If you or a family member carry a gene mutation, or cancer runs in your family, find out what it means, who should be tested, and how risk can be managed.
This map explains BRCA1 and BRCA2 mutations: the cancers they raise, screening, prevention, treatment and family testing.
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BRCA1 and BRCA2 are genes that normally repair damaged DNA. A harmful mutation in one copy raises the risk of some cancers.
Both women and men can carry and pass on a BRCA mutation. Each child has a 1 in 2 chance of inheriting it.
Carrying a mutation means a higher risk, not a certainty. Many carriers never get cancer, and screening and prevention lower the risk further.
Approximate lifetime risk (up to age 80). Tap a group on the map.
Cancer
Average Indian woman
BRCA1
BRCA2
Breast
About 1 in 28
About 7 in 10
About 6 in 10
Ovarian, fallopian tube, peritoneal
Less than 1 in 100
About 4 in 10
About 1 to 2 in 10
BRCA1 breast cancers are often triple-negative and occur at a younger age.
Breast cancer: about 1 to 7 in 100 (higher with BRCA2). Rare otherwise in men.
Prostate cancer: higher risk, earlier and more aggressive with BRCA2.
Pancreatic cancer, especially with BRCA2.
Melanoma (BRCA2).
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Age
What is done
From 18
Know how your breasts normally look and feel; report changes.
From 25
Breast examination by a doctor every 6 to 12 months; breast MRI every year.
From 30
Breast MRI and mammogram every year (often 6 months apart).
There is no reliable screening test for ovarian cancer. CA-125 and ultrasound do not find it early enough, which is why removing the tubes and ovaries is advised.
Age
What is done
From 35
Breast examination every year.
From 40
PSA blood test every year (especially BRCA2).
If a close relative has had pancreatic cancer: MRI or endoscopic ultrasound of the pancreas every year, from about 50.
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Advised after childbearing: around 35 to 40 for BRCA1 and 40 to 45 for BRCA2. Keyhole surgery.
Lowers the risk of ovarian cancer by about 8 in 10 and helps carriers live longer.
Causes early menopause; hormone replacement is usually safe until the natural age of menopause in women without breast cancer.
Risk-reducing mastectomy lowers breast cancer risk by more than 9 in 10. Reconstruction can be done at the same time.
A personal choice: careful MRI screening is a reasonable alternative.
Tamoxifen may lower breast cancer risk in some carriers.
The contraceptive pill lowers ovarian cancer risk.
Breastfeeding, a healthy weight, exercise and avoiding alcohol help.
Treatment follows the usual plan for that cancer, with some differences.
PARP inhibitor tablets (olaparib, niraparib, talazoparib) work especially well in BRCA-related cancers.
BRCA-related cancers often respond well to platinum chemotherapy.
In breast cancer, the BRCA result may change the choice of surgery.
What the research shows
OlympiA: a year of olaparib after treatment for high-risk early breast cancer with a BRCA mutation lowered the risk of return and helped patients live longer.
SOLO-1: olaparib maintenance in newly diagnosed BRCA-mutated ovarian cancer: about 2 out of 3 patients were alive at 7 years, compared with about half.
PROfound and POLO: olaparib helped patients with BRCA-mutated prostate and pancreatic cancer.
Parents, brothers, sisters and children each have a 1 in 2 chance of carrying the same mutation.
They can have a simple single-site test from 18 years of age.
Men should be tested too, for their own risk and their daughters'.
Cancer types