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TESTING HER2- MBC PATIENTS FOR A gBRCA MUTATION

AT

DIAGNOSIS

CAN HELP INFORM TREATMENT PLANNING1*

*Relevant for patients who did not receive previous gBRCA testing and/or for patients who received only somatic BRCA testing.

HOW TO TEST GERMLINE VS SOMATIC TESTING

Germline

INHERITED MUTATIONS

CARRIED IN ALL CELLS OF THE BODY
DETECTED IN A BLOOD OR SALIVA SAMPLE

Germline mutations, such as inherited BRCA mutations, can be passed on to the next generation.

Germline mutations can be detected in a blood sample, cells in a cheek swab, or saliva. The sample is sent to a genetic laboratory for analysis and results are available in as early as 7 to 10 days.2-4

Somatic

ACQUIRED MUTATIONS

USUALLY ONLY PRESENT IN THE TUMOR
DETECTED WITH A TUMOR BIOPSY

A biopsy of tumor tissue must be analyzed to detect somatic mutations.

BRCA mutations detected in DNA extracted from a sample of tumor tissue can either be germline or somatic. A subsequent blood test can determine what type of mutation it is. The entire testing process may take several weeks.2,5,6

THE ROLE OF GENETIC COUNSELING

gBRCA test results may have familial implications for the MBC patient, and therefore, genetic counseling, telegenetic counseling, and/or physician-directed discussions may need to be considered to advise your patients appropriately.7,8

Testing for a gBRCA mutation may be covered in many cases by commercial insurance plans, including Medicare and Medicaid.

Patients should call their insurance provider to ask about any limits to their plan’s coverage. Healthcare provider office staff may be helpful in navigating patients through the insurance process and answering any questions that they might have.9,10

References: 1. American Society of Clinical Oncology. Genetic testing. American Society of Clinical Oncology Web site. https://www.asco.org/practice-guidelines/cancer-care-initiatives/genetics-toolkit/genetic-testing. Accessed April 6, 2018. 2. Lynch JA, Venne V, Berse B. Genetic tests to identify risk for breast cancer. Semin Oncol Nurs. 2015;31(2):100-107.
3. Cook‐Deegan R, Niehaus A. After Myriad: genetic testing in the wake of recent Supreme Court decisions about gene patents. Curr Genet Med Rep. 2014;2:223-241. doi:10.1007/s40142-014-0055-5. 4. Myriad. HBOC FAQs: BRCA1 or BRCA2 mutation and BRACAnalysis. Myriad Web site. https://myriadgenetics.eu/healthcare-professional-treating-diseases/hereditary-cancer-testing/hereditary-breast-and-ovarian-cancer-hboc-syndrom/hboc-faqs/. Accessed June 15, 2018. 5. Vergote I, Banerjee S, Gerdes A-M, et al. Current perspectives on recommendations for BRCA genetic testing in ovarian cancer patients. Eur J Cancer. 2016;69:127-134. 6. FoundationOne. Genomic testing. https://www.foundationmedicine.com/genomic-testing/foundation-one. Accessed June 15, 2018. 7. National Institutes of Health. National Cancer Institute. BRCA mutations: cancer risk and genetic testing. What are BRCA1 and BRCA2? National Institutes of Health Web site. https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q5. Accessed May 10, 2018. 8. Kinney AY, Steffen LE, Brumbach BH, et al. Randomized noninferiority trial of telephone delivery of BRCA1/2 genetic counseling compared with in-person counseling: 1-year follow-up. J Clin Oncol. 2016;34(24):2914-2924. 9. FORCE: Facing Our Risk of Cancer Empowered. Paying for genetic services. FORCE Web site. http://www.facingourrisk.org/understanding-brca-and-hboc/information/finding-health-care/paying_for_testing/basics/medicare_and_genetic_testing.php. Accessed April 25, 2018. 10. FORCE: Facing Our Risk of Cancer Empowered. Paying for genetic services. FORCE Web site. http://www.facingourrisk.org/understanding-brca-and-hboc/information/finding-health-care/paying_for_testing/basics/medicaid_and_genetic_testing.php. Accessed June 12, 2018. 

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