The Atlanta PEACH BRCA study through JScreen at Emory University is now closed. We will soon have a new, national testing option for BRCA and other cancer genes. To stay up-to-date on the launch of this new testing program, sign up for our mailing list below.
If you live in the metro-Atlanta area and want to pursue genetic counseling and testing before the national program launches, contact the Winship Cancer Institute at (888) 946-7447 or (404) 778-1900 to schedule an appointment. If you live outside the Atlanta area, go to NSGC to find a genetic counselor in your area.
What is BRCA?
The name “BRCA” is an abbreviation for “BReast CAncer gene.” We all have two BRCA genes, BRCA1 and BRCA2. These genes are important because they repair DNA breaks that might lead to cancer. When either BRCA gene is not working properly (in other words, when there is a mutation in one of these genes), it may not be effective at preventing cancer. Because of this, people with a BRCA mutation are more likely to develop certain cancers, such as breast, ovarian, pancreatic, and prostate cancers.
Why should I consider doing BRCA testing?
People who carry BRCA mutations are at increased risk for certain cancers, including breast, ovarian, pancreatic, and prostate cancers. Information about carrier status can help guide medical management. For example, female carriers may elect to have increased cancer surveillance (such as frequent mammograms and breast MRIs), or risk-reducing surgeries (such as preventative mastectomies and removal of ovaries). Male carriers are encouraged to have yearly clinical breast and prostate exams. Carriers who know their status are encouraged to speak with a genetic counselor and appropriate medical specialists, as well as discuss with other family members who are also at-risk to carry mutations. Knowing this information can be life-saving for yourself and others.
Which cancers are associated with BRCA?
Female carriers of BRCA mutations are at increased risk to develop breast and ovarian cancers. Males with mutations are at increased risk for breast and prostate cancers. Both females and males with mutations are at risk for pancreatic cancer and may have an increased risk of melanoma. While the risks are increased, not all BRCA carriers will develop cancer.
Can men have BRCA mutations?
Yes. A parent with a BRCA mutation has a 50% chance of passing it on to each of his/her children (son or daughter). This means that both men and women are at equal risk for inheriting a BRCA mutation. Males with a BRCA mutation are at increased risk for breast, prostate and pancreatic cancers.
If I have a mutation, will my kids have it too?
Each child (son or daughter) has a 50% chance of inheriting a BRCA mutation. Reproductive options, such as in vitro fertilization with genetic testing of the embryo, are available to BRCA carriers who are planning on having a child and want to avoid passing down their mutation.
What does being Ashkenazi Jewish have to do with BRCA?
While anyone could have a mutation in his/her BRCA genes, individuals with Ashkenazi Jewish (Eastern and Central European) background are at 10 times greater risk. One in 40 Ashkenazi Jews will have a mutation—even if there is no family history of BRCA-related cancer.
Is all cancer hereditary?
No. Most cancer happens by chance. However, some cancers are due to hereditary changes in genes, even if cancer hasn’t been seen in the family. For example, about 5-10% of breast cancers and about 20-25% of ovarian cancers are due to inherited genetic changes that increase the risk to develop these types of cancer. Many cases of breast and ovarian cancers are due to BRCA mutations, but there are other genes that increase the risk for these and other forms of cancer. It is important to consult with a genetic counselor if you think that you or a family member might have a hereditary cancer risk.
How is BRCA testing different than JScreen’s reproductive carrier screening panel?
JScreen’s reproductive carrier screening panel tests for diseases like Tay-Sachs and cystic fibrosis, many of which present in infancy or early childhood. Most carriers of these diseases have no symptoms, but may pass down their genetic mutations to their children. If two carriers of the same disease have a child together, there is a 25% chance for that child to be affected with the disease. So, the JScreen reproductive carrier panel is designed to provide you with information about the health of your children.
The BRCA test is different in that it could tell you if you carry a genetic mutation that would predispose you to certain cancers. If you do carry a mutation, each of your children has a 50% chance of inheriting that mutation and its associated cancer risks. As you can see, the BRCA test may give you information about your own health, as well as risks to your family members.
Does insurance cover BRCA testing?
Most insurance carriers will cover BRCA testing and genetic counseling if the individual has a personal or significant family history of BRCA-related cancers.
If my insurance company learns I am positive for a mutation in a cancer predisposition gene, will my insurance coverage change?
It depends on what type of insurance you have and where you live. According to the GINA law, health insurance companies that provide plans for businesses with 15 or more employees cannot change your coverage based on the results of your genetic testing. However, other types of insurance, such as life, disability, and long-term care, do not have restrictions about using your genetic information to set their plans, and each state has its own mandates regarding the use of genetic information. You can learn more about this topic here.
If my employer learns I am positive for a mutation in a cancer predisposition gene, are there grounds for firing me?
The GINA law makes it illegal for employers with 15 or more employees to use your genetic information to make decisions about hiring, firing, promotion, pay, privileges or terms. In other words, your employer may not use family health history and genetic test results in making decisions about your employment. Please be aware that GINA’s protections in employment do not extend to the US military or employees of the federal government.
I am worried about my results getting in the wrong hands. How will you ensure that all of my information is kept private?
The privacy of your health information is very important to us. To protect your personal health information, we will follow federal and state privacy laws, including the Health Insurance Portability and Accountability Act and regulations (HIPAA). The only people who will have access to your medical and genetic information will be the study team, its overseers, and the laboratory. Each study participant will also be given a copy of his/her results after they are reviewed with a genetic counselor and will have the option to share them with their personal health-care provider.
Emory University notice of privacy practices.
The PEACH BRCA Study was made possible thanks to the generosity of the Marcus Foundation, the Florence and Laurence Spungen Family Foundation, the Kay Family Foundation Fund of the Community Foundation of Greater Atlanta, and The Jewish Women’s Fund of Atlanta.