Frequently Asked Questions for BRCA1 and BRCA2 Genetic Testing by Individuals with a relative has a BRCA1/BRCA2 mutation (is “BRCA--positive”). This means he or she has a higher chance of developing certain cancers.

What are the chances of developing cancer for a BRCA-­positive person?

What is my chance of having the gene mutation?

What are my options if I learn that I have an increased chance of cancer?

How much will the test cost? Will my insurance cover it?

What about insurance discrimination because of genetic testing results?

Where do I get genetic testing, or find out more about genetic testing?

Your relative recently had genetic testing and found that he or she has a BRCA1/BRCA2 mutation (is “BRCA--‐positive”). This means he or she has a higher chance of developing certain cancers.

Q: What are the chances of developing cancer for a BRCA-­positive person?

A: A woman with a BRCA1 or BRCA2 mutation has a 50--‐85% chance of developing breast cancer by the age of 70, compared to a 12% chance in the average woman.

A woman with a BRCA1 mutation has a 20--‐50% chance of developing ovarian cancer by the age of 70, and a woman with a BRCA2 mutation has a 10--‐30% chance. The average woman has a 1.5% chance of developing ovarian cancer by that age.

A man with a BRCA1 or BRCA2 mutation has a 5--‐10% chance of developing male breast cancer. BRCA--‐positive men may develop prostate cancer at earlier than average ages. Other cancers seen, particularly in people with BRCA2 mutations, are pancreatic cancer and melanoma.

To read more about cancer risks related to a BRCA1 or BRCA2 mutation go to Cancer Risks in HBOC.

Q: What is my chance of having the gene mutation?

A: Your chance of having the gene mutation depends on many things, including how you are related to the family member who is positive for a mutation in their BRCA1 or BRCA2, and your personal and family history. The best way to determine your chance is to see a genetic counselor. He or she can educate you on hereditary cancer and evaluate your family history and medical records, at which point you can decide whether or not to pursue genetic testing. Hereditary Breast and Ovarian Cancer Syndrome is inherited in an autosomal dominant manner. To learn more about what autosomal dominant inheritance is go to Genetics 101 and scroll down to Patterns of Inheritance section. If a first degree relative (mother, father, brother, sister, child) has the BRCA1 or BRCA2 gene mutation then you have a 50% of carrying the same gene mutation.

Q: What are my options if I learn that I have an increased chance of cancer?

A: There are a variety of options available to people who have an increased chance of cancer based on their family history or genetic testing results. These include increased surveillance, medications which decrease the risk of cancer, and risk--‐reducing surgery. All of these options are usually discussed in detail at your initial genetic counseling session. To learn more about these options go to Managing HBOC.

Q: Will my insurance cover the cost of genetic testing for the BRCA1 and BRCA2 genes?

A: Many insurance companies will partially or fully cover genetic counseling and testing. Genetics testing can cost any where from $200 to $1000's depending on the test ordered. Different insurance companies have different criteria for genetics testing. Before you meet with a genetics professional you should check with your insurance company to confirm that they cover genetic testing and genetic counseling. Contact your genetics professional if you need the CPT codes more specific information.

Q: What about insurance discrimination because of genetic testing results?

A: The Genetic Information Nondiscrimination Act (GINA) passed by Congress prevents health insurers from using genetic testing results to discriminate against individuals. This means that a health insurer in the United States cannot raise your rates or deny you coverage based on the results of genetic testing. Note that GINA does not apply to long--‐term care insurance, disability insurance, or life insurance. To read more about GINA and laws against insurance discrimination go to Genetic Testing, Insurance and Privacy.

Q: Where do I get genetic testing, or find out more about genetic testing?

A: Where possible, we have provided your relative with information or a pamphlet about this type of genetic testing, as well as contact information for a genetic counselor for you. There are several websites you can use to look up a genetic counselor near you:

National Society of Genetic Counselors --‐ http://www.nsgc.org (click on Find a Counselor)

National Cancer Institute Directory --‐ http://www.cancer.gov/search/genetics_services

GeneTests Clinic Directory --‐ http://www.genetests.com (click on Clinic Directory)