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What are BRCA1 and BRCA2?

What to know about the BRCA genes and breast cancer – and whether you should be tested

July 14, 2017

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Most cancer occurs by chance. However, some people have a higher risk of developing cancer because of a gene error that runs in their family.

Errors in two particular genes – BRCA1 and BRCA2 – are the most talked about. Most of the attention started after Angelina Jolie wrote an editorial for the New York Times. In it, she explained that she had undergone a double mastectomy because she carries a BRCA1 mutation.

Recently, researchers looked more closely at what they call the “Angelina Jolie effect.” They found that testing for breast cancer risk genes has skyrocketed since her editorial 4 years ago. But they also found that it’s probably not the right women who are getting tested.

So who should be tested? Megan Hanson, a certified genetic counselor from the Park Nicollet Frauenshuh Cancer Center, answers some of the most common questions she receives about BRCA testing.

What are the BRCA genes?

BRCA1 and BRCA2 are two genes that work in a way to help protect us from cancer. We inherit these genes from our parents. If someone is born with one of these genes not working correctly, that person may have increased risks of certain types of cancer. These types include female breast, male breast, ovarian and prostate. Other potential cancer risks include pancreatic cancer and melanoma.

How does the BRCA test work?

Genetic testing for BRCA1 and BRCA2 involves a blood draw. Then, the genes are analyzed. It’s sort of like scanning a manual for any spelling errors, deletions, duplications or chapters in the wrong order.

Mutations in BRCA1 and BRCA2 are the most common answer for an increased risk of breast and/or ovarian cancer. But, an increased risk can also come from mutations in other genes. That’s why we sometimes suggest a test that looks at multiple genes at the same time. Those tests are called hereditary cancer risk multi-gene panels.

Do I need the BRCA test?

Genetic testing is one way to gather information. But, there are other ways to help screen for cancer. In general, genetic testing may be recommended if there is:

  • A personal or family history of cancer (including breast, colon or uterine cancer) before 50 years old.
  • A personal or family history of rare cancers, such as ovarian cancer or male breast cancer.
  • A known hereditary cancer syndrome in the family, like a relative with a BRCA1 or BRCA2 mutation.

It’s best to start by having a conversation with your OB-GYN or primary care doctor. They can help you understand your risk for breast and ovarian cancer. From there, they can help you decide if you should meet with a genetic counselor.

A genetic counselor can help you decide if genetic testing is right for you, and can select the best test based on your family history of cancer. They can also assist with questions related to insurance coverage.

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