Family History of Cancer? Do You Need BRCA Testing?

A family history of either breast or ovarian cancer may make a person wonder if their chances of getting an inherited type of cancer are higher, and BRCA testing may then be necessary in such cases. BRCA1 and BRCA2 are genes involved in DNA repair that help in DNA restoration, and harmful inherited mutations in these genes can increase the risk.

A genetic test may not necessarily be required if there is a family history of cancer. It will depend on the kind of cancer present in the family, the age at which the cancer was diagnosed, whether several family members have had similar types of cancer and other factors.  In case a person requires a genetic test, LifeCell’s BRCA1 & BRCA2 Gene Analysis_ONCO can be considered.

What Are BRCA1 and BRCA2 Genes?

BRCA1 and BRCA2 are the genes responsible for repairing damaged DNA. Every individual carries two copies of both these genes, which are inherited from their parents. If a person has a harmful alteration in either of these genes, their ability to repair some forms of DNA damage may be hindered, and they may be at risk of developing certain cancers.

The strongest and best-established associations have been observed with breast and ovarian cancer; however, harmful alterations in BRCA1 and BRCA2 may increase the risk of developing other cancers, such as pancreatic cancer and prostate cancer.

It must be noted that having a harmful BRCA variant does not mean that the individual will definitely develop cancer. Rather, it indicates an increased risk of cancer, the extent of which may vary depending on several factors.

When Might BRCA Testing Be Worth Considering?

BRCA testing may be recommended when there are indications of a higher likelihood of an inherited mutation in the BRCA1 or BRCA2 genes based on a person’s personal or family history.

Early-onset breast cancer may be one of the indicators of inherited cancer susceptibility. Personal or family history of early-onset breast cancer, defined as breast cancer diagnosed before the age of 50, is recognised by the National Cancer Institute as an indicator that could suggest an increased likelihood of an inherited BRCA variant.

The degree of relationship between the affected individual and the patient should not be overlooked. Several close family members diagnosed with cancer might provide more convincing evidence of inherited susceptibility than the cancer in a more distant relative.

If there is a pattern of breast cancer, ovarian cancer, or both within a family, then hereditary breast and ovarian cancer syndrome can be suspected. According to the American College of Obstetricians and Gynecologists (ACOG), this syndrome is described as having multiple family members with breast cancer or ovarian cancer, or both.

It is not just about how many family members have had cancer but also how they relate to the patient, their age at diagnosis, and the type of cancer.

What Does a Positive BRCA Test Mean?

A positive test result means a harmful or potentially harmful genetic variant has been found in BRCA1 or BRCA2. This indicates an increased risk of particular types of cancer; however, it does not indicate whether or when an individual will develop cancer.

Large studies of BRCA1 and BRCA2 carriers have shown significant differences in the risk of breast and ovarian cancers compared with the general population. In addition, this research has also shown differences in risk between BRCA1 and BRCA2 carriers.

Therefore, a positive result can provide important information that can help make decisions about future cancer screening and prevention strategies. Healthcare professionals can discuss different approaches with individuals depending on their circumstances including earlier or more frequent screening tests, medicines, or risk-reducing surgeries.

The appropriate approach will depend on the individual case, including the particular genetic alteration, individual and family medical history, and personal preferences.

What If the BRCA Test Is Negative?

A negative test result does not necessarily indicate that a person’s risk for cancer is the same as that of the general population.

If there is a known harmful BRCA variant in the family, and the negative result shows that the patient has not inherited the particular mutation, the test outcome can be considered a true negative for familial mutation. Nevertheless, if there is no known familial mutation, the result may be less informative, as there may be other genetic or non-genetic factors that can contribute to the development of cancer.

This explains why family history continues to be relevant even after negative BRCA testing. A medical practitioner may recommend screening based on the person’s family and personal history.

What Can Families Do with the Results?

The results of the test may have wider implications for family members beyond the individual taking the test. In cases where a mutation is identified in the BRCA1 and BRCA2 genes, other blood relatives might also have a higher likelihood of carrying the same variant.

This may enable them to discuss their risk with a doctor and possibly consider genetic counselling and testing where appropriate.

For individuals seeking a clinically relevant BRCA test, LifeCell’s BRCA1 & BRCA2 Gene Analysis_ONCOmay be one option to consider. However, this decision should not be made only because a member of the family had cancer.

Conclusion

BRCA testing may be beneficial for those individuals whose personal or familial histories suggest an increased likelihood of an inherited alteration in BRCA1 or BRCA2 genes. A family history of breast or ovarian cancer, as well as certain other types of cancer, such as male breast cancer, pancreatic cancer and high-risk prostate cancer, can suggest a need for BRCA Testing.

It should be noted that having a family history of cancer does not necessarily mean that BRCA testing is needed. Genetic counselling can help assess the need for this test and interpret its possible outcomes. A positive test may indicate an inherited increased risk of cancer; however, a negative or inconclusive outcome will require interpretation based on the individual’s broader personal and family medical history.

In this regard, analysing family history and taking professional advice into account may prove to be more helpful than deciding on BRCA testing solely on the basis of family history.