Should you consider genetic testing for BRCA-related cancer risks? A UK Guide
Every year, thousands of people learn about the BRCA1 and BRCA2 genes after a relative is diagnosed with cancer or following widespread media coverage about hereditary cancer risk.
While most breast cancer, ovarian cancer and prostate cancer cases occur by chance, some are linked to inherited gene changes that place an individual at a higher risk of developing certain cancers and significantly increase their overall cancer risk.
Understanding whether you carry one of these inherited mutations can help guide screening, prevention and treatment decisions for both you and your family.
The important thing is that if you are considering genetic testing for BRCA, it should always be accompanied by expert genetic counselling, which will help you understand whether testing is appropriate and what your results may mean.
Read on for Check4Cancer's UK guide on genetic testing for BRCA-related cancer risks. Contact us to ask a question or explore our genetic testing and counselling services here.
What are BRCA genes, and why do they matter?
Everyone is born with BRCA genes, which normally play an important role in repairing damaged DNA and protecting cells from becoming cancerous.
Problems arise when there is an inherited gene change (also called a pathogenic variant or mutation) in one of these genes. Instead of effectively repairing damaged cells, the body's natural protective mechanisms are weakened, increasing the likelihood that certain cancers may develop over time.
Although BRCA mutations are relatively uncommon in the general population, identifying them can dramatically change how someone's future cancer risk is managed.
BRCA1 or BRCA2: what do these genes do?
BRCA1 and BRCA2 are tumour suppressor genes whose normal function is to repair damaged DNA.
Because BRCA mutations are inherited, family members may carry the same gene change even if they have never developed cancer themselves.
If someone inherits a faulty copy of either gene, their lifetime risk of developing several cancers may be substantially higher, placing them at a higher risk than someone without the mutation.
Importantly:
- Men and women can both inherit BRCA mutations
- A parent with a mutation has a 50% chance of passing it to each child
- The mutation may affect multiple generations
- Not everyone who carries a mutation will develop cancer, but their risk is significantly increased.
BRCA genes and their associated cancer risk
Most people associate BRCA mutations with breast and ovarian cancer, but they are also linked to several other cancers.
These include:
- Breast cancer
- Ovarian cancer
- Prostate cancer
- Pancreatic cancer
- Male breast cancer
Some studies suggest links with other cancers, although evidence varies depending on the specific gene mutation.
Knowing about an inherited mutation allows healthcare professionals to recommend enhanced surveillance and, where appropriate, preventive strategies designed to detect cancer early.
Breast cancer and BRCA genetic testing
Inherited BRCA mutations are responsible for a significant proportion of hereditary breast cancer cases.
Women carrying a BRCA1 mutation may have an estimated lifetime risk of breast cancer of around 55-72%, while BRCA2 carriers may have a lifetime risk of approximately 45-69%, although individual risk varies depending on personal and family factors.
Women carrying a BRCA1 or BRCA2 mutation are considered to be at higher risk of developing breast cancer than the general population, which is why enhanced screening and preventative options may be recommended.
If testing identifies a mutation, management options may include:
- Earlier and more frequent cancer screening
- Breast MRI alongside mammography
- Lifestyle advice
- Risk-reducing medication in appropriate patients
- Discussion of risk reducing surgery where clinically indicated.
For individuals already diagnosed with breast cancer, knowing their BRCA status may also influence treatment decisions, including access to targeted therapies.
For individuals already diagnosed with breast cancer, knowing their BRCA status may influence treatment decisions, including access to targeted therapies and, in some cases, eligibility for clinical trials evaluating new treatments for inherited cancers.
Ovarian cancer and BRCA genetic test results
Unlike breast cancer, there is currently no national screening programme proven to detect ovarian cancer early in the general population.
For women with BRCA mutations, understanding their genetic status can therefore be particularly important.
Following expert assessment, options may include:
- Enhanced surveillance where appropriate
- Discussions about preventive surgery involving the ovaries and fallopian tubes
- Family planning considerations
- Access to specialist care and ongoing monitoring.
- These decisions are highly personal and should always be made following consultation with experienced clinical genetics professionals.
Prostate cancer and BRCA-related risk
BRCA mutations are not just relevant to women.
Men carrying certain BRCA mutations, particularly BRCA2, may have a higher cancer risk of developing prostate cancer, often at a younger age or with more aggressive disease.
Genetic testing may therefore help inform:
- Earlier PSA monitoring
- MRI-based assessment where appropriate
- Family risk assessment
- Treatment decisions if cancer has already been diagnosed.
Are there other cancers linked to BRCA genes?
Yes.
Research has shown associations between BRCA mutations and several cancers, including:
- Pancreatic cancer
- Male breast cancer
- Prostate cancer
Some studies have also explored possible links with colorectal cancer, although the evidence is less clear and the increased risk appears to be much smaller than for breast or ovarian cancer.
Having a BRCA mutation does not mean you will definitely develop these cancers. Rather, it means your risk may be higher than that of the general population, allowing preventive strategies to be considered.
How do I qualify for BRCA testing?
Testing is usually recommended based on your medical history and family history of cancer, rather than curiosity alone.
You may be considered for assessment if:
- Several family members have had breast or ovarian cancer
- Cancer occurred at a young age
- The same cancer appears across multiple generations
- A close relative has already tested positive for BRCA
- There is a history of male breast cancer
- You belong to certain ethnic groups, such as those with Ashkenazi Jewish ancestry, where BRCA mutations are more common.
In the UK, your GP can refer you to NHS clinical genetics services where appropriate. Some people may also choose private assessment, particularly if they wish to access specialist counselling or testing more quickly.
Your healthcare professional or genetic counsellor will review your family medical history, looking for patterns such as multiple relatives diagnosed with breast, ovarian, prostate, pancreatic or colorectal cancer, particularly at a young age.
What happens during genetic testing?
The process is usually straightforward:
- An initial consultation with a genetic counsellor or healthcare professional.
- Review of your personal and family medical history.
- Discussion of the benefits, limitations, and possible outcomes of testing.
- Collection of a blood test or saliva sample.
- Laboratory analysis for relevant gene changes.
- A follow-up appointment to explain your genetic test results and discuss any next steps.
Results may be:
- Positive (a disease-causing mutation is identified)
- Negative (no relevant mutation is found)
- Uncertain (a variant is identified, but its significance is currently unclear).
Should you only consider genetic testing if you have a strong family history of cancer?
Not necessarily.
Although a strong family history remains one of the most important indicators, some people carrying BRCA mutations have surprisingly little known family history. Small families, adoption, limited knowledge of relatives, or cancers occurring predominantly in male relatives can all obscure inherited risk.
Equally, many people with several relatives affected by cancer may not have a BRCA mutation at all.
This is why assessment by a genetic counsellor is so valuable. They consider your entire family tree and medical background before recommending whether a gene test is appropriate.
Can my health insurance provider pay for my genetic testing?
Some UK private medical insurance policies may cover genetic testing when it is considered medically appropriate, although cover varies between insurers and individual policies.
Eligibility often depends on:
- Your personal diagnosis
- Your family history of cancer
- Whether a screening test has been recommended by a specialist
- The terms of your policy.
If you're unsure, it's worth checking directly with your insurer before proceeding.
Speak to our genetic counsellors today
Deciding whether to undergo BRCA genetic testing is about far more than receiving a laboratory result. It is about understanding your personal risk of cancer, the implications for your family, and the options available to help protect your health.
Seeing several relatives diagnosed with the same cancer, or with different cancers known to be associated with BRCA mutations, may indicate an inherited genetic risk and should prompt discussion with a genetic counsellor.
At Check4Cancer, our experienced clinical team and genetic counsellors can guide you through every stage of the process, helping you make an informed decision based on expert advice rather than uncertainty.
Whether you have a family history of cancer, have already been diagnosed with cancer, or believe you may be at higher risk because of an inherited gene, professional counselling and appropriate testing can provide valuable clarity and support. Get in touch with our team.
