Joining FORCES is the FORCE newsletter with news, views and supportive information for individuals concerned about hereditary breast and ovarian cancer.
by Sue Friedman
People of similar ethnic backgrounds often share a likelihood of developing certain diseases.
In some cases, disease-causing mutations that run in ethnic groups or populations, like those in BRCA1 and BRCA2, are the cause. Hundreds of different BRCA mutations have been identified and found in people of every ethnicity, but some are more common in various groups. People of Ashkenazi (Eastern European) Jewish descent, for example, are more likely to inherit one of three specific BRCA 'founder mutations' — roughly 2.5% (one in forty) are estimated to carry one of these mutations. This equates to about a 10-fold higher risk of having a mutation than someone in the general population. Even with this increased risk, however, most Jewish people do not carry a BRCA mutation. About 40% of Jewish women with ovarian/ fallopian tube cancer and 20% who have premenopausal breast cancer have a BRCA mutation at a much higher rate than non-Jewish populations.
Because more than 90% of BRCA mutations found in Ashkenazi Jewish individuals are a founder mutation, their testing usually begins with a "Multisite 3" panel. Multisite 3 looks only for the three known founder mutations and is less expensive than the approximate $3,500 cost of full sequencing. When people who are Ashkenazi Jewish on both sides of their family test negative for Multisite 3, they are unlikely to have a mutation elsewhere in the BRCA1 and BRCA2 genes, and insurance may not cover 'reflex testing' which includes full sequencing of both the BRCA1 and BRCA2 genes.
It is important for people of all ethnicities and racial backgrounds to be aware of the risk factors and the potential need for genetic counseling and testing. A genetic counselor can review your family history and take your ethnicity or heritage into account to determine whether you're a candidate for testing, and assure that the appropriate genetic test is ordered.
You or any family member has had:
More than one family member on the same side of the family has had:
FORCE's brochure, 'What Every Jewish Woman Should Know About Breast & Ovarian Cancer' contains basic information about genetic counseling and testing for BRCA in Jewish women. View FORCE brochures.