Nina, a resident of East Baltimore, celebrated her 41st birthday last Sunday. Surrounded by family and friends, she struggled for breath to extinguish the candles on her cake. Two years ago Nina was diagnosed with breast cancer. Genetic testing and prophylaxis might have prevented her illness, but unlike actress Angela Jolie, her financial resources did not allow her to take the $3,400 test. Now Nina suffers from the same disease that took the life of her mother when she was in her 40s, and her older sister, who died at the age of 34 from breast and ovarian cancer. With 11 chemotherapy infusions and two blood transfusions behind her, this wife and mother of two young daughters faces formidable odds. This is the sad result of a biomedical Wild West marketplace fiercely competing for the promise that genomic advances hold for the discovery and development of new therapies.