Are you aware of a BRCA test? (BRCA Testing) A way to identify cancer risk early!

You've probably heard the word `BRCA` (BRCA) when talking about things like breast cancer, ovarian cancer. Maybe your doctor has also mentioned it. What exactly is this `BRCA` gene? What can we learn by doing this `(BRCA testing)`? Today we will talk about all this very simply, in a way that you can understand. Just like talking to a friend.

What is BRCA? Why is it important to us?

Simply put, `BRCA1` and `BRCA2` are two special genes in our body. They are like the guards inside our cells. Their main job is to repair damage to our `DNA` and to stop cells from growing too quickly and out of control in places like the breast and ovaries. Think of these genes as a little "brake" system in our body that stops cancer cells from forming. That's why we call them `(tumor suppressor genes)`.

However, sometimes these important `BRCA` genes can have certain changes, or `mutations` . That's when the problem starts. When these genes don't work properly, the cells I mentioned are more likely to grow out of control. Then the risk of developing not only breast cancer, ovarian cancer, but also several other types of cancer increases.

The important thing is that these `BRCA` gene mutations are passed down from generation to generation. That means you can inherit this mutation from your mother or father. It's like a family heirloom. We do a genetic test called `(BRCA testing)` to find out if you have these `BRCA` mutations. For this, a small blood sample is taken from you and tested.

Who should get the BRCA test? Does everyone need it?

Actually, these `BRCA` gene mutations are not that common. For example, about 0.2% of the American population has this condition. That is a very small percentage. Therefore, most doctors do not recommend that everyone get this `BRCA` test. However, if you have certain risk factors, your doctor may advise you to get this test.

Now let's see what those risk factors are:

• If you have had breast cancer , especially if it developed before you were 50 years old.
• If a close relative in your family (mother, father, siblings, children) has already been diagnosed with a `BRCA` mutation.
• If one or more members of your family have had breast cancer (especially if men have had breast cancer, that is also important).
• If you have both breast cancer and ovarian cancer.
• If you are of the Ashkenazi Jewish ethnic group (people of this ethnic group are more likely to have BRCA mutations).
• If you or someone in your family has a history of developing multiple types of cancer.
• If someone in your family has a genetic risk factor for cancer, for example, Cowden syndrome, Fanconi anemia, Li-Fraumeni syndrome, or Peutz-Jeghers syndrome.

If one or more of these factors apply to you, it would be wise to talk to a doctor and consider getting a BRCA test.

What can we learn from a BRCA test?

Imagine that you have this test. If it shows that you have a mutation in either the `BRCA1` or `BRCA2` genes, it means that you have a much higher risk of developing breast cancer than the average person . Some studies have shown that a person with a `BRCA` mutation is about six times more likely to develop breast cancer by the age of 80 than the average person. Also, the cancer is more likely to develop at a younger age and to affect both breasts .

Not only that, BRCA mutations can increase the risk of several other types of cancer. The main ones are:

• Ovarian cancer and two related cancers, fallopian tube cancer and peritoneal cancer.
• Prostate cancer - This is important for men.
• ` (Pancreatic cancer)` (pancreatic cancer).
• ` (Fanconi anemia)` (Fanconi anemia) - This is a very rare cancer, most often occurring in childhood.

Important: Having a BRCA mutation does not mean you will definitely develop cancer. It does mean that you are at increased risk. Knowing this can help you take steps to reduce your risk.

What happens before the BRCA test?

Before you have a BRCA test, you will need to see a genetic counselor . This is a very important step. This genetic counselor will explain to you how the genes you inherit from your family may affect your risk of cancer. They will explain to you:

• What does it mean if a BRCA test result is positive or negative?
• How does your test result affect your cancer risk?
• How does your result affect the risk of other members of your family?

It's best to take the test only after you have a good understanding of all of this.

What happens when you get a BRCA test?

It's really simple. The BRCA test only requires a small amount of your blood. It's the same as a regular blood test or a blood donation. The doctor or nurse will insert a small needle into a vein in your arm and draw a small amount of blood into a small vial.

You may feel a little pain when the needle is inserted and removed. But this will go away in less than five minutes. If there is some bleeding, a small bandage may be applied to the area. Sometimes, this test can be done with a saliva sample.

What happens after the BRCA test?

Your doctor will tell you how long it will take to get your results. After your results come back, it's important to see your genetic counselor again. They can explain the results to you and explain your options.

What are the possible results of a BRCA test?

There can be three types of results.

1. What if the result is positive?

If you have a BRCA mutation, it means that you have a significantly increased risk of developing cancer. But, don't worry. It doesn't mean that you will definitely get cancer. Knowing this can help you take positive steps to prevent cancer, detect it early, or even prevent it. It can also help others in your family understand their risk.

Talk to your doctor and genetic counselor to decide if other members of your family should get tested. They will also tell you about preventive measures you can take. For example:

• Getting more frequent cancer screenings: For example, getting mammograms more often.
• Additional testing methods: Things like a breast MRI scan.
• Limiting the use of some birth control pills: While some birth control pills may reduce the risk of ovarian cancer, they can increase the risk of breast cancer in some people. You should talk to your doctor about this.
• Use of anti-cancer drugs: For example, drugs like tamoxifen.
• Preventive surgery: Removing healthy breast tissue before cancer develops (prophylactic mastectomy) or removing the ovaries and fallopian tubes (prophylactic removal of ovaries and fallopian tubes). These are big decisions, so they should be made after careful consideration and discussion with your doctor.

2. What if the result is negative?

A negative result means that you do not have a `BRCA` mutation. Also, you will not pass a `BRCA` mutation to your children. However, a negative `BRCA` test does not guarantee that you will never develop cancer. It means that your risk is similar to that of someone in the general population.

However, if your test is negative, but one or more members of your family have had breast cancer before age 50, the situation is a little more complicated. This may mean that your family has another genetic mutation that increases your risk of cancer. Your genetic counselor can help you understand these results and decide if further testing is needed.

3. What if the result is uncertain?

Sometimes the result may be "indeterminate." This means that you have a change in one of your BRCA1 or BRCA2 genes, but that change has not yet been identified as a mutation that increases your risk of breast cancer. This is called a "Variant of unknown significance" (VUS) . If this happens, your genetic counselor will explain the results to you and help you decide if you or others in your family need further genetic testing.

What are the benefits of a BRCA test? Are there any risks?

The biggest advantage of this test is that it tells you whether you have a `BRCA` gene mutation. This gives you a better understanding of your cancer risk. Also, this information can help your family make decisions about their health. Now there are ``comprehensive genetic testing panels`` that test for several other genes in addition to ``BRCA1/BRCA2``. Your genetic counselor can guide you on which test is most suitable for you.

As for the risks, there aren't any major risks with this test. It's just a very simple blood draw.

What should I ask my doctor/nurse?

If you're thinking about this test, or have already had it, it's a good idea to ask your doctor or genetic counselor these questions:

• Is it a good idea for anyone else in my family to have this `BRCA` test?
• If my test is positive, does that mean my children will also have that genetic mutation?
• How will my test result affect breast cancer screenings, as well as screenings for other types of cancer?
• If my test is positive, what should I do to reduce my risk of developing certain types of cancer?
• Can the type of test I did detect other genetic mutations?

It is very important for you to know the answers to these questions.

Finally, things to remember (Take-Home Message)

The `BRCA` test is a test that looks for abnormal changes, or mutations, in the genes `BRCA1` and `BRCA2`. If the result is positive, it means that you have a higher risk than the average person of developing breast, ovarian, and certain other types of cancer.

But, most importantly, knowing that you have a BRCA gene mutation can help you take steps to reduce your risk and prevent cancer. This information can also be very important for your family. So, don't be afraid to talk to your doctor or a genetic counselor about whether you need this test and, if so, how to proceed with the results.

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