Posted By Dr Farah Arshad | Breast Cancer Specialists ,Lucknow
What Is This Test, Really?
Most people have heard the word “BRCA” somewhere — maybe from a celebrity news story or a relative’s doctor visit. But very few people understand what getting tested actually means for their life.
This is not just a blood test. It is a decision that can change how you screen for cancer, how you plan surgery, how you think about your family, and how you feel every day.
Let’s walk through it in plain language.
What Are BRCA Genes?
Everyone has BRCA1 and BRCA2 genes. These genes normally protect you from cancer — they help repair damaged cells.
But some people are born with a fault (called a mutation) in these genes. When the gene is faulty, it cannot do its protective job properly. This raises the risk of breast and ovarian cancer significantly.
Having a BRCA mutation does not mean you have cancer. It means your risk is higher than average, and you need a closer watch.
Who Should Think About Getting Tested?
You should seriously consider BRCA testing if any of the following apply to you:
- You were diagnosed with breast cancer before age 45
- You have triple-negative breast cancer before age 60
- You or anyone in your family has had ovarian cancer
- A male relative has had breast cancer
- Multiple relatives on the same side of the family have had breast or ovarian cancer
- A family member has already tested positive for BRCA
What If Your Family History Is Not Very Clear?
This is a very common situation, especially in India. Families are smaller. Old relatives passed away without a proper diagnosis. Some cancers were called “stomach problems” or “abdominal cancer” without biopsy confirmation.
The absence of a clear family history does not automatically mean low risk. Tumor biology — meaning what type of cancer it is and how aggressive it behaves — also matters a great deal. An experienced breast surgeon will look at the full picture, not just the family tree.
Your Risk If You Test BRCA Positive
At-a-Glance Risk Chart
| Cancer Type | Average Population Risk | BRCA1 Mutation Risk | BRCA2 Mutation Risk |
|---|---|---|---|
| Breast Cancer | ~12% | Up to 72% | Up to 69% |
| Ovarian Cancer | ~1–2% | Up to 44% | Up to 17% |
| Second Breast Cancer | Low | Significantly higher | Significantly higher |
This chart shows why a positive result is taken seriously. The risk is not doubled — in some cases, it is multiplied five to six times. That demands a proper plan, not panic.
What Changes After a Positive Result?
Finding out you carry a BRCA mutation opens up a clear, structured path. Here is what typically changes:
Screening becomes more intense. Mammograms begin earlier, often from age 25–30, and MRI scans are added each year. The goal is to catch any cancer as early as possible, when it is most treatable.
Surgery becomes a real conversation. Risk-reducing surgery — removing the breasts or ovaries before cancer develops — is not mandatory, but it is discussed. A preventive mastectomy can reduce breast cancer risk by around 90%. Removing the ovaries reduces ovarian cancer risk significantly and also lowers breast cancer risk in BRCA1 carriers.
Cancer treatment itself may change. If you already have cancer and you are BRCA positive, certain chemotherapy drugs called PARP inhibitors work especially well in your case. This is why testing is sometimes urgent, not just preventive.
Your family needs to know. A BRCA mutation is inherited. Your siblings have a 50% chance of carrying the same mutation. Your children may need testing in the future. This is shared biology, and it affects the whole family.
What a Negative Result Does NOT Mean
This is one of the most misunderstood parts of BRCA testing.
A negative BRCA test does not mean “you are safe.” It means BRCA1 and BRCA2 mutations were not found. There are other genes — such as PALB2, CHEK2, and ATM — that also raise breast cancer risk. If your family history is strong but your BRCA test is negative, the conversation should continue with your doctor, not end.
The Gray Zone: Variants of Uncertain Significance
Sometimes the lab finds a change in the gene, but science does not yet know whether that change is harmful or harmless. This is called a Variant of Uncertain Significance, or VUS.
Living with a VUS result can feel frustrating. You are not clearly positive. You are not clearly negative. Managing this requires experience and patience — not rushed decisions about surgery, and not complete dismissal either. Regular follow-up is key.
The Emotional and Psychological Side
Genetic testing is not just a medical event. It is a personal and family event.
Some patients feel relieved to have answers finally. Others feel guilt — worrying that they may have passed a mutation to their children. Some feel angry or overwhelmed. Some families fall into difficult conversations about who should test and who doesn’t want to know.
This is normal. And this is exactly why genetic counseling before and after the test is so important. A good counselor helps you prepare for the result before it arrives, and helps you process it after.
When It Makes Sense to Wait Before Testing
Testing is not always urgent. Sometimes it is right to pause if:
- There is no significant family history and no current cancer diagnosis
- You are going through a very stressful life period
- You have not yet spoken with a genetic counselor
- You are not sure what you would do with the result
Testing without preparation can leave you with anxiety and no clear path forward. Readiness matters just as much as risk.
The Long Game: Testing Is Not a One-Time Event
If you test positive, this is not something you deal with once and forget. It becomes part of your ongoing health plan. Screening schedules are reviewed yearly. Surgical timing is planned based on your age and family goals. Guidelines are updated as research improves. What your management plan looks like at 28 will look very different at 42.
Young BRCA-positive women especially face layered decisions — around fertility, egg freezing, the timing of ovary removal, and the menopause that follows. These decisions deserve time, expert guidance, and honest conversations.
Final Thought
If you are reading this and wondering whether BRCA testing is right for you or someone you love, the most important step you can take is to speak with a specialist who understands not just the genetics — but the whole person behind the test.
Dr. Farah Arshad, recognized as the Best Breast Surgeon in Lucknow, brings together clinical precision and genuine patient care in every consultation. Whether you are navigating a strong family history, processing a recent breast cancer diagnosis, or simply trying to understand your risk, Dr. Farah Arshad provides the guidance you need to make informed, confident decisions.
BRCA testing is not a form you fill out online. It is a conversation — one that deserves the attention of an experienced breast surgeon who has walked this path with hundreds of patients before you.
If you are in Lucknow or the surrounding region and have concerns about your breast cancer risk, reach out to Dr. Farah Arshad’s clinic. Early conversations save lives. The right doctor makes all the difference.
Frequently Asked Questions on the BRCA Gene Test
1. How do I know if I need BRCA testing?
If you have a close family member who has had breast or ovarian cancer — especially at a young age — or if you yourself have been diagnosed with breast cancer before 45, you should speak with a breast specialist about whether BRCA testing is right for you. Dr. Farah Arshad, the best breast surgeon in Lucknow, can assess your personal and family history and guide you through this decision in a single consultation.
2. Is BRCA testing painful or complicated?
Not at all. The test itself is simple — it requires either a blood sample or a saliva swab. The process takes just a few minutes. What requires more care is the preparation before the test and the counseling after the result, which is why doing this under the guidance of an experienced breast surgeon is strongly recommended.
3. If my BRCA test is negative, does that mean I will never get breast cancer?
No. A negative BRCA result means that the two most well-known high-risk gene mutations were not found in your sample. It does not eliminate your breast cancer risk entirely. Other genes, lifestyle factors, and hormonal history also play a role. Regular screening and annual check-ups with a breast specialist remain important even after a negative result.
4. Can men get BRCA testing, and should they?
Yes, men can carry and pass on BRCA mutations, and male BRCA2 carriers have a meaningfully higher risk of breast cancer, prostate cancer, and pancreatic cancer. If there is a known BRCA mutation in your family, male relatives should also consider testing. This is an area that is often overlooked but is taken seriously in a thorough clinical evaluation.
5. How soon should I act after a positive BRCA result?
A positive result does not require immediate surgery or panic. It requires a clear, structured plan made with your surgeon. Depending on your age, your cancer history, and your family goals, the plan will look different for every person. Dr. Farah Arshad, widely regarded as the best breast surgeon in Lucknow, specializes in creating individualized long-term management plans for BRCA-positive patients — so that every decision is made with confidence, not fear.
