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BRCAvantage Plus™ Test Menu

Test code(s) 92587, 92573, 92586

The FAQ information attached by the previously provided link was retired on 01/25/2017. The link continues to be available for your historic reference. Current FAQs can be viewed at QuestDiagnostics.com/FAQs

Question 1. What is the difference between the 3 test codes listed above?

See the following descriptions for differences between these 3 codes.

92587, BRCAvantage Plus™

This panel is a one-step analysis for point mutations, deletions, and duplications in 7 genes: BRCA1, BRCA2, TP53, PTEN, CDH1, STK11, and PALB2.

92573, BRCAvantage™ with Reflex to Breast Plus Panel

This is a two-step analysis that first tests for point mutations, deletions, and duplications in BRCA1 and BRCA2, which are the most common causes of hereditary breast cancer. If BRCA1 and BRCA2 analysis does not detect a pathogenic or likely pathogenic mutation, a panel of 5 genes (TP53, PTEN, CDH1, STK11, and PALB2) is analyzed.

Evaluating hereditary breast cancer predisposition using this reflex test may offer cost benefits in some scenarios compared to the BRCAvantagePlus™ test.

92586, Breast Plus Panel without BRCA

This test detects point mutations, deletions, and duplications in 5 genes: TP53, PTEN, CDH1, STK11, and PALB2. BRCA1 and BRCA2 are not analyzed.

Question 2. Who may be appropriate for these BRCAvantage™ tests?

Individuals may be appropriate for one of these tests if they have:

  • A personal history of breast cancer and a family history consistent with more than 1 condition related to hereditary breast cancer
  • No personal history of breast cancer but have a family history of breast or other cancers consistent with more than 1 condition related to hereditary breast cancer

The Breast Plus Panel without BRCA should only be used when the person has tested negative for BRCA1 and BRCA2 mutations, deletions, and duplications.

When the familial mutation is unknown, test an affected family member first whenever possible. If a familial mutation has been identified, use an alternative test code. Refer to the National Comprehensive Cancer Network (NCCN) guidelines for more detailed criteria for selecting individuals for genetic testing.The guidelines strongly recommend Genetic Counseling for the patient before ordering any of these tests.

For more information or to discuss a family history with a Quest Diagnostics Genetic Counselor, please call 866-GENE-INFO.

Question 3. The familial mutation in my patient’s family is known. Is there a better test for my patient?

When the familial mutation associated with hereditary breast cancer is known, contact a Genetic Counselor at 866-GENE-INFO to help you select the most appropriate test.

Question 4. My patient has a positive result. What does this mean?

If your patient tests positive for a deleterious mutation, he/she has a significantly increased risk for developing breast and other related cancers relative to that in the general population.

The NCCN provides up-to-date surveillance and management recommendations for mutation carriers of many genes (http://www.nccn.org/professionals/physician_gls/f_guidelines.asp). Consider referring the patient to an oncology center experienced in treating patients with a hereditary predisposition to cancer. Such a center can discuss available options with the patient. These options may include increased surveillance, chemoprevention, and prophylactic surgery.

Question 5. My patient has a negative result. What does this mean?

  • Patient previously diagnosed with breast cancer—No mutation was found in the genes included in the panel. Your patient’s risk of recurrence or a related new cancer is based on his/her personal and family histories of cancer. In some instances, it may be appropriate to test for other hereditary forms of cancer. Call 866-GENE-INFO to discuss possible further studies.
  • Patient not previously diagnosed with breast cancer, but with a family history of breast cancer—No mutation was found in the genes included in the panel. Testing an affected family member is recommended for proper risk assessment. Your patient’s risk of cancer is based on his/her personal and family histories of cancer. In some instances, it may be appropriate to test for other hereditary forms of cancer. Call 866-GENE-INFO to discuss possible further studies.

Question 6. My patient has a variant of uncertain significance. What does this mean?

Variants that have not been previously described in the literature or whose significance is unclear based upon all currently available evidence must be correlated with the patient’s clinical presentation and family history. Family studies may be indicated to better understand the clinical significance of this variant. Please call 866-GENE-INFO to discuss with a Genetic Counselor if you have further questions.

 

Reference
 
  1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Genetic/familial high-risk assessment: breast and ovarian. V2.2014. Rockledge, PA: National Comprehensive Cancer Network, 2014. Available online with free registration.
This FAQ is provided for informational purposes only and is not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.

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