Genetic test for breast cancer: when is it useful?

Ever since she had her breasts amputated as a precaution, Angelina Jolie has triggered inquiries from breast centers and clinics around the world for breast cancer genetic testing. You can find out in the article whether such a test is also useful for you.

Genetic test for hereditary breast cancer

In Germany, breast cancer is unfortunately no longer a rare diagnosis , and according to published figures from the cancer data registry, a quarter of the women who have the disease also have an increased incidence of this type of cancer in their families. However, we would like to inform you in advance that only 5 to 10 percent of the 70,000 new cases each year have a genetic cause for breast cancer .

If breast cancer or other cancers are known in your family, it makes sense that you seek advice from a specialist and undergo a genetic test, the so-called gene expression test.

Carrying out the genetic test

If you have decided to have the risk checked, you should first contact your gynaecologist. He will refer you to a suitable breast center. Once there, there is an admission interview with clarification of the family background.

For this purpose, the family risk constellation is examined in each case. In the anamnesis (admission interview) it is determined how many women in your family had diseases on the mother’s and father’s side that were clearly diagnosed  as breast cancer or ovarian cancer.

You can prepare yourself in advance for the appointment and the interview. Ask your mother or father whether the following figures apply to your family, regardless of how old they were at the time of their illness:

  • 3 women breast cancer or 2 women breast cancer and one of them under 51 years of age,
  • 1 woman breast cancer and 1 woman ovarian cancer,
  • 2 women ovarian cancer,
  • 1 woman breast and ovarian cancer,
  • 1 woman breast cancer, but under 35 years of age,
  • 1 woman with bilateral breast cancer under 50 years of age,
  • 1 man breast cancer (there is that too!) and 1 woman breast and ovarian cancer.
  • The costs of the test are partially or fully covered by the statutory health insurance companies . In any case, you should ask before the consultation appointment.
  • The private funds usually bear all the costs. Here, however, it is worth asking the state aid office if you are entitled to an aid.
  • In general, there must be a suspicion of the described risk in order for the costs to be covered, which the doctor treating you explains in a brief report.

If one or more of the disease constellations listed are present in your family, the doctor at the breast center will consult you in detail and will probably recommend a genetic test. 

For this purpose, blood is taken from you, which is examined in the laboratory for known genetic changes. Well-known breast cancer genes include BRCA 1, BRCA 2 and RAD51C. If one of these genes is detected in your blood, the doctor will talk about a hereditary risk of breast cancer in your presence.

BUT! A positive test result does not mean that you will actually develop breast cancer. It also says nothing about a possible course of the disease. The result only confirms that you have an increased risk of developing either breast cancer or ovarian cancer. 

AND! A negative test result in no way assures you that you will not develop breast or ovarian cancer. Even without proof of the numbered genes, there may be an increased family risk.

If one of the genes is clearly proven, you will be explained in the consultation what disease risks there are for you as a carrier of the brood cancer gene:

  • You are now included in the group of people who can develop breast or ovarian cancer about 20 years earlier than women with no proven risk.
  • Your lifetime risk of developing breast cancer is 50 to 80 percent.
  • There is a 60 percent chance that both sides of the chest will be affected.
  • The probability of developing ovarian cancer is 10 to 40 percent.

Should I get tested?

Ultimately, no one can make this decision for you and it will always be answered differently on an individual basis. If you are one of those women who plan every step in life and are very organized, you may want to know your risk probability. However, many women also consciously decide against genetic testing because they refuse to look into a “glass ball” and reject the “what if?” world of thought.

In any case, after the family tree has been taken, the doctor will consult with you and discuss all the pros and cons of the test and how to deal with a test result. In addition, you will have enough time to think about a decision for or against the test with relatives.

At the same time, you will be offered psychological counselling. Accept this if it’s good for you. You should not underestimate the psychological stress that such a genetic test represents. Not least because it can sometimes take months for the test result to be available. 

Genetic test after surviving breast cancer

A genetic test also makes sense during and after breast cancer treatment. However, it should not always apply to every woman. The clinical parameters give the doctor indications as to whether or not he should advise the woman about the test.

During breast cancer treatment, a test makes sense in that the affected person receives additional decision-making support. If there is no recommendation for or against chemotherapy or surgery, a clear test result can provide clarity.

After surviving breast cancer, a genetic test can clarify the risk of whether a recurrence (recurrence) or metastases  are to be expected or not. However, the negative psychological consequences that a positive test result triggers at this stage cannot be dismissed out of hand. So let your doctor advise you in detail.


The development of breast cancer genetic testing is a medical advance. Remember that a test result, no matter what it is, can not only bring you advantages. You cannot assess the psychological stress in advance. Also think of your relatives, who will live on with the test result. If it is positive, they ask themselves whether they should also be tested. If employers or even insurance companies find out about the test, unexpected problems may arise. Think carefully and above all calmly whether a genetic test is an option for you and weigh all the advantages and disadvantages.

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