Criteria for Ordering BRCA1/BRCA2 Testing for Cancer Risk Assessment in the Medical Lab Setting in the United States

Summary

• BRCA1/BRCA2 testing is typically ordered for patients with a strong family history of breast or ovarian cancer.
• Guidelines recommend testing for individuals with a personal history of breast or ovarian cancer before the age of 45.
• Patients with specific ethnic backgrounds, such as Ashkenazi Jewish descent, may also be candidates for BRCA1/BRCA2 testing.

Introduction

BRCA1/BRCA2 testing is a genetic test that can help assess an individual's risk of developing breast or ovarian cancer. This test is typically ordered for patients with a strong family history of these types of cancer, as well as for individuals with a personal history of breast or ovarian cancer at a young age. In this article, we will discuss the specific guidelines and criteria for ordering BRCA1/BRCA2 testing in a patient for cancer risk assessment in a medical lab setting in the United States.

Family History Criteria

One of the primary criteria for ordering BRCA1/BRCA2 testing is a strong family history of breast or ovarian cancer. This typically includes the following scenarios:

1. Having two or more close relatives, such as a parent, sibling, or child, who have been diagnosed with breast or ovarian cancer.
2. Having a close relative who was diagnosed with breast cancer before the age of 50, or ovarian cancer at any age.

Personal History Criteria

Individuals with a personal history of breast or ovarian cancer may also be candidates for BRCA1/BRCA2 testing. Specific criteria for testing based on personal history include:

1. Being diagnosed with breast cancer before the age of 45.
2. Being diagnosed with ovarian cancer at any age.
3. Having both breast and ovarian cancer in the same individual.

Ethnic Background Criteria

In addition to family and personal history criteria, certain ethnic backgrounds may also warrant BRCA1/BRCA2 testing. For example, individuals of Ashkenazi Jewish descent have a higher prevalence of BRCA1/BRCA2 mutations, making them more likely to benefit from testing. Other ethnic groups with increased risk of these mutations may also be considered for testing based on their background.

Other Considerations

While the above criteria are common guidelines for ordering BRCA1/BRCA2 testing, Healthcare Providers may also take other factors into consideration when determining whether testing is appropriate for a patient. These factors may include:

1. Whether the patient has a known BRCA1/BRCA2 mutation in the family.
2. Any other genetic mutations or syndromes that may increase cancer risk.
3. The patient's age, overall health, and personal preferences for testing.

Conclusion

BRCA1/BRCA2 testing plays a crucial role in cancer risk assessment for individuals with a high likelihood of carrying these genetic mutations. By following specific guidelines and criteria for ordering this testing in a medical lab setting in the United States, Healthcare Providers can help identify patients who may benefit from increased surveillance, preventive measures, or early intervention for breast or ovarian cancer.

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