Clinical Education Center
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- ABL Kinase Domain Mutation in CML, Cell-based
- ABO Group and Rh Type
- Acid-Fast Bacillus (AFB) Identification, Sequencing and Stain, Paraffin Block
- ADAMTS13 Activity with Reflex to ADAMTS13 Inhibitor
- Alcohol Metabolites, Quantitative, Urine
- Alpha-Globin Common Mutation Analysis
- Alpha-Globin Gene Deletion or Duplication
- Alpha-Globin Gene Sequencing
- Anti-Müllerian Hormone AssessR™
- Anti-PF4 and Serotonin Release Assay (SRA) for Diagnosing Heparin-induced Thrombocytopenia/Thrombosis (HIT/HITT)
- Antiphospholipid Antibodies
- ASCVD Risk Panel with Score
- Autoimmune Epilepsy Evaluation
- Autoimmune Diseases, Tests for
- B-cell and T-cell Clonality Assays by PCR
- B-Type Natriuretic Peptide (BNP)
- BCR-ABL1 Gene Rearrangement, Quantitative PCR
- Beta-Globin Complete
- BRCAvantage®, Ashkenazi Jewish Screen
- BRCAvantage®, Rearrangements
- BRCAvantage™, Comprehensive
- BRCAvantage™, Single Site
- CDH1 Sequencing and Deletion/Duplication
- Clostridium difficile Diagnostic Testing
- C1 Inhibitor, Protein and Functional Tests
- Calreticulin (CALR) Mutation Analysis
- Carbapenem Resistant Enterobacteriaceae Culture Screen
- Cardio IQ Lipoprotein Fractionation, Ion Mobility
- Cervical Cancer, TERC, FISH
- CFvantage® Cystic Fibrosis Expanded Screen
- Chlamydia trachomatis, TMA
- Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA
- Chromosomal Microarray, POC, ClariSure®, Oligo-SNP
- Chromosomal Microarray, Postnatal, ClariSure® Oligo-SNP
- Chromosome Analysis and AFP with Reflex to AChE, Fetal Hgb, Amniotic Fluid
- Chromosome Analysis, Amniotic Fluid
- Chromosome Analysis, Blood
- Chromosome Analysis, Blood with Reflex to Postnatal, ClariSure® Oligo-SNP Array
- Chromosome Analysis, Chorionic Villus Sample
- Chromosome Analysis, High Resolution
- Chromosome Analysis, High Resolution with Reflex to Postnatal, ClariSure® Oligo-SNP Array
- Chromosome Analysis, Mosaicism
- Chromosome Analysis, Neonatal Blood
- Chromosome Analysis, Sister Chromatid Exchange
- Chromosome Analysis, Tissue
- Chromosome DEB Assay for Fanconi anemia
- Chronic Lymphocytic Leukemia (CLL) - Diagnostic and Prognostic Testing
- Culture, Fungus
- Culture, Urine, Routine
- Cystic Fibrosis Screen
- Cytomegalovirus (CMV) and Epstein Barr Virus (EBV) PCR
- D-Dimer, Quantitative
- Dementia, Secondary Causes
- Dengue Virus Testing
- Diabetes Risk Panel with Score and Cardio IQ® Diabetes Risk Panel with Score
- Drug Testing, General Toxicology (Blood, Urine, or Serum)
- Drug Toxicology Alcohol Metab, QN, Oral Fluid
- Drug Toxicology Monitoring, Oral Fluid Testing
- Factor V (Leiden) Mutation Analysis
- Familial Mediterranean Fever Mutation Analysis
- First Trimester Screen, hCG
- First Trimester Screen, Hyperglycosylated hCG (h-hCG)
- FISH, Angelman
- FISH, MET Amplification
- FISH, Myeloma, 17p-, rea 14q32 with Reflexes
- FISH, Prader-Willi
- FISH, Prenatal Screen
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- HCV Genotyping
- Helicobacter pylori (H pylori) Antibody Discontinuation
- Heparin, Anti-Xa
- Hepatitis B Surface Antibody, Quantitative
- Hepatitis C Antibody with Reflex to HCV RNA, PCR with Reflex to Genotype
- Hepatitis C Viral RNA Genotype 1 NS5A Drug-resistance
- Hepatitis C Viral RNA Genotype 3 NS5A Drug Resistance
- Hepatitis C Viral RNA NS3 Drug Resistance
- Hepatitis C, RNA, Quantitative, PCR
- Hereditary Cancer Panels: MYvantageTM Hereditary Comprehensive Cancer Panel and GIvantageTM Hereditary Colorectal Cancer Panel
- Hereditary Hemochromatosis DNA Mutation Analysis
- Herpes Simplex Virus (HSV) Type-Specific IgG Antibodies
- Herpes Simplex Virus Type 2 (HSV-2) IgG Inhibition, ELISA
- HIV-1 Coreceptor Tropism, Proviral DNA
- HIV-1 Coreceptor Tropism, Ultradeep Sequencing
- HIV-1 Integrase Genotype
- HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes
- HPV mRNA E6/E7
- Influenza A and B Antigen, Immunoassay
- Influenza Type A and B Antibodies
- Insulin, Intact, LC/MS/MS
- Integrated Screen, Part 1
- Integrated Screen, Part 2
- Intrinsic Factor Blocking Antibody
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- Maternal Serum AFP
- Melanoma, BRAF V600E and V600K Mutation Analysis, THxID®
- Metanephrines, Fractionated, Free, LC/MS/MS, Plasma
- Methylenetetrahydrofolate Reductase (MTHFR), DNA Analysis
- Microalbumin (Urinary Albumin Excretion)
- Pain Management and CYP2D6/CYP2C19
- Pain Management, Naltrexone, Quantitative, Urine
- Partial Thromboplastin Time, Activated (aPTT)
- Penta Screen
- PIK3CA Mutation Analysis
- PNH with FLAER (High Sensitivity)
- Prothrombin Time with INR
- PTH, Intact and Calcium
- Streptococcus pneumoniae (Pneumococcal) Antibody Tests
- Saccharomyces cerevisiae Antibodies (ASCA) (IgG, IgA)
- Sequential Integrated Screen, Part 1
- Sequential Integrated Screen, Part 2
- Serum Integrated Screen, Part 1
- Serum Integrated Screen, Part 2
- Serum Pregnancy Tests
- Sickle Cell Screen
- Stepwise, Part 1
- Stepwise, Part 2
- SureSwab® Trichomonas vaginalis RNA, Qualitative TMA
- SureSwab®, Candidiasis, PCR
- TP53 Sequencing and Deletion/Duplication
- T4, Free
- Tamoxifen and Metabolites, LC-MS/MS
- Testosterone Testing
- Total Testosterone, LC/MS/MS
- Triple Screen
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BRCAvantage Plus™ Test MenuTest 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.1 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.
- 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.
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