BRCA Genetic Testing at Home — What to Know Before You Buy

By Amy Harris, MS, RN, CNM

Do you feel like getting the healthcare you want gets more complex and more expensive every day? You’re not alone if you are looking for DIY options or at least ways to cut costs and simplify staying healthy. More people are interested in longevity and in preventing diseases, such as cancer, to lessen their healthcare woes.

In the past, testing for these genetic changes was a specialty care service, provided only in person at medical offices, healthcare clinics, or hospitals. Thanks to advances in modern medicine, you can now take some of these genetic tests from the privacy of your own home. This type of test is known as a direct-to-consumer genetic test. There is even a direct-to-consumer test for the breast cancer genes, BRCA1 and BRCA2. Here’s what you need to know about BRCA genetic testing at home.

The Basics of Genetic Testing for Breast Cancer

Genetic testing is a study of your DNA. DNA is the chemical code with the instructions your body needs to stay alive and healthy. Genetic testing can reveal changes in the code that are similar to typos in writing. Some of these genetic typos, called mutations, in your genes can make it more likely that you may develop breast cancer. BRCA1 and BRCA2 (pronounced brah-kuh) are two of the most well-known of the breast cancer genes.

What to Know Before Buying an At-Home BRCA Genetic Test

If you are considering at-home genetic testing, such as the BRCA test, there are a few essential things to know before clicking on the “Buy Now” button. Keep in mind that:

1. Not all breast cancer is genetic.

2. The only currently FDA-approved at-home BRCA test looks for 3 out of the 1000 known mutations of the BRCA genes. It does not tell you about your risk for any other types of cancer except breast, ovarian, pancreatic, and prostate.

3. At-home cancer screening options offer convenience, privacy, and sometimes a lower price point.

4. There are different types of at-home genetic tests for breast cancer, as well as other cancers such as colon cancer.

Not All Breast Cancer Is Genetic

Even though most people have heard of the BRCA genes, they actually only cause a fraction of breast cancers. Only a minimal amount of breast cancers (5%–10% in the U.S.) are caused by genetic mutations, and BRCA1 and BRCA2 account for about half of the breast cancers caused by genetic mutations. This works out to be a relatively small number, only about 2 out of every 100 women with breast cancer.

Risk factors for breast cancer are anything that increases your chances of getting breast cancer. Breast cancer risk factors can be divided into two categories: things you can change and things you can’t change. Genetic changes such as BRCA1 and BRCA2 mutations fall into the category of things you can’t change.

The good news is that there are non-genetic breast cancer risk factors that you can do something about. The American Cancer Society lists the following as risk factors that may be related to your lifestyle:

• Drinking alcohol

• Having excess body weight (overweight or obesity)

• Not being physically active

• Not having children

• Not breastfeeding

Another fact to keep in mind when learning about risk factors is that even if a blood test for cancer gives you a positive result, it does not mean you will automatically get cancer. It just tells you that your risk for developing cancer might be higher than that of other people.

There Is More Than One Genetic Test for Breast Cancer

As you consider your breast cancer testing options, keep in mind that there are several different types of genetic testing for breast cancer. The BRCA genetic test type analyzes the DNA in your cells. The BRCA1 and BRCA2 genes are considered high-risk genes for breast cancer. Having the BRCA mutations also increases your risk of ovarian cancer, pancreatic cancer, and possibly some other cancers.

Another type of genetic testing does not look at your DNA directly. Tests like the GalleriⓇ Multi-Cancer Detection Test look for markers (like traffic hazard signs) of gene changes. This newer type of genetic test screens for more than 50 kinds of cancer with one blood test.

The GalleriⓇ Multi-Cancer Detection Test not only tells you if you have any of these cancer-linked markers, but also where in the body the marker came from. The multi-cancer early detection tests can accurately tell you where in the body you have cancer about 90% of the time. That means one out of every 10 tests may not correctly identify where the cancer is.

Choosing the Right At-Home Genetic Test for You

If you are looking for information about how to prevent cancers for which you might be at higher risk, a screening test for multiple cancers, like the GalleriⓇ Multi-Cancer Detection Test, might be a good choice.

If, on the other hand, you have a reason to think that you may have a BRCA mutation, then BRCA genetic testing may give you more of the answers you are looking for. The National Cancer Institute identifies several situations for which BRCA testing could be helpful:

• Having a family member with an inherited harmful change in the BRCA1 or BRCA2 gene

• Having Ashkenazi Jewish heritage

• Having a personal or family history of breast cancer at age 50 or younger

• Having a personal or family history of ovarian cancer, male breast cancer, pancreatic cancer, or metastatic or high-risk prostate cancer

How Does the BRCA Genetic Test Work?

If you choose the direct-to-consumer option, you will likely receive a test kit by mail after purchasing the test online. In some cases, such as if the test is run on your blood sample, you will need to make an appointment at a laboratory collection site.

The BRCA test requires a small sample of fluid or tissue from your body, most often your blood. Tests can also be run on a saliva sample or a swab from the inside of your cheek. Depending on whether you take the test at home or at a laboratory, either the lab or you will then mail the sample back to a genetic testing laboratory. Test results are typically returned within two to three weeks.

Everlywell Makes At-Home Genetic Testing Easy, Affordable, and Private

So, the upsides of at-home cancer genetic testing are pretty straightforward. These three C’s are easy to remember:

• Convenience

• Confidentiality

• Cost

Traditional genetic testing can involve multiple healthcare appointments, visits with a specially trained genetic counselor, and waiting for results. The cost of conventional in-person genetic testing is generally higher than that of at-home testing. If you have health insurance, it is more likely to cover the cost of genetic testing when it is performed in a healthcare setting with a genetic counselor.

Deciding whether to take a genetic cancer test is a personal decision. When making that decision, consider the security of your personal health data and genetic information. Everlywell is pleased to announce that its best-in-class, secure handling of personal health information has earned the company “Highly Compliant” status.

Virtual care visits offered through Everlywell allow you to speak one-on-one with healthcare providers about cancer screening options. They can help you learn more about breast cancer, your lifestyle, and your individual risk factors so you can make personalized decisions about at-home genetic testing options.

When deciding how to incorporate healthier habits to prevent cancer, it can be helpful to know your specific risk factors. For some cancers, like breast cancer, gene changes are risk factors for cancer. Thanks to Everlywell, you now have the option to screen for those gene changes as part of your plan for a healthier you.