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You are likely at Higher Risk

than the general population for breast and/or ovarian cancer.

Because you answered

You or a close family member had breast cancer before age 50
You or a close family member had two separate breast cancer diagnoses in the same person
You are of Ashkenazi/Eastern European Jewish ancestry.

So now what?

We know that wasn’t the result you were hoping for, but knowledge of your family history and cancer risk is powerful.

We recommend that you meet with a genetic counselor to further discuss your risk as you are likely at greater risk for certain cancers than the general population.

Favorite this URL to revisit your results in the future or download below

Get genetic counseling

Be proactive about your health. Since you’re likely at higher risk, we recommend meeting with a genetic counselor to discuss your family history, get a formal evaluation, and explore the benefits and limitations of genetic testing. Ready to take action?
​ A genetic counselor will help you do a comprehensive analysis of your family and personal health history. Once you provide information on your family and personal cancer history, they will assess your risk for breast, ovarian, and/or other cancers and based on your results, may recommend genetic testing. You will be asked to give consent to do genetic testing if necessary and be provided education on the potential benefits, harms, limitations, and outcomes of testing, including sharing results with family. A genetic counselor will help interpret results after testing and discuss management of screening or risk reduction options and may refer you to breast, ovarian, or other cancer specialists.

Insurance Coverage for genetic counseling and genetic testing:

Most health insurance companies will cover the cost for genetic counseling and genetic testing if a person meets particular criteria indicating that hereditary cancer might run in the family. A genetic counselor can determine if your insurance will cover genetic testing and help with the process.

Under the Affordable Care Act, insurance companies are required to pay for both genetic counseling and testing for individuals who meet certain criteria. For these individuals, insurance companies must cover the entire cost of genetic counseling and BRCA testing with no out-of-pocket costs to the individual.

Even in situations that are not covered under the Affordable Care Act, health insurance often covers the costs of genetic counseling and testing. A genetics expert can work with your insurance company to assure that you receive the services you need while minimizing the costs to you, and to help you appeal if your insurance company denies these services. A genetics expert can often assist with finding financial assistance for those who require it.

About GINA – Genetic Information Nondiscrimination Act

Currently, a federal law called the Genetic Information Nondiscrimination Act (GINA) enacted in 2008 protects individuals from discrimination in the workplace or by health insurance companies based on genetic testing information. This means that employers can’t hire or fire you based on your genetic health information and health insures can’t use your genetic health information to make decisions that impact your coverage, cost, eligibility, or other benefits of your health insurance. Genetic information is defined as an individual’s and/or family member’s genetic tests or family medical history. Violations of GINA can be reported.

Limitations of GINA:

GINA does not protect against discrimination for life insurance, long-term care, and disability. Small businesses (less than 15 employees) are exempt from GINA laws. GINA does not apply to individuals who get insurance through the federal government or the military.

Read more about GINA: http://www.ashg.org/policy/gina.shtml

​About at home / direct to consumer genetic testing.

We recommend consulting with a health expert with advanced training in genetics for before undergoing genetic testing.

Recent years have seen the emergence of many genetic testing companies that offer direct to consumer (DTC) genetic testing. DTC testing means that individuals can carry out various forms of genetic testing directly through products offered by the company without going through a healthcare professional to order the testing. Different companies offering direct to consumer testing use a variety of technologies for genetic testing and offer different services such as genetic counseling as part of their services. Some DTC companies offer genealogical DNA testing to learn about your family ancestry vs genetics.

Information from DTC testing that provides genetic ancestry testing is limited and may only report on a few genes and a few gene variants out many genes and thousands of variants that are relevant to determining genetic risk of disease. These health reports indicate that they should not be used for making health decisions and any result, positive or negative, requires confirmation testing with a medical-grade genetic test. Medical-grade genetic tests are designed to be used to make health decisions. Medical-grade tests look comprehensively at each gene, including thousands of potential variants in that gene, to provide a complete assessment of any increased genetic risk of disease. Importantly a genetic counselor or other medical professional trained in genetics can counsel you on potential benefits, harms, and risks of testing and post-testing management.

We recommend consulting with a health expert with advanced training in genetics for before undergoing genetic testing.

Visit our link to find a genetic counselor in your area.

Talk to your Family

Identifying cancer in your family tree can be a good indicator of your risk. Download our Family Tree Worksheet here. Be sure to include yourself, children, parents, siblings, aunts, uncles, and grandparents.

Have a trusted healthcare provider

Having a relationship with a health care provider you know and trust is one of the most important decisions you’ll make about your health care. Click here to find more information on finding a provider.

Share this tool

Share this with others –  Share this tool with your family and friends. Help them get educated and know their risk, so they can be proactive about their health. Link to share this quiz.

*This tool is designed to quickly identify who should be referred for cancer genetic counseling to formally evaluate their family history and discuss benefits and limitations of genetic testing for hereditary breast and/or ovarian cancer. This quiz is a screening tool, not a “yes” or “no” diagnostic test.

This screening tool does not assess non-familial risk factors for breast and/or ovarian cancer. Learn more about breast and ovarian cancer.

It is important to talk to a health care provider if you have questions about these results and your cancer risks.

Care to Share?

In an effort to improve this tool, we'd love to know a little more about you and how you got here.

Keep in touch

Keep in touch to get valuable information on how to be proactive about your health. Get updates on your risk assessment.
Assess Your Risk Tool

You are likely at Higher Risk

than the general population for breast and/or ovarian cancer*

This is why

You or a close family member had breast cancer before age 50
You or a close family member had two separate breast cancer diagnoses in the same person
You are of Ashkenazi/Eastern European Jewish ancestry.

Please bring these results with you when you meet with a genetic counselor or a health care provider. Please visit your health care provider if you have any health concerns.

Talk to your Family

Talking to your family and identifying cancer in your family tree can be a good indicator of your health risks. Download our Family Tree Worksheet here.  Be sure to include yourself, children, parents, siblings, aunts, uncles, and grandparents.

Get Educated

Know your body and be proactive about your health. Learn about your breast and ovarian health. Learn about the risk factors and signs & symptoms for breast and ovarian cancer.

Trusted Healthcare Provider

Having a relationship with a health care provider you know and trust is one of the most important decisions you’ll make about your health care. Click here to find a provider

Higher Risk in the Ashkenazi Jewish Population

In the general population, around 1 in 400 people carry a BRCA1 or BRCA2 mutation. People of Ashkenazi Jewish ancestry have a 1 in 40 chance of carrying a BRCA mutation, making them 10 times as likely to carry a BRCA mutation as someone in the general population. Whether you’re a man or a woman, if you have a BRCA mutation then there is a 50% chance of passing the mutation on to your children, whether they are boys or girls. It’s important to note that these mutations significantly increase risk, but are not a guarantee a person will get cancer.

Why is the Ashkenazi Jewish population at higher risk?

Over 90% of the BRCA mutations found in the Jewish community are one of three “founder mutations”. A founder mutation is a specific gene mutation in a population that was founded by a small group of ancestors that were geographically or culturally isolated. Because the population was isolated, the rate of founder mutations in descendants is much higher than it would be if the population were larger and co-mingling with more genetically diverse populations. A large expansion in the population caused the current high frequency of the mutations in the Ashkenazi Jewish population. If you are of Ashkenazi Jewish ancestry, the chance of carrying a BRCA gene mutation compared to the general population is increased tenfold. BRCA mutations can be passed down from either your mother’s or father’s side, and may be associated with any of the following cancers:
  • Breast cancer
  • Ovarian cancer, fallopian tube, peritoneal cancer
  • Male breast cancer
  • Prostate cancer
  • Pancreatic cancer
  • Colon Cancer

Ready to take action? Knowledge is power. Take this short quiz to be proactive about your health.

Genes 101

Our bodies are made of many tiny building blocks called cells. Our cells contain a copy of our genome – all of the DNA genetic code we inherited from our parents. Our genome is organized into 46 chromosomes, 23 inherited from mom and 23 from dad. Each chromosome has hundreds or thousands of genes. Each gene has the instructions to make a protein that may control the structure or function of cells, can determine many things including how tall we are or the color of our eyes. Genes also contain instructions for many things inside of us that we cannot see, such as how our bones are formed or how our heart works. Each gene is made up of molecules called nucleic acids (A, T, C, and G). The specific sequence of the nucleic acids holds the instructions that control all the components and their functions in cells.

If the DNA sequence is changed, like a spelling mistake, the instructions may not make sense. The technical term for this change is “mutation,” meaning there is a change to the usual genetic code that may change the instructions stored in the gene. A mutation in a gene that repairs DNA damage or controls cell growth can increase the risk of developing cancer.

Sporadic vs Hereditary Cancers:

Ovarian and breast cancer can be either sporadic or hereditary. Sporadic cancers make up the vast majority (85-90%) of ovarian and breast cancers and are not associated with family history of either cancer or inherited cancer-associated mutations. Sporadic cancers arise from genetic mutations acquired in some cells of the body by events part of normal metabolism and environmental factors. This type of cancer can happen to anyone. Most acquired gene mutations are not shared among relatives or passed on to children.

Hereditary (also known as inherited, or familial) cancers are those that occur due to genetic mutations that are inherited from mom or dad. Other blood relatives may also share these same gene mutations. Parents give one copy of each gene to their children. If a parent has a genetic mutation in a gene, each of their children have a 50% chance of inheriting that mutation. Therefore, even in families with hereditary cancer, not all family members inherit the mutation that is causing cancer, and their risk of cancer is similar to the average person in the general population. Individuals who are suspected to have a family history with high incidence of ovarian, breast, and other cancers may be offered genetic testing to try to find the specific genetic mutation that may put them at risk. Importantly, individuals who do not have a known genetic mutation but have high incidence of ovarian, breast, or other cancers in their families are still considered at higher risk for developing those cancers.

Hereditary cancers often occur at an earlier age than the sporadic form of the same cancer, so experts often recommend starting cancer screening at a younger age for individuals at high risk for hereditary cancer. Hereditary cancers can also be more aggressive than the sporadic form of the same cancer. Individuals who have inherited a gene mutation may be at a higher risk for more than one type of cancer.

BRCA 1 and BRCA 2: Most Common hereditary breast and ovarian cancer

The genes that are most commonly involved in hereditary breast and ovarian cancer (HBOC) are BRCA1 and BRCA2. These genes are named for their link to breast (BR) cancer (CA), but they are also linked to ovarian cancer risk as well as other cancers. Both women and men can inherit mutations in these HBOC genes. BRCA1 and BRCA2 are tumor suppressor genes that have a usual role in our body of providing instructions on repairing DNA damage and preventing cancer. When a family has an inherited mutation in BRCA1 or BRCA2, this leads to an increase in cancer risk. Not every man or woman who has inherited a mutation in the BRCA1 or BRCA2 gene will develop cancer, but people who have a mutation do have a significanlty increased chance of developing cancer, particularly cancer of the breasts or ovaries.

While breast and ovarian cancers are the most common cancers diagnosed in people with BRCA1 and BRCA2 mutations, the risk of some other cancers is also increased. Men with BRCA1 and BRCA2 mutations have a higher risk of early-onset prostate cancer than men without mutations in either gene. Other cancers seen at increased rates, particularly in individuals with BRCA2 mutations, include pancreatic cancer and melanoma. Researchers are continuing to find new genes that are involved in hereditary breast and/or ovarian cancer so it is important to follow up with a genetic counselor on a regular basis if hereditary breast and ovarian cancer is likely in your family.

Talk to your family about your health history and take the Assess Your Risk quiz here

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