Hereditary Breast and Ovarian Cancer – GP Process

The BraOVO panel looks at high and moderate high risk genes associated with an increased lifetime risk of breast and ovarian cancers, as well as other cancers such as prostate and pancreatic cancer.

The panel contains 13 genes – ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, STK11 and TP53.

Of these, BRCA1 and BRCA2 are the most widely known.

Genetic testing for inherited cancer is a complex process that generates results that can have significant medical and psychological implications for patients and their families.  As part of our laboratory accreditation, Genomic Diagnostics must ensure that patients receive appropriate genetic counselling for this type of testing. GPs are not trained or accredited to provide genetic counselling services.

Genetic counsellors are specifically trained to provide pre-test counselling to discuss the test, the test outcomes and the potential implications of the results, and following the release of results, provide post-test counselling to discuss those results and what further action, if any, might be required.

Genetic counselling involves discussing benefits, limitations and the possible consequences of the genetic testing to be performed. It can be provided by your referring specialist or a qualified genetic counsellor and must be undertaken before testing.

Post-test counselling to fully understand what the results mean for you, as well as any implications for family members is also important.

As a complex, cancer risk test, where the results can have important medical and psychological implications for both the patient and their family, our national accreditation body requires genetic counselling to be performed prior to genetic testing.

Following counselling you are required to consent to genetic testing. If you do not wish to proceed with the testing, you may stop the process here.

Your results will be delivered to your general practitioner and also your genetic counsellor. Possible findings include:

Pathogenic variant found – also known as a ‘positive’ result. This means a gene change was identified that is known to increase your cancer risk. It does not mean you will definitely develop cancer if you don’t have a personal history of cancer, but if you have cancer it may influence your medical management. The result should be shared with your relatives who may want to be tested to understand their own cancer risk.

No pathogenic variants found – also known as a ‘negative’ result. This means you do not have a harmful change in any of the genes that were tested. It does not mean you will not get cancer, as there are many other factors that contribute to cancer risk, and it does not rule out changes in genes that were not tested.

Variant of unknown significance (VUS) found – this means a gene change was identified however its impact on hereditary cancer risk is not yet understood. This finding will not change your ongoing medical care.

Genetic testing for inherited cancer is most often accessed through state-funded Familial Cancer Services at major public hospitals, and private medical specialists and clinics with an interest in inherited cancers. These options continue to be available.

Unfortunately, due to increased awareness of testing, wait times for pre-test counselling and genetic testing can be very long (6 -12 months) and can be even longer for patients in regional and remote areas.

While testing through public and private services can be free of charge this is not always the case, as patients may not meet the eligibility requirements of the medical service or Medicare criteria.

The Genomic Diagnostic option for breast and ovarian cancer genetic testing requested by GPs provides medically referred, rapid and safe access for patients looking for an alternative offering to traditional pathways to testing.  We recommend that you talk to your GP to see if this option is right for you.

Overall, the process of counselling and testing takes approximately 8 weeks.

You will be contacted by our Genetic Counselling partners, PGWA, to book your pre-test genetic counselling appointment within 2 – 3 business days from the the laboratory forwarding the request.

Counselling with occur within 1 – 2 weeks and once completed, genetic testing can proceed.

Testing for multiple genes takes approximately 4 weeks.

Your results are then forwarded to back to the genetic counsellor who will discuss them with you in the post-test counselling session.

If you have a family member with a known familial variant, such as BRCA1, it is possible to get tested for that variant alone.

You must be able to provide a report from the family member, stating the exact details of the variant so that we can test for it.

You will still need to undertake genetic counselling and pay for the package up front, however a partial rebate will apply.

The collection centre cannot take your payment. However, you can pay online anytime by clicking here. If you’re unable to pay online, you can make payment by phone Monday-Friday between 8am-6pm AEST on 1800 822 999.

You may change your mind about testing at any stage during the process. Please call our Customer Care team on 1800 822 999 to arrange a partial refund. Administrative and counselling costs may apply.

Please call our Customer Care team on 1800 822 999 to discuss a refund if you do not wish to proceed with testing. Administrative costs may apply.