If you have a high-grade serous epithelial carcinoma you are automatically eligible for BRCA1/2 genetic testing. This is because a high-grade serous epithelial carcinoma diagnosis automatically puts you over the significant risk threshold.
In all other cases, NHS England says genetic testing will be offered to a person with breast or ovarian cancer if their combined BRCA1 and BRCA2 gene mutation carrier probability is 10% or more.
If they haven’t already talked to you about it, you can ask your cancer team about testing. Together you will decide whether you are to be referred to a genetics centre or offered a BRCA1/2 genetic test.
A referral to a genetics centre may not be needed if you are being cared for in hospitals that offer BRCA1/2 genetic testing as part of your cancer care.
Hospitals that currently offer this include Hammersmith Hospital, the Royal Marsden (through the Mainstreaming Cancer Genetics Initiative), the Christie and Addenbrookes. In these hospitals you may be asked whether or not you would like to have a BRCA1/2 genetic test by a nurse, doctor or other healthcare professional. Contact your local hospital to find out if they offer BRCA1/2 genetic testing.
If you are to be BRCA1/2 genetic tested, NICE guideline CG164 1.5.2 recommends pre-test counselling. This allows you the opportunity to discuss the potential risk and benefits of BRCA1/2 genetic testing, the chances of finding a mutation, the implications for you and your family, and the different types of test results.
You should also have the chance to ask questions to help you make the decision about whether or not you wish to have BRCA1/2 gene testing.
To help demonstrate your right to BRCA testing you can download one of the following template letters and take it to your GP:
These are NHS England guidelines (also followed in Wales). You can download a PDF of this guide containing NHS Scotland guidelines here. If you have any questions please contact Ross@ovarian.org.uk.