name but don’t fully understand: genetic testing for hereditary cancer risk. Dr. Campbell blends deep clinical experience as an OB/GYN with business and policy insight from time at MIT and major health insurers. Today, she helps lead patient access and clinical strategy at Myriad Genetics. What follows is a practical, clinician-forward conversation about who should be tested, how tests like MyRisk work, what results actually mean, and how to use genetic information to lower cancer risk for you and your family.

Table of Contents

• About Dr. Campbell — from the clinic to precision medicine
• Why genetics matters in women’s health
• Who should get genetic testing?
• Understanding the MyRisk test and the risk score
• What happens if a test detects a mutation?
• Screening and prevention thresholds
• Why genetic tests can be negative even with many cancers in the family
• Lifestyle factors and prevention
• Privacy, data, and collective benefit
• Real-world impact: stories that illustrate why testing matters
• The future of genetic testing and precision medicine
• Practical advice: How to work the system
• Common misconceptions and clarifications
• Short checklist: steps to take if you’re thinking about testing
• FAQ
• Final thoughts and encouragement

About Dr. Campbell — from the clinic to precision medicine

How did your career move from being an OB/GYN to health policy and genetics?

We left active clinical practice after about a decade for personal reasons, but maintained a strong commitment to women’s health. Working with insurance organizations opened our eyes to how payer decisions shape care, for better and worse. That experience revealed a persistent divide: business leaders made system-level decisions, and clinicians executed them, but few people bridged both worlds.

We returned for an MBA at MIT to learn how to fuse clinical and business thinking. That combination—clinical credibility plus systems strategy—led directly to roles where we could affect access to genomic medicine at scale. That is what brought us to Myriad: to help make precision medicine practical and equitable for patients.

Why genetics matters in women’s health

Were you interested in genetics before joining Myriad, and why does it matter so much in women’s health?

Yes. In obstetrics and gynecology, cancers such as breast and ovarian cancer are central concerns. Those cancers have a substantial hereditary component. Even in routine practice, we encounter screening decisions and risk questions that link directly back to genetics. While serving as a medical director reviewing genetic test prior authorizations, we developed subject-matter expertise and began teaching clinicians how to evaluate and deploy genetic testing thoughtfully.

People often think “BRCA positive or negative” is the whole story. Is that true?

Not at all. BRCA1 and BRCA2 are two well-known genes, but the clinical landscape is broader. The MyRisk test screens 48 cancer-associated genes; roughly 11 of those are directly linked to breast cancer risk. Limiting a conversation to BRCA misses many important mutations, plus it ignores the powerful role of calculated risk scores that combine genetics with personal and family history.

Who should get genetic testing?

Who qualifies for a hereditary cancer test like MyRisk?

Insurance typically covers testing for people who meet specific clinical criteria. Those criteria come from curated guidelines like NCCN. They are intentionally comprehensive but can be extremely complex to parse alone. In practice, a healthcare provider should help you determine your qualification.

As a rule of thumb, testing becomes likely to be covered if you have:

• Breast cancer in a relative under age 50
• Any family history of ovarian cancer
• Pancreatic cancer or certain aggressive prostate cancers in first-degree relatives
• Multiple relatives on the same side with cancer diagnoses (patterns matter)
• A personal history of young-onset cancers or atypical pathology on biopsy

Even if you do not meet strict criteria, there are options: Myriad and other providers work to make testing affordable when insurance won’t cover it. If you have concerns—especially after a relative is diagnosed—we recommend discussing testing with your clinician and asking them to evaluate your eligibility.

What if I’m adopted, or I don’t have a clear family history?

When family history is limited, genetics becomes even more valuable. For patients who are adopted, or whose relatives are deceased or unknown, we counsel based on personal risk and often recommend testing if it’s affordable. Some insurers do cover testing for adopted patients or those with limited family history, but policies vary. We encourage people in this situation to talk to a provider about coverage and financial assistance programs tied to clinical labs.

Understanding the MyRisk test and the risk score

What exactly does the MyRisk hereditary cancer test measure?

Myriad’s MyRisk performs three complementary functions in a single assessment:

1. It sequences 48 genes known to increase hereditary cancer risk. Eleven of those genes are linked to breast cancer risk, including BRCA1, BRCA2, PALB2, CHEK2, and others.
2. It calculates a clinical risk estimate using established tools—commonly the Tyrer-Cuzick model—based on personal factors like age, reproductive history, breast density, family history, ancestry, and hormonal factors.
3. It computes a polygenic or genomic risk component from many small DNA markers that individually have a minor impact but together modify risk.

The output is a consolidated risk score that gives both a 5-year risk estimate and a lifetime risk percentage. That combined score can materially change clinical recommendations compared with using the clinical model alone.

How does the combined risk score change care?

Two patients with identical family histories and clinical features could have notably different combined risk scores because of their polygenic markers. For example, a patient with a Tyrer-Cuzick lifetime risk of 22 percent might see a MyRisk score of 37 percent after the genomic contribution is included. Crossing a risk threshold changes recommended screening and prevention strategies.

What happens if a test detects a mutation?

If my test shows a pathogenic mutation such as BRCA1, what comes next?

First, we emphasize interpretation and counseling. Myriad and many clinical practices provide pre- and post-test genetic counseling. The key is to use the result, not to be paralyzed by it.

Action steps commonly include:

• Enhanced screening: start earlier and use more sensitive modalities. For many high-penetrance genes, screening begins around age 25 and may include annual MRI in addition to mammography and ultrasound.
• Risk-reducing medical therapy: medications such as tamoxifen or aromatase inhibitors can reduce breast cancer risk in some high-risk women.
• Risk-reducing surgery: prophylactic mastectomy and salpingo-oophorectomy (removal of ovaries and fallopian tubes) are choices some patients make, particularly when risks are high and childbearing is complete.
• Family cascade testing: relatives often have a 50 percent chance of carrying an autosomal dominant mutation. Identifying a mutation in one person can trigger testing and prevention for many family members.

People sometimes say they don’t want to know because they’d rather not live with the anxiety. How do you counsel that concern?

We explain it with a simple analogy: if there were smoke behind a curtain and children in the room, wouldn’t you look? Genetic testing is the same. Knowing a risk lets us intervene. Discovering a mutation is not a death sentence; it creates opportunities to reduce risk through screening, surgery, medications, and lifestyle changes.

“Knowledge is power.”

Screening and prevention thresholds

At what age should people consider genetic testing, and when does screening change?

We typically recommend testing around age 25 for patients at elevated hereditary risk because screening and risk-reduction decisions often start in the mid-20s for certain genes. For the general population, standard mammography screening historically begins around age 40, but genetic information changes that:

• If you carry a high-penetrance mutation, imaging often begins as early as age 25 and includes MRI.
• If your combined risk score is 20 percent lifetime risk or higher, enhanced screening may start around age 30—including mammogram, ultrasound, and alternating annual MRI.
• If your risk is low and you have no family history, you may follow routine screening guidelines, which usually start at age 40 or 10 years earlier than the youngest affected relative.

In our practice, we often obtain a baseline mammogram and ultrasound at age 35, even for women considered low risk. That early baseline can help catch otherwise missed disease and establish a comparative starting point for future imaging.

Why genetic tests can be negative even with many cancers in the family

We’ve seen families with multiple cancers but negative genetic panel results. How can that be?

Panels detect mutations we already know about. Many hereditary mechanisms remain undiscovered. A negative panel means negative for the genes tested, not negative for all possible genetic risk. If family clustering of cancer exists despite a negative panel, we still take it seriously: enhanced screening and risk-reduction measures may still be appropriate.

Lifestyle factors and prevention

Beyond genes, what are modifiable risk factors that matter most?

Lifestyle matters. One of the strongest modifiable risk factors for breast cancer is alcohol. Studies associate alcohol with an increased breast cancer risk, and the relationship is dose-dependent. Current guidelines often suggest limiting alcohol to no more than one standard drink per day for women, but emerging data favors even lower intake. We encourage patients to minimize alcohol because it is one of the most modifiable risk factors.

Privacy, data, and collective benefit

Many people worry about genetic data privacy. How do you think about that?

Concerns about genetic privacy are understandable. Reputable clinical labs adhere to strict privacy standards and legal protections. From our perspective, responsibly accrued genomic data generates enormous collective value: better risk models, more precise preventive strategies, and improved detection for future patients. That aggregated knowledge is what allows tools like combined risk scores to evolve and become more accurate.

Real-world impact: stories that illustrate why testing matters

Can genetic testing truly change outcomes for families?

Yes. We’ve seen multiple examples where a single test changed the trajectory for a whole family.

One patient did not meet traditional criteria but advocated to be tested. She had BRCA1. Her aunt, after testing, underwent an evaluation that found an early-stage ovarian cancer that was treated successfully. Another time, we overheard someone at a social event mention a relative with pancreatic cancer. We encouraged testing; it turned out that many members of that family carried a BRCA mutation. Identifying those carriers allowed surveillance and prevention measures that likely saved lives.

The future of genetic testing and precision medicine

Where is genetic testing headed?

We expect several converging trends:

• Wider access early in life, possibly making family history less of a gatekeeper for testing.
• Improved polygenic risk models and AI-driven risk stratification that blend genetics, imaging, and clinical data.
• Lower costs and better insurance coverage as the clinical utility of testing becomes clearer and more standardized.
• More personalized prevention pathways tailored to an individual’s genetic and environmental risk profile.

Spontaneous mutations and unknown ancestry make family history an imperfect proxy for genetic risk. As testing becomes more affordable and better integrated into care, we hope to move beyond family history as the primary trigger for testing.

Practical advice: How to work the system

What specific advice do you give patients who want to use their insurance wisely and get comprehensive care?

Be proactive. Use your insurance—it’s there for prevention as well as treatment. We recommend breaking up the well-woman checklist into multiple focused visits rather than trying to cover everything in a single annual exam. For example:

• One visit dedicated to family history and genetic testing discussion
• One visit for cervical screening, contraception, or Pap-related matters
• Separate visits for menopause, bone health, hormonal therapy, or other concerns

This approach helps you get focused attention and allows providers to spend the needed time without squeezing everything into one appointment. If you aren’t satisfied with a clinician, keep looking. Find someone who listens and takes your concerns seriously.

If someone wants to take the MyRisk test, how do they start?

Begin by documenting your family health history. Holidays and family gatherings can be good opportunities to ask relatives specific questions about cancer type and age at diagnosis. Then visit getmyrisk.com for resources and to see if you meet testing criteria. Talk to your clinician about coverage, counseling, and next steps. Labs and manufacturers often provide patient assistance to make testing affordable if insurance does not cover it.

Common misconceptions and clarifications

What is the biggest misconception about genetic testing for cancer?

People often think testing is a prediction of inevitable cancer. That is inaccurate. Genes interact with the environment. Inherited mutations raise risk but do not guarantee disease. Crucially, knowing about an increased risk enables concrete actions—earlier and more sensitive screening, preventive medications, or surgery—that can substantially lower cancer incidence and mortality.

Short checklist: steps to take if you’re thinking about testing

• Collect family cancer history: types of cancer, ages at diagnosis, number of relatives affected, and which side of the family.
• Make a focused appointment with your clinician to discuss genetic testing specifically. Ask for the visit to be with the clinician, not delegated.
• Use getmyrisk.com for an initial self-assessment and to learn about MyRisk features and counseling options.
• If you test positive, involve genetic counselors and discuss cascade testing for relatives.
• Discuss lifestyle modifications—especially alcohol reduction—and prevention strategies appropriate to your risk profile.

FAQs

At what age should I get genetic testing?

For most hereditary cancer syndromes, testing around age 25 is reasonable if you have an elevated family or clinical risk. For people without major risk signals, testing timing depends on personal preference, family planning goals, and clinical context. Discuss timing with your clinician.

Does insurance cover MyRisk testing?

Many insurers cover hereditary cancer testing when a patient meets established clinical criteria, which can be complex. If you don’t meet the criteria, labs often offer financial assistance or self-pay options. Talk to your provider and the lab’s patient support team for help.

If I test positive, do my children and siblings automatically have the gene?

For many high-penetrance mutations, inheritance is autosomal dominant. That means a biological parent who carries the mutation has a 50 percent chance of passing it to each child. Siblings of a positive person also have a 50 percent chance of being carriers. Cascade testing through relatives is essential.

Can a negative test be reassuring if many family members had cancer?

A negative result means you do not have the mutations tested for. It does not rule out hereditary risk from unknown genes or non-genetic causes for family clustering. Families with multiple cancers may still warrant enhanced screening. Clinical context and family history remain important.

Is my genetic data safe?

Reputable clinical laboratories follow legal and ethical standards for handling genetic data, including HIPAA and company-specific privacy protections. Weigh privacy concerns, but also consider the public health value of aggregated, de-identified data that improves risk models. Ask your testing provider about their privacy practices if you have concerns.

What does the MyRisk score actually change in my care?

The combined MyRisk score can alter screening age and frequency. A lifetime risk of 20 percent or higher typically prompts earlier and more intensive imaging, such as starting at age 30 and including annual MRI. A pathogenic mutation often triggers screening and risk-reduction strategies starting around age 25.

Can men take the MyRisk test?

Yes. Men can carry and pass on hereditary cancer mutations such as BRCA. Some mutations increase male cancer risks, too; for example, certain BRCA2 mutations increase prostate cancer risk. Testing provides actionable information for men and their families.

Final thoughts and encouragement

We want to leave you with three practical takeaways:

1. Document your family cancer history and revisit it annually. Small changes in family health can shift your risk category.
2. Be proactive with your care: schedule problem-focused visits for family history and genetic counseling, and advocate for the time and attention needed to review your risk.
3. Understand that testing is empowering. It gives you options—screening, medical prevention, and surgery—that reduce the chance that you or those you love will be diagnosed late.

If you are ready to explore testing, start by collecting family history and visiting getmyrisk.com for guidance about eligibility and next steps. The combination of genetics, better risk models, and thoughtful prevention is transforming cancer care from reactive to proactive, and we should all feel empowered to participate.

This article was created from the video Unlock Your Cancer Risk: MyRisk® Test Reveals What You Need to Know ft. Dr. Campbell | SHE MD for Dr. Thais Aliabadi’s website.