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Breast and Ovarian Hereditary Cancer Syndrome (BRCA1 and BRCA2) Sequencing
2011954
Ordering Recommendation

To determine if there is a heritable predisposition for breast or ovarian cancer in adults with any of the following:
• Breast cancer diagnosed at age 50 or younger
• Ovarian cancer
• Multiple primary breast cancers either in the same breast or opposite breast
• Both breast and ovarian cancer
• Male breast cancer
• Triple-negative (estrogen receptor negative, progesterone receptor negative, and HER2/neu [human epidermal growth factor receptor 2] negative) breast cancer
• Pancreatic cancer with breast or ovarian cancer in the same individual or on the same side of the family
• Ashkenazi Jewish ancestry
• Two or more relatives with breast cancer, one under age 50
• Three or more relatives with breast cancer at any age
When a relative has been previously tested, see Familial Mutation, Targeted Sequencing (2001961).

Mnemonic
BRCA FGS
Methodology
Polymerase Chain Reaction/ Sequencing
Performed
Sun-Sat
Reported
14-21 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
 
Collect
Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). 
Specimen Preparation
Transport 3 mL whole blood. (Min: 1 mL) 
Storage/Transport Temperature
Refrigerated 
Unacceptable Conditions
 
Remarks
 
Stability
Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable 
Reference Interval
Interpretive Data
Background Information for Breast and Ovarian Hereditary Cancer Syndrome (BRCA1 and BRCA2) Sequencing
Characteristics:
Female carriers of BRCA1 mutations have a breast cancer risk of 57 percent and ovarian cancer risk of 40 percent by age 70. Female carriers of BRCA2 mutations have a breast cancer risk of 49 percent and ovarian cancer risk of 18 percent by age 70. BRCA1 mutation carriers may also be at increased risk for fallopian, peritoneal, cervical, uterine, and pancreatic cancer. BRCA2 mutation carriers may be at increased risk for pancreatic, stomach, gallbladder, bile duct, and melanoma cancers. Men with BRCA1 mutations are at increased risk for breast cancer and possibly pancreatic, prostate, and testicular cancers while male carriers of BRCA2 mutations are at increased risk for breast, pancreatic and prostate cancers.
Prevalence: 1 in 500 individuals has a BRCA1 or BRCA2 mutation; 5-10 percent of breast cancer and 10-15 percent of ovarian cancer are caused by germline BRCA1 or BRCA2 mutations.
Inheritance:
Autosomal dominant.
Cause:
Pathogenic germline mutations in several genes cause hereditary breast and ovarian cancer (HBOC) syndrome. Mutations in tumor suppressor genes, BRCA1 and BRCA2, are causative for 20-60 percent of HBOC.
Genes Tested: BRCA1 and BRCA2.
Clinical Sensitivity:
Approximately 90 percent of BRCA1 and BRCA2 mutations.
Methodology: Bidirectional sequencing of the entire BRCA1 and BRCA2 coding regions and intron-exon boundaries.
Analytical Sensitivity and Specificity: 99 percent.
Limitations
: BRCA1 and BRCA2 gene regulatory region mutations, deep intronic mutations, and large deletions/duplications will not be detected. Other genes causing HBOC are not tested. Rare diagnostic errors can occur due to primer site mutations.

Compliance Statement C: The performance characteristics of this test were validated by ARUP Laboratories. The U.S. Food and Drug Administration (FDA) has not approved or cleared this test. However, FDA approval or clearance is currently not required for clinical use of this test. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing. Counseling and informed consent are recommended for genetic testing. Consent forms are available online.

Components
Component Test Code*Component Chart NameLOINC
2011955BRCA Sequencing Specimen31208-2
2011956BRCA Sequencing Interpretation59041-4
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • HBOC