I have noticed that recently there have been a lot of commercials on television about getting your BRACAnalysis®.  You might be wondering what a BRAC analysis is? Or maybe you are wondering if you should get one?  The BRAC test is a genetic test that will test your genome for the presence of two genes that have been correlated with certain types of breast and ovarian cancer.

Mutations in these genes, known as BRCA1 and BRCA2, are strongly associated with 7% of breast cancers and 11-15% of ovarian cancers (1).  In most people, the BRCA genes are tumor suppressors, meaning they encode proteins that help regulate cell growth.   When these genes are mutated, they can lose their ability to control cell growth, and cancer can thus develop.  However, it is important to realize that not every woman who has a mutated BRCA1 or BRCA2 gene will develop cancer.  About 12% of the general population of women will develop breast cancer; while approximately 60% of women with a BRCA mutation will develop breast cancer.  Similarly, about 1.4% of women will develop ovarian cancer, compared to 15-40% of women with a BRCA mutation.  However, since these two genes are only associated with certain types of breast and ovarian cancer, a negative test (no mutation) does not guarantee that you will not develop cancer at some point in your lifetime (2).

Because the genes are located on the autosomal chromosomes (as opposed to the sex chromosomes), the mutation can be inherited from either your mother or your father.  Most women who decide to undergo genetic BRCA testing have a family history of breast or ovarian cancer.  However, there are no current medical guidelines for recommending BRCA tests.   Also, having a family member with the mutation does not necessarily mean you will have it to.  Once a woman tests positive for either BRCA1 or BRCA2, she has several options to help reduce her risk.  The most conservative options would be to monitor the breast and ovarian tissue with frequent screenings such as mammography or ultrasound.  More drastic options include removing the breast tissue and/or ovaries before cancer has a chance to develop, or taking chemotherapeutic drugs to help prevent cancer (clinical trials have demonstrated some success of these drugs in prevention of breast cancer).

A BRAC analysis test usually involves collection of a blood sample, and could cost you anywhere from several hundred to several thousand dollars, and it may not be covered by your insurance company.  The good news however, is that the Genetic Information Nondiscrimination Act of 2008 prevents discrimination from insurance companies or employers against people who have undergone genetic testing.  With personalized medicine on the rise, many individuals are concerned that their genetic information might be sold to employers and insurance providers and used to exclude them from employment or health coverage.  This law is meant to protect an individual’s right to privacy with his or her genetic information.

Ultimately it is your decision if you would like to undergo genetic testing.  It is important, however, to think about the emotional stress of undergoing such a test and receiving your results.  You might want to think beforehand about what you would do with the information.  If your test is positive, would you elect for preventative surgery?  Will your insurance cover early screening if you think you need it?  Knowing your risk can be both empowering and daunting.  I recently watched a wonderful documentary by filmmaker Joanna Rudnick, titled In the Family, that explores her own emotional struggle with genetic testing for breast and ovarian cancer.  View the trailer below:

To learn more about the film click here.

1.  Claus EB, Schildkrauten JM, Thompson WD, Risch NJ, et al. The genetic attributable risk of breast and ovarian cancer. Cancer. 1996;77:2318-2324.

2.  National Cancer Institute Fact Sheet on BRCA1 and BRCA 2. http://www.cancer.gov/templates/doc.aspx?viewid=ABCB7812-A132-4E78-A532-F002C92FA9B9

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Comments

Thanks for the article. We definitely need come together and help to find a cure for breast cancer. I have known so many women who have this awful disease and some who are not with us anymore. Lets Fight Against Breast Cancer! -kelly

Our public really needs to understand this topic better. Good work in writing this article!

Great article. Just came across it when researching similar topics and thought I would commend you for writing an easy to understand article on this topic.

Good information about the BRAC testing. And thnnks for emphasizing that genetic predisposition does not necessarily lead to actual manifestation of the disease. I think being able to handle the information resulting from a positive test would be a prerequisite of some sort. Emotional stress in itself could be an aggravating factor, from what little I understand about epigenetics.

I would be very cautious about getting a test like this done. Our thoughts and feelings have a great impact on our cells and genes. I would think that if you found out that you had a mutated BRCA1 or BRCA2 gene, you could end up making yourself sick from worry.

This is great news for women! Isolating this particular genome really is a step in the right direction & we can only hope that one day all significant genes will be identified for preliminary testing. Even tho the test may cost you a few thousand dollars, you really can't put a price on early detection & a chance to undertake preventative measures. I think this is a positive break through & hope to see more like it over the next few years.

Genetic predisposition does not necessarily lead to actual manifestation of the disease. I understand about the epigenetics that the Emotional stress in itself could be an aggravating factor.

Getting these tests can be scary but it is definitely a good idea for everyone.

Although I think there are many advantages to testing for predisposition to certain types of illnesses, I think the emotional toll would potentially out weigh the benefits of such a test. Don't get me wrong, I think insurance companies, doctors, and most health related fields would benefit from having access to such markers we as individuals would potentially have less fulfilling lives as a result of having access to such information.

does anti cancer supplements and diets will prevent this cells to mutate? is it possible to detect this genetic defects during pregnancy? or newly wed should be undergo test if they have these genes before getting to have a baby?

With great power comes great responsibility. The BRAC test can indeed provide a predisposition toward a disease that too many families are dealing with. The question becomes... Where does it stop? Once the case for genetic testing becomes the norm, then the case for using the results to discriminate will also become an accepted practice. Not only health insurance and life insurance companies will have an interest in this but future employers may also jump on this bandwagon. James

Genetic counseling is critical before any DNA testing is actually done. All patients undergo need to undergo some pre-testing with the genetic counseling. This involves the assessment of the personal information of the patient as well as the medical history of the family. It also includes some cancer education as well as discussing the risks, limitations of the test, as well as the benefit. For example a family history of cancer at an early age, or incidents of ovarian cancer and/or breast cancer in the genetic gene pool makes you at higher risk then others and it is more likely that the testing will be conducted. If you carry a mutation of the BRCA1 or BRCA2 gene you are at a higher risk of developing breast cancer. If you test negative then you are at no greater risk than any other women even if you have had family members with breast cancer.

First of all everyone should be aware of breast cancer. Isolating a particular genome really is a good step in a right direction. Without risk nobody can get a good result. Good article on Genetic Testing for Cancer for a good cause and better solution.

Very good post. The public needs awareness like this. Great information and details.

People should be more careful when relying solely on the BRAC results. I sent my DNA to three different testing centres and although two gave me the same outcome one was completely different from the other two.

We are starting to see life insurance companies attempt to screen for genetic predisposition for certain cancers in women.

I have always wondered about BRAC analysis. Although there doesn't seem to genetic genes in our family linked to cancer, this sounds like a good way for other people who may have cancer in their family to determine what kind of risk they are at.

There is federal legislation that has been passed that prohibits discrimination based on genetics. If anyone comes across this they should remind their insurance companies. Unfortunately, some self-insured companies are except from federal laws. I would suggest checking the exact language of these laws.

The Genetic Information Nondiscrimination Act (Pub.L. 110-233), signed into law in May 2008, also prohibits health insurers from denying coverage or setting rates based on a person's genetic makeup, such as a predisposition to a disease.

I agree that the emotional stress of a BRAC test can be significant. How are you going to feel if you test positive. Are you going to think you are 100% safe if you test negative. There are many layers to this onion.

Even if some emotional stress is involved, still it is worth it to have the test if you have any suspicion of the breast or ovarian cancer.

Thanks for the great post! Have an awesome day!

Thanks for your article but mammograms and check breasts.if you doing all of these things gives you the best chance to find cancer as early as you can. I just linked this from my blog because I want my members to read this.

Thanks for your article about mammograms and check breasts.if you doing all of these things gives you the best chance to find cancer as early as you can. I just linked this from my blog because I want my members to read this.

When it comes to heath you really shouldn't play around. Women should do this test and be sure they are all right. Thanks for a great post!

I have been diagnosed with bowel cancer at 30 yrs old, although cancer is in my family I never realised how at risk I was, I had my operation to remove the tumor and now about to undergo 6 months of chemotherapy, due to my age and the rareness of someone my age having this they are looking into it being hereditary which means my two young children may also be at risk, I had symptoms for 3 years and just dismissed them instead of getting checked! There is not enough awareness of the symptoms cancer causes to rise alarm for people to get seen too early enough!

I recently came across your blog and have been reading along. And i think you have great job to writing this article. Keep writing and sharing about anything. Thanks.

Even if some emotional stress is involved, still it is worth it to have the test if you have any suspicion of the breast or ovarian cancer.

I have known women who have this braca1 and braca2 gene. One lady had surgery before it was to late as when they opened her up it had just started into cancer. She was lucky. I know the tests are expensive but can save your life.

The selling of genetic information to employers and insurance providers is something that has concerned me for a long time. It is reassuring to hear that the Genetic Information Nondiscrimination Act prevents discrimination from insurance companies or employers against people who have undergone genetic testing. Having a number of illnesses I’ve always found it difficult to get travel insurance with medical conditions. If insurance companies could readily get their hands of this kind of infomation teh cost of life or travel insurance or I suppose any kind of insurance would sky rocket. That is if you could even get it. Thanks for that.

Nice presentation of information and I love the way it was delivered to the readers. I think all people around the world must read this article since they can get lots of relevant information that they can use to cure or even prevent the deadliest sickness, the cancer.

"The BRAC test is a genetic test that will test your genome for the presence of two genes that have been correlated with certain types of breast and ovarian cancer". Is it hurt to take the Brac test? EDITOR's COMMENT: They just take a blood sample and collect your medical history.

Good information, very useful post. Thanks for sharing this. I definitely learned something valuable for curing and preventing the worlds deadliest enemy "cancer".Must bookmark this blog so that I could come back for more future readings.

"Ultimately it is your decision if you would like to undergo genetic testing. It is important, however, to think about the emotional stress of undergoing such a test and receiving your results" I had not thought of the emotional side of test. thanks for the info.

Lost my mother many years ago, long before this type of testing. A double mastectomy bought her 2 years, but genetic testing may have prevented her early death. Thanks for sharing this.

Once we know the genes that help certain diseases, com act? I think right now we are not applying knowledge to take advantage and benefit mankind.

Genetic testing for cancer is very risky if there is a history of malignancy. This is really a valuable post.

Very Good and useful information about cancer. Thanks for sharing this. Have to bookmark this blog, that I could come back in the near future

Hi, I lost my grandmother about 10 years ago. There is a history of cancer in my family and this information is really valuable as far as my position now. Thanks for the post.

It is very common that most people think that only breast cancer affects women, but there is a large percentage of the male population that suffers from this type of cancer, then every man should assess at any time of the year if they suffer from this type of cancer EDITOR'S NOTE; Latest stats indicate that less than 1% of breast cancer is in men...but that still accounts for 2000 cases a year in the U.S and 450 deaths.

hi, i Am 21 year old,there is no history opf cancer in our family so shuold i go for genetic cancer check up or not....sorry for bad english

I am very interested in your topic about but "Genetic Testing for Cancer: Knowing Your Risk" I merely desired to throw a big thanks! We actually discovered this on google, and im happy I did so. Ill definitely be finding its way back. Thank you for sharing

Thanks for sharing this information. I learned a lot from your post. I wasn't having any knowledge regarding it. I will also go through genetic testing. Great work!

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