Overview

BRCA1 and BRCA2 are genes that help repair damaged DNA and protect against cancer. But having a pathogenic variant in one of these genes stops the gene from working well. This means you will have a higher-than-average risk to develop breast, ovarian, and some other cancers. BRCA (say "BRAH-kuh") stands for "BReast CAncer."

BRCA pathogenic variants aren't common. Your doctor may talk to you about testing based on your family medical history or your personal medical history. Your doctor may ask you questions, such as if you have family members who had breast or ovarian cancer, if you were diagnosed with breast cancer before age 50, or if you have an Ashkenazi Jewish heritage.

If you are concerned that you may have a BRCA pathogenic variant, talk with your doctor. The BRCA1 and BRCA2 genes are not the only genes that help protect against cancer, and pathogenic variants in other genes can also increase your risk of developing cancer.

In the table below, the figures are only rough estimates from research studies of females. These numbers may not apply to you, but they can give you an idea of how high your risk may be. ^{footnote 1}

Genetic testing can show if you have a pathogenic variant that increases your risk for breast cancer and ovarian cancer. Before you have genetic testing, you may want to see a genetic counsellor. Genetic counselling will help you decide about genetic testing.

Ways to reduce cancer risk

Experts know that people who have a BRCA pathogenic variant are more likely to get breast cancer and ovarian cancer. If you have a BRCA pathogenic variant, you can take steps to reduce your risk of these cancers.

To help those with BRCA pathogenic variants, experts study women with BRCA pathogenic variants to predict how much breast and ovarian cancer risk could be reduced by certain methods. These methods include:

• Having the breasts removed (mastectomy).
• Having the fallopian tubes and ovaries removed (salpingectomy and oophorectomy).
• Having a mammogram every year starting at age 30 and breast MRI every year starting at age 25. These screening tests don't prevent breast cancer. But they can find cancer early, when a cure is most likely.

The results of a study from 2010 are shown in the tables below.

The study also looked at having the surgeries at different ages. For example, you can see what difference it might make if you keep your breasts and ovaries until you're past your childbearing years. These results are one piece of information you can use as you explore how to lower your cancer risk. Your doctor or genetic counsellor can discuss the most up-to-date information about ways to lower your cancer risk.

Surgery and screening tests are not your only options. You can also talk to your doctor about medicines, such as tamoxifen. Or you may choose to have no treatment or extra screening.

Women with BRCA1 pathogenic variants

According to the study, here's how the different prevention methods affect the lifespans of those with BRCA1 pathogenic variants. ^{footnote 2}

Women with BRCA2 pathogenic variants

According to the study, here's how the different prevention methods affect the lifespans of those with BRCA2 pathogenic variants. ^{footnote 2}

Deciding about your options

Take some time to think about your options. A genetic counsellor can help you understand how the prevention options affect your cancer risk. You may want to discuss them with your family and close friends. Then you can reach a decision that is right for you.