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Illness & Conditions - Medical Care DecisionsBreast Cancer Risk: Should I Have a BRCA Gene Test?You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Breast Cancer Risk: Should I Have a BRCA Gene Test? Get the facts Your options
Key points to remember
FAQs
How do you know if you have a strong family history of breast or ovarian cancer?Your doctor will ask questions about you and your health and about your family's health to see how strong your family history is. If you are thinking about having a gene test, your doctor will send you to a genetic counselor. This expert will help you understand your chances of getting cancer and help you decide whether to be tested. Jewish women are more likely to be BRCA gene carriers. Some experts recommend gene tests for women who are Ashkenazi Jews (Jews whose ancestors came from Eastern Europe) if they have one or both of the following: 1
If you are not Jewish, some experts recommend a gene test if you have one or more of the following: 1
When you and your doctor or counselor have looked at the details of your family history, you will have an idea of how high your risk is. This will help you decide whether to have a BRCA gene test. If you have a family member who has breast or ovarian cancer, think about asking that family member to have a gene test first. If your relative's test shows that she has a changed BRCA gene, that specific change is called a "known mutation." You and other family members can then be tested for that specific gene change. But if your family member's test comes back negative, it is not likely that you carry the gene change. What can you do if your test result is positive?If you test positive for a BRCA gene change, you may face hard decisions about what you should do next. You may have several options that can lower your chances of getting cancer:
Talk with your doctor about which of these options may be best for you. Why might your doctor recommend a gene test?If you have a strong family history of breast or ovarian cancer, your doctor may advise you to talk to a genetic counselor. This expert can help you understand your chances of getting cancer. It will be up to you whether to have the test, but a genetic counselor can help you make a good decision. Compare your options Compare
Have a BRCA gene test
Have a BRCA gene test
Don't have a BRCA gene
test
Don't have a BRCA gene
test
Personal stories Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide. Personal stories about having a gene test for breast and ovarian cancerThese stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. My mother died of ovarian cancer, and I am of Ashkenazi Jewish descent. I want to know if I have inherited a BRCA gene defect, so I am going to have the test. If my test result is positive, I won't hesitate to have surgery to keep from getting either one of these cancers. Fran, age 30 I have some family history of breast cancer, but I'm not going to have a gene test. I know that most people with a family history don't have a BRCA gene defect—they just have a family history. There's a difference. And I don't think I want to live the rest of my life knowing that I have a higher chance of getting cancer than most people. I also heard that having a positive test result on my medical record might affect my rates for life insurance. Callie, age 32 My grandmother died of breast cancer, my mother had breast cancer, and I just finished treatment for my own breast cancer. I'm going to have a gene test, because I want my children to know whether a BRCA gene defect runs in the family. If I test positive, my children and my brother's family will have more information to protect their health. Samantha, age 55 My mother died of breast cancer at 47, so I wanted the test. If it was positive, I was ready to have my breasts and ovaries removed. When I found out my test was negative, my first thought was, "I'm going to live!" But after the counselor explained that my risk for getting breast cancer was still almost 30% due to my family history, I cried all the way home. Having the test didn't erase my worries about getting cancer. All I learned is that I don't have the gene change, and so my daughter won't either. But my sister might, so she will need testing. And I might still get breast cancer, so now I get preventive tests every 6 months. This means cancer is always on my mind. So really, I don't sleep any better at night than I did before. Jane, age 40 What matters most to you? Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to have a breast cancer gene test Reasons not to have a gene test I want to let relatives know if I test positive so that they can think about having the test. If I tested positive, I would not want to tell my relatives. More important Equally important More important
It's important for me to know whether or not I have inherited a BRCA gene defect. I would rather take my chances than know for sure whether I carry the BRCA gene. More important Equally important More important
If I tested positive, I would want to have treatment, such as medicine or surgery, to prevent cancer. I wouldn't take medicine or have surgery, even if I tested positive. More important Equally important More important
I am not worried about how the test results might affect my ability to get life insurance. I am very worried about how the test results might affect my ability to get life insurance. More important Equally important More important
My other important reasons: My other important reasons: More important Equally important More important
Where are you leaning now? Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Having the gene test NOT having the test Leaning toward Undecided Leaning toward
What else do you need to make your decision? Check the facts
1.
If I am at all worried about getting breast cancer, I should have a gene test even if I don't have a strong family history of breast cancer or ovarian cancer.
2.
Even if I have a strong family history of breast or ovarian cancer, there's a good chance that I don't have BRCA gene changes.
3.
If I do have a BRCA gene change, my chances of getting breast or ovarian cancer are higher than normal.
4.
If I test positive for a BRCA gene change, I will face hard decisions about what I should do next.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice? Certainty
1.
How sure do you feel right now about your decision? Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps. Your Summary Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Your decisionNext steps Which way you're leaning How sure you are Your comments
Your knowledge of the factsKey concepts that you understood Key concepts that may need review Getting ready to actPatient choices Credits and ReferencesCredits
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Breast Cancer Risk: Should I Have a BRCA Gene Test?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
1. Get the factsYour options
Key points to remember
FAQs
How do you know if you have a strong family history of breast or ovarian cancer?Your doctor will ask questions about you and your health and about your family's health to see how strong your family history is. If you are thinking about having a gene test, your doctor will send you to a genetic counselor. This expert will help you understand your chances of getting cancer and help you decide whether to be tested. Jewish women are more likely to be BRCA gene carriers. Some experts recommend gene tests for women who are Ashkenazi Jews (Jews whose ancestors came from Eastern Europe) if they have one or both of the following: 1
If you are not Jewish, some experts recommend a gene test if you have one or more of the following: 1
When you and your doctor or counselor have looked at the details of your family history, you will have an idea of how high your risk is. This will help you decide whether to have a BRCA gene test. If you have a family member who has breast or ovarian cancer, think about asking that family member to have a gene test first. If your relative's test shows that she has a changed BRCA gene, that specific change is called a "known mutation." You and other family members can then be tested for that specific gene change. But if your family member's test comes back negative, it is not likely that you carry the gene change. What can you do if your test result is positive?If you test positive for a BRCA gene change, you may face hard decisions about what you should do next. You may have several options that can lower your chances of getting cancer:
Talk with your doctor about which of these options may be best for you. Why might your doctor recommend a gene test?If you have a strong family history of breast or ovarian cancer, your doctor may advise you to talk to a genetic counselor. This expert can help you understand your chances of getting cancer. It will be up to you whether to have the test, but a genetic counselor can help you make a good decision. 2. Compare your options
Personal storiesAre you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide. Personal stories about having a gene test for breast and ovarian cancerThese stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. "My mother died of ovarian cancer, and I am of Ashkenazi Jewish descent. I want to know if I have inherited a BRCA gene defect, so I am going to have the test. If my test result is positive, I won't hesitate to have surgery to keep from getting either one of these cancers." — Fran, age 30 "I have some family history of breast cancer, but I'm not going to have a gene test. I know that most people with a family history don't have a BRCA gene defect—they just have a family history. There's a difference. And I don't think I want to live the rest of my life knowing that I have a higher chance of getting cancer than most people. I also heard that having a positive test result on my medical record might affect my rates for life insurance." — Callie, age 32 "My grandmother died of breast cancer, my mother had breast cancer, and I just finished treatment for my own breast cancer. I'm going to have a gene test, because I want my children to know whether a BRCA gene defect runs in the family. If I test positive, my children and my brother's family will have more information to protect their health." — Samantha, age 55 "My mother died of breast cancer at 47, so I wanted the test. If it was positive, I was ready to have my breasts and ovaries removed. When I found out my test was negative, my first thought was, "I'm going to live!" But after the counselor explained that my risk for getting breast cancer was still almost 30% due to my family history, I cried all the way home. Having the test didn't erase my worries about getting cancer. All I learned is that I don't have the gene change, and so my daughter won't either. But my sister might, so she will need testing. And I might still get breast cancer, so now I get preventive tests every 6 months. This means cancer is always on my mind. So really, I don't sleep any better at night than I did before." — Jane, age 40 3. What matters most to you?Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to have a breast cancer gene test Reasons not to have a gene test I want to let relatives know if I test positive so that they can think about having the test. If I tested positive, I would not want to tell my relatives. More important Equally important More important
It's important for me to know whether or not I have inherited a BRCA gene defect. I would rather take my chances than know for sure whether I carry the BRCA gene. More important Equally important More important
If I tested positive, I would want to have treatment, such as medicine or surgery, to prevent cancer. I wouldn't take medicine or have surgery, even if I tested positive. More important Equally important More important
I am not worried about how the test results might affect my ability to get life insurance. I am very worried about how the test results might affect my ability to get life insurance. More important Equally important More important
My other important reasons: My other important reasons: More important Equally important More important
4. Where are you leaning now?Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Having the gene test NOT having the test Leaning toward Undecided Leaning toward
5. What else do you need to make your decision?Check the facts1. If I am at all worried about getting breast cancer, I should have a gene test even if I don't have a strong family history of breast cancer or ovarian cancer.
You're right. Most women don't need a breast cancer gene test. It is only recommended for women who have a strong family history of breast or ovarian cancer.
2. Even if I have a strong family history of breast or ovarian cancer, there's a good chance that I don't have BRCA gene changes.
You're right. Most women with a family history of breast or ovarian cancer—even a strong family history—don't have BRCA gene changes.
3. If I do have a BRCA gene change, my chances of getting breast or ovarian cancer are higher than normal.
Yes, you're right. Having a BRCA gene change increases your chances of getting breast or ovarian cancer.
4. If I test positive for a BRCA gene change, I will face hard decisions about what I should do next.
That's right. If you test positive, you will have to decide what steps, if any, you want to take to prevent cancer.
Decide what's next1. Do you understand the options available to you? 2. Are you clear about which benefits and side effects matter most to you? 3. Do you have enough support and advice from others to make a choice? Certainty1. How sure do you feel right now about your decision? Not sure at all
Somewhat sure
Very sure
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps. Credits
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version. Last Revised: June 28, 2011 Author: Healthwise Staff Medical Review: Sarah Marshall, MD - Family Medicine & Douglas A. Stewart, MD - Medical Oncology 
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions. To learn more visit Healthwise.org © 1995-2013 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. |
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