“Am I eligible for genetic testing?” It’s not surprising I get asked this question a lot and as a genetic counsellor it’s a very reasonable question to pose. In Ontario we have many of rules, 13 to be exact, that help us answer this question. I’m not going to go through all 13 because no one remembers 13 of anything. Instead, I want to point out three simple and easy to remember criteria that, in Ontario, always make someone eligible for genetic testing of the BRCA1/2 genes.
- Male Breast Cancer – Any man who has been diagnosed with breast cancer, regardless of his age or family history, is eligible for genetic testing for BRCA1/2 gene mutations. Breast cancer in men is rare. In the general population the risk is less than 1%. Men with a BRCA1/2 gene mutation have up an 8% chance or 1 in 12 chance of getting breast cancer. Men with BRCA mutation should receive clinical breast exams. Men may even receive mammograms depending upon their personal medical and family history.
- High Grade Serous Ovarian Cancer – Any woman who has been diagnosed with high-grade invasive serous ovarian cancer, regardless of her family history, is eligible for genetic testing for BRCA1/2 gene mutations. Every woman has a 1-2% lifetime risk for ovarian cancer. Women with a BRCA1/2 gene mutation have a 15-50% chance of getting ovarian cancer. Unfortunately, current screening for ovarian cancer has never proved to detect ovarian cancer at an early stage. Because of this, removal of both ovaries is recommended to female BRCA carriers between the ages 35-40.
- Breast Cancer under Age 35 – Any woman diagnosed with breast cancer under age 35, regardless of her family history, is eligible for genetic testing for BRCA1/2 gene mutations. Based on Canadian Cancer Statistics, there is a 0.4% chance that a woman will develop breast cancer between the ages 30-39. Breast cancer in women under 35 is rare in the general population but it is not rare in women with a BRCA1/2 gene mutation. All women with a BRCA1 or BRCA2 gene mutation are eligible for annual mammogram and MRI under the Ontario Breast Screening Program for Women at High Risk starting at age 30. There are many ways to reduce the risk of breast cancer, for more information talk to your oncologist or genetic counsellor!
What if I want to get tested but do not qualify? What is the cost? I’ve heard that the price has come down recently.
I have a family history of Ovarian and kidney cancer. Have just been diagnosed with Kidney cancer myself and was told I need to register for the genetic testing for my kids. How do I go about doing this?
Hi Mary,
If you had a genetics assessment in the past and learned you do not qualify for genetic testing I would encourage you to contact your genetic counsellor. They should be able to reassess your risk and provide information on how to pursue private testing.
Hi Evelyn,
I’m sorry to hear about your recent diagnosis. You may have any physician refer you to the Cancer Genetics and High Risk Program at the Sunnybrook Odette Cancer Centre. In the referral ask you doctor to include your personal and family history of cancer as you did. Our fax number is 416-480-6002. Please feel free to call me if you have any questions at 416-480-5000 ext.83683
Hi Evelyn,
I’m sorry to hear about your recent diagnosis. Typically when it comes to genetic testing it is best to do genetic testing on the person most likely to have a gene mutation, in this case, someone who has cancer. If a gene mutation is identified then other members of the family, including children, may then be tested for the known gene mutation. To start this process you may have any physician refer you to see a genetic counsellor who will assess your risk of having a gene mutation given your personal and family history. At the Sunnybrook Odette Cancer Centre a referral can be made to the Cancer Genetics and High Risk Program. In the referral ask you doctor to include your personal and family history of cancer as you did. Our fax number is 416-480-6002. Please feel free to call me if you have any questions at 416-480-5000 ext.83683
Hi Mary,
If you had a genetics assessment in the past and learned you do not qualify for genetic testing I would encourage you to contact your genetic counsellor. They should be able to reassess your risk and provide information on how to pursue non OHIP-covered genetic testing. If you have not had a genetics assessment in the past, then I would encourage you to ask to be referred to meet with a genetic counsellor. There are many criteria aside from the 3 I highlighted that may make a woman eligible for genetic testing. If you are ineligible for genetic testing after meeting with a genetic counsellor, ask the genetic counsellor what your options are for non OHIP-covered genetic testing.