- No FAQs found
- ATM Sequencing and Deletion/Duplication
- 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-PF4 and Serotonin Release Assay (SRA) for Diagnosing Heparin-induced Thrombocytopenia/Thrombosis (HIT/HITT)
- Antiphospholipid Antibodies
- APC Sequencing and Deletion/Duplication
- ASCVD Risk Panel with Score
- Autoimmune Epilepsy Evaluation
- Autoimmune Diseases, Tests for
- BAP1 Sequencing and Deletion/Duplication
- BLM Sequencing and Deletion/Duplication
- Bordetella pertussis toxin (PT) antibody
- B-cell and T-cell Clonality Assays by PCR
- B-Type Natriuretic Peptide (BNP)
- BCR-ABL1 Gene Rearrangement, Quantitative PCR
- Beta-Globin Complete
- Biotin: Interference with Laboratory Assays
- BRCA Ashkenazi Jewish Screen
- BRCA Ashkenazi Jewish Screen with Reflex to BRCA Panel (BRCA1, BRCA2)
- BRCA Panel (BRCA1, BRCA2)
- BRCA Panel Plus
- BRCA1 and BRCA2 Deletion/Duplication
- BRCAvantage®, Rearrangements
- BRCAvantage™, Single Site
- CDH1 Sequencing and Deletion/Duplication
- CDKN2A Sequencing and Deletion/Duplication
- CHEK2 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
- CardioIQ® Insulin Resistance Panel with Score
- CDH1 Sequencing and Deletion/Duplication
- Cervical Cancer, TERC, FISH
- CFvantage® Cystic Fibrosis Expanded Screen
- Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA
- Chromogranin A Testing
- Chromosomal Microarray, POC, ClariSure®, Oligo-SNP
- Chromosomal Microarray, Postnatal, ClariSure® Oligo-SNP
- Chromosomal Microarray, Prenatal, 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
- Comprehensive Hereditary Cancer Panel
- COVID-19 Vaccine-Induced Immune Thrombotic Thrombocytopenia
- Culture, Fungus
- Culture, Urine, Routine
- Cystic Fibrosis Screen
- Cytomegalovirus (CMV) and Epstein Barr Virus (EBV) PCR
- Cytomegalovirus (CMV) IgG avidity
- D-Dimer, Quantitative
- Dementia, Secondary Causes
- Dengue Virus Testing
- Diagnosis of Intestinal Parasites
- Donor Testing
- Drug Monitoring, Antidepressants, With Confirmation, Urine and Serum
- Drug Testing, General Toxicology (Blood, Urine, or Serum)
- Drug Toxicology Alcohol Metabolite, with Confirmation, Oral Fluid
- Drug Toxicology Monitoring, Oral Fluid Testing
- FH Gene Sequencing and Deletion/Duplication
- FLCN Sequencing and Deletion/Duplication
- FLT3 Mutation Analysis
- Factor V (Leiden) Mutation Analysis
- Factor VIII Activity, Clotting
- Familial Hypercholesterolemia (FH) Panel
- Familial Hypercholesterolemia (FH) Single Site
- 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
- Follicular Lymphoma, EZH2 Mutation, COBAS
- HOXB13 Sequencing and Deletion/Duplication
- Helicobacter pylori (H pylori) Antibody Discontinuation
- Heparin, Anti-Xa
- Hepatitis B Surface Antibody, Quantitative
- Hepatitis B Surface Antigen, Quantitative, Monitoring
- 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 Viral RNA, Genotype, LiPA
- Hepatitis C Virus Antibody and RNA Testing
- Hereditary Breast Cancer Panel
- Hereditary Cancer Single Site(s)
- Hereditary Colorectal Cancer Panel
- Hereditary Endocrine 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 Pre-exposure Prophylaxis (PrEP) Testing
- HIV-1 Coreceptor Tropism, Proviral DNA
- HIV-1 Coreceptor Tropism, Ultradeep Sequencing
- HIV-1 Integrase Genotype
- HIV-1 Resistance, Proviral DNA (RTI, PI, Integrase Inhibitors)
- HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes
- HPV mRNA E6/E7
- Infliximab and Adalimumab Drug and Anti-drug Antibody Testing
- 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
- Isocitrate Dehydrogenase 1 and 2 (IDH1/IDH2) Mutation Analysis (IDH1 and IDH2 Mutation)
- LDL Cholesterol Calculations
- LeukoVantage® Myeloid Neoplasm Mutation Panels
- Li-Fraumeni Syndrome, TP53 Sequencing and Deletion/Duplication
- Lupus Anticoagulant (LA) Evaluation with Reflex
- Lyme Disease Testing
- Lynch Syndrome Panel
- Lynch Syndrome, MLH1 Sequencing and Deletion/Duplication
- Lynch syndrome, MSH2 Sequencing and Deletion/Duplication (Including EPCAM)
- Lynch Syndrome, MSH6 Sequencing and Deletion/Duplication
- Lynch Syndrome, PMS2 Sequencing and Deletion/Duplication
- MEN1 Sequencing and Deletion/Duplication
- MUTYH Sequencing and Deletion/Duplication
- 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)
- Myeloproliferative Neoplasm Diagnosis: Molecular Evaluation
- NF1 Sequencing and Deletion/Duplication
- NAFLD Fibrosis Score
- Nevoid Basal Cell Carcinoma (NBCCS) (Gorlin) Syndrome Panel (PTCH1, SUFU)
- No FAQs found
- PALB2 Sequencing and Deletion/Duplication
- PTEN Sequencing and Deletion/Duplication
- Pain Management and CYP2D6/CYP2C19
- Pain Management Antipsychotics, With Confirmation, Serum and Urine
- Pain Management, Naltrexone, Quantitative, Urine
- Partial Thromboplastin Time, Activated (aPTT)
- Penta Screen
- Pharmacogenomics Panel
- PIK3CA Mutation Analysis
- Platelet Antibody Screen (Indirect)
- PNH with FLAER (High Sensitivity)
- Porphyria Testing
- Prothrombin Time with INR
- PTH, Intact and Calcium
- SMARCA4 Sequencing and Deletion/Duplication
- STK11 Sequencing and Deletion/Duplication
- Streptococcus pneumoniae (Pneumococcal) Antibody Tests
- Saccharomyces cerevisiae Antibodies (ASCA) (IgG, IgA)
- SARS-CoV-2 Antibody Testing
- 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
- TP53 Sequencing and Deletion/Duplication
- T4, Free
- Tamoxifen and Metabolites, LC-MS/MS
- Testosterone Testing
- Total Testosterone, LC/MS/MS
- Triple Screen
- Tuberous Sclerosis Complex Panel (TSC1, TSC2)
- No FAQs found
- VHL Sequencing and Deletion/Duplication
- Varicella Zoster Virus Antibody (IgG)
- Vitamin D Testing
- von Willebrand Comprehensive Panel
- No FAQs found
- No FAQs found
BRCA Ashkenazi Jewish Screen with Reflex to BRCA Panel (BRCA1, BRCA2)Test code(s) 92140
Question 1. What is the clinical application of this test?
This test is for individuals of Ashkenazi Jewish descent to identify if they have hereditary breast and ovarian cancer (HBOC) syndrome due to a BRCA1 or BRCA2 pathogenic variant. It is designed to detect the 3 pathogenic variants in BRCA1 and BRCA2 known to be more common in people of Ashkenazi (Eastern European) Jewish descent. Specifically, the only pathogenic variants included are 185delAG (c.68_69delAG) and 5382insC (c.5266dupC) in the BRCA1 gene and 6174delT (c.5946delT) in the BRCA2 gene.
If an individual tests negative for those 3 pathogenic variants, then whole-gene testing for single-nucleotide variants, deletions, and duplications in the BRCA1 and BRCA2 genes will be performed.
If an individual tests positive for any of the first 3 pathogenic variants – ie, 185delAG (c.68_69delAG), 5382insC (c.5266dupC) in the BRCA1 gene and 6174delT (c.5946delT) in the BRCA2 gene – then whole-gene testing for the BRCA1 and BRCA2 genes will not be performed.
Question 2. What other tests might be appropriate?
If an individual is not of Ashkenazi Jewish descent, this test should not be ordered. Depending on an individual’s personal and family histories, the BRCA Panel (BRCA1, BRCA2 [test code 91863]) may be appropriate.
If an individual is of Ashkenazi Jewish descent and the familial mutation is unknown, or if the familial mutation is 1 of the 3 Ashkenazi Jewish founder mutations, the BRCA Ashkenazi Jewish Screen (test code 91864) may be appropriate.
If an individual is of Ashkenazi Jewish descent and there is a familial mutation that is not 1 of the 3 Ashkenazi Jewish founder mutations, consider testing for both the founder mutations (BRCA Ashkenazi Jewish Screen [test code 91864]) and the familial mutation (Hereditary Cancer Single Site[s] [test code 93945]).
Additional tests, such as multigene panel tests, are available to help assess the risk of hereditary breast cancer. For more information, please visit our website QuestHereditaryCancer.com. To discuss a family history with a Quest Diagnostics genetic counselor, please call Quest Genomics Client Services at 1.866.GENE.INFO (1.866.436.3463).
Question 3. What are the clinical indications for this testing?
Generally, test may be indicated for men and women of Ashkenazi Jewish ancestry with a personal or family history of breast cancer, ovarian cancer, high-grade (Gleason score ≥7) prostate cancer, or pancreatic cancer.1
Informed consent following genetic counseling is strongly recommended before ordering these tests. Whenever possible, consider testing the person in the family with the youngest age at the time of diagnosis of breast cancer or ovarian cancer.
Question 4. Whom can I ask for help regarding a specific case?
For more information or to discuss a family history with a Quest genetic counselor, please call Quest Genomics Client Services at 1.866.GENE.INFO (1.866.436.3463).
Question 5. When is the right time to pursue this test?
The right time is different for every individual. An individual’s current medical status, personal and family experience with cancer, treatment or screening plan, and general readiness for genetic information all influence the decision to be tested. Having an open dialogue with individuals about these topics can assist with shared decision-making.
Question 6. How do I know if insurance will cover this testing?
Upon receipt of a fully completed order, our team will verify coverage with your patient’s healthcare insurance plan and estimate their likely out-of-pocket responsibility. If your patient’s estimated responsibility is over $100, we will notify you and/or your patient prior to test initiation to discuss options for continuation or cancellation of the test. Please, note that orders lacking complete information will not be processed.
Question 7. How quickly can I expect results?
On average, results will be completed 14 to 21 days after receipt of the sample in the laboratory if the family history form and order are complete and the health plan does not require preauthorization. Turnaround time may vary based on delays caused by incomplete orders or insurance authorizations.
Question 8. What does a positive result mean?
Individuals with a positive result have a pathogenic or likely pathogenic variant(s) detected in the BRCA1 and/or BRCA2 gene(s), and a diagnosis of HBOC syndrome. A positive result does not mean that an individual has a diagnosis of cancer. Specific risk information will be provided in the result report, and you can visit our website at QuestHereditaryCancer.com for more information.
The National Comprehensive Cancer Network (NCCN®) provides up-to-date surveillance and management recommendations for individuals with a positive result.1
Question 9. What does a negative result mean?
A negative result means that a pathogenic or likely pathogenic variant was not detected in the BRCA1 and BRCA2 genes. For more information regarding specific genetic variants analyzed in this assay, please refer to the methods and limitations section of the genetic testing report. The implications of this result depend on the situation:
Individual with a known family history of 1 of the 3 Ashkenazi Jewish mutations: None of the 3 Ashkenazi Jewish founder mutations or other known mutations in BRCA1 and BRCA2 were detected. The patient’s risk of breast and ovarian cancer is likely equivalent to that of the general population. Consider testing for other hereditary forms of cancer if appropriate based on personal or family history of cancer.
Individual with previously diagnosed cancer: An individual’s risk of recurrence or a related new cancer is based on their personal and family histories of cancer. In some instances, it may be appropriate to test for other hereditary forms of cancer. Please call Quest Genomics Client Services at 866.GENE.INFO to discuss possible additional studies with a genetic counselor.
Individual without previously diagnosed cancer but with a family history of cancer: An individual’s risk of tumors or cancer is based on their personal and family histories. Testing an affected family member may further inform this risk assessment. In some instances, it may be appropriate to test for other hereditary forms of cancer. Please call Quest Genomics Client Services at 1.866.GENE.INFO (1.866.436.3463) to discuss possible additional studies with a genetic counselor.
Question 10. What does a variant of uncertain clinical significance (VUS) result mean?
A VUS result means that the variant has not been previously described in the literature or that the clinical significance is unclear based upon currently available evidence. Medical management decisions should be based on personal and family history. Family studies may help to learn more about the clinical significance of this variant. The classification and interpretation of the variant(s) identified reflect the current state of Quest’s understanding at the time of the report. Variant classification and interpretation are subject to professional judgment and may change for a variety of reasons including, but not limited to, updates in classification guidelines and availability of additional scientific and clinical information. It is important to check in with the laboratory annually for variant updates because new information regarding the variant and classification may become available over time. Please visit QuestDiagnostics.com/VariantIQ for information about variant classification. If you have questions, please call Quest Genomics Client Services at 1.866.GENE.INFO (1.866.436.3463) to speak with a genetic counselor.
- National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Genetic/familial high-risk assessment: breast, ovarian, and pancreatic. Version 1. 2020. Published December 4, 2019. https://www.nccn.org