BRCA testing: What, Why & How

Why test for BRCA?

BRCA carriers can manage their risk of developing cancer, but only if they are aware of their status.

Therefore, those at increased risk of being a carrier, like individuals with Jewish ancestry, may wish to undergo BRCA testing.

Testing involves having a sample of either saliva or blood taken. This is then sent to the lab where DNA is extracted and checked for faults in either the BRCA1 or BRCA2 gene. All responsible BRCA testing should involve both pre and post-test genetic counselling too. 

BRCA testing is something important for both men and women to consider. It is a misconception that BRCA is a female-only issue. Male BRCA carriers have increased cancer risk, just like women. Also, male carriers have a 50% chance with each child of passing on their BRCA mutation. This applies to both male and female children alike.

What to consider before testing?

Whether to get tested is a big decision and entirely personal. Anyone who is considering BRCA testing must undergo responsible genetic counselling before making a decision. Factors to consider and discuss with a genetic counsellor are

  • Potential options if found to be a carrier
  • Whether the timing is right for you to take a test
  • What a positive would mean to you and how it may impact you emotionally
  • How a positive result would impact your relatives
  • What a positive result would mean if you are planning a family

How to get BRCA testing

The current options for BRCA testing in the UK are either:

  1. NHS BRCA Testing
    The NHS currently offers BRCA testing for Jewish people who fit their eligibility criteria (read more below). At the moment, this means that not everyone with Jewish origin is able to access NHS BRCA testing.

However, from early 2023, NHS England plan to allow anyone with at least one Jewish grandparent to be tested. If you want us to notify you when this service is available, please complete this form and we will be in touch.

  1. Private testing for BRCA
    There are private options for those who do not fit the NHS criteria and do not want to wait until the new NHS service in early 2023. Several private BRCA testing services are available to people living in the UK. These vary greatly in the cost and services that they provide. If opting for private testing, we strongly recommend using a service that includes genetic counselling.
     
    Please contact Jnetics on 020 8123 5123 or info@jnetics.org if you would like to be signposted to a private consultant or a private service provider. 

Current eligibility for NHS BRCA testing

In general, you are eligible for BRCA testing if you are classified as having a 10% or greater chance of carrying a BRCA mutation.

The following factors are likely to determine whether you are eligible:

  • Your age
  • Whether you currently have or have previously had breast, ovarian or prostate cancer
  • If you know that a close blood relative is BRCA positive
  • If you have a strong family history of breast, ovarian and or prostate cancer. Generally, this means at least 2 close family members with these types of cancers on the same side of the family
  • The nature of your family history including the number of family members who have developed these types of cancers, their gender, and the age of cancer onset
  • If you are of Ashkenazi origin

Importantly, you are automatically eligible for testing on the NHS if:

  • You are Ashkenazi Jewish and have had breast cancer at any age
  • You have High-grade non mucinous epithelial ovarian cancer at any age

Please see these useful links for more information:

https://ovarian.org.uk/risktool/

https://www.nhs.uk/conditions/predictive-genetic-tests-cancer/

If you think you are eligible for NHS BRCA testing, the first step is to speak to your GP about your family’s cancer history. If appropriate, they will refer you to your regional genetics clinic where a genetic counsellor will assess your eligibility and provide you with support and information. Alternatively, you may wish you wait until 2023 for the new NHS BRCA testing programme to be in place.