There are many reasons why people choose to have genetic testing for hereditary breast and ovarian cancer. Choosing to test is a very personal decision. Here are some of the most common considerations.

Pros

Some reasons why people choose to have testing are:

• They have a known BRCA1 or BRCA2 mutation in the family.
• They have a personal history of breast and/or ovarian cancer and a family history of similar cancers.
• They have relatives with breast and/or ovarian cancer.
• They are of Ashkenazi Jewish (Eastern European) ancestry — an ethnic group that is at high-risk for carrying BRCA mutations.
• A positive test result would affect decisions such as:
  • surgical intervention — such as having a mastectomy or oopherectomy.
  • healthcare decisions such as birth control, hormone replacement, or estrogen treatments like tamoxifen.
  • lifestyle decisions such as smoking, alcohol consumption, and diet.
  • future planning (financial, family planning) or coping (emotional).
• They perceive that their risk for having a BRCA mutation is high.
• They can afford to pay for testing or know that testing is covered by insurance.
• They have a reliable support network of family and friends, and are at a point in life when they can cope with test results — whether positive or negative.

Cons

Some reasons why people decide not to have testing are:

• There is no personal or family history of breast or ovarian cancer.
• There is not enough information to adequately interpret a genetic test result: They do not have relatives who have had genetic testing, a documented family history of cancer, or an ethnic background with known genetic mutations.
• They know that BRCA tests do not look for all possible mutations — and that test results cannot guarantee 100 percent that someone does not have a BRCA mutation.
• Test results would not affect their medical decisions or lifestyle changes.
• They do not consider their risk for being a carrier high.
• They have a personal history of depression or anxiety and are concerned about how they would cope with test results — whether positive or negative.
• They do not have a reliable support network of family and friends, or they are not at a point in life when they can cope with results — whether positive or negative.
• They do not want test results in their medical record due to concerns about insurance (health or life) or employment discrimination.
• They cannot afford to pay for testing or do not have insurance coverage.