BRCA Gene Testing and Ovarian Cancer: What You Need to Know
You may have heard of BRCA genes in discussions about breast cancer. Despite this, many people are unsure of what they do, the role they play in ovarian cancer risk, and whether they should undergo BRCA gene testing.
For some, knowing their BRCA status can help them make informed decisions about screening, prevention, and treatment, if necessary. Here is a brief overview of BRCA gene testing to help you decide if getting tested is the right choice for you.
What is BRCA Gene Testing?
BRCA1 and BRCA2 are genes that help repair damaged DNA and keep cells healthy. Everyone has these genes, but some people inherit a harmful change, or mutation, in one of them. A BRCA gene test looks for these changes.
“A positive result doesn’t mean you have cancer, but it does mean you have a higher chance of developing certain cancers during your lifetime, including ovarian and breast cancer,” explains Samuel Im MD, gynecologic oncologist (GYN/ONC) at PIH Health. “A negative result usually means no harmful BRCA mutation was found, although it doesn't eliminate your overall cancer risk.”
Who Should Consider BRCA Testing?
BRCA testing is most helpful for people who have a higher chance of carrying an inherited mutation. Your healthcare provider may recommend testing if you have:
- A personal history of ovarian, fallopian tube, or primary peritoneal cancer
- A personal history of breast cancer diagnosed at a younger age or certain types of breast cancer
- A close family member with ovarian cancer
- Multiple family members with breast, ovarian, pancreatic, or prostate cancer
- A known BRCA mutation in your family
- Ashkenazi Jewish ancestry along with a personal or family history of these cancers
Your provider may refer you to a genetic counselor before testing. Genetic counselors help explain what the test can and cannot tell you and discuss how the results could affect you and your family.
How Accurate is BRCA Testing?
BRCA testing performed by certified laboratories is highly accurate at identifying known inherited BRCA1 and BRCA2 mutations. But accuracy is only part of the picture.
A positive test cannot predict whether you will develop cancer or when it might happen. Likewise, a negative test does not guarantee you will never develop ovarian or breast cancer. Many cancers are caused by factors other than BRCA mutations.
Sometimes the test finds a "variant of uncertain significance." This means a gene change was found, but experts do not yet know whether it increases cancer risk. In these cases, your healthcare provider and genetic counselor can help determine the next steps.
What Happens When You Have the Results?
If you have a harmful BRCA mutation, your healthcare team may recommend earlier or more frequent cancer screening, as well as medications that reduce cancer risk or preventive surgery in some situations. If you are diagnosed with ovarian cancer, BRCA test results may also help guide treatment decisions.
Your results may also be important for close relatives, since BRCA mutations can be passed from parent to child.
Should You Be Tested?
If you have a personal or family history that suggests an inherited cancer risk, talk with your healthcare provider. They can review your family history, determine whether genetic counseling is appropriate and help you decide if BRCA testing is right for you.
