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Cancers develop when a mutation in your DNA causes cells in different parts of the body to grow out of control. Breast cancers are no exception.

While some genetic mutations that cause breast cancer are acquired and develop because of cell damage during your lifetime, others are passed down through families. These inherited mutations, like BRCA1 and BRCA2, are believed to cause as many as 10 percent of all breast cancers.

If you have blood relatives with breast cancer, or a family history of some other types of cancers, you may want to consider genetic testing.

Genetic testing can give you information about specific gene mutations that run in your family and what these mutations mean in terms of your cancer risk. Laboratories have traditionally performed this testing, but there are new options that allow you to take these tests at home.

This article will explore how these tests work and which ones are worth exploring.

There are several types of inherited genetic mutations that can cause breast cancer. BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2) are gene mutations passed through families. These genes tell the body how to make proteins that repair damaged cells and help suppress tumor growth.

Everyone inherits one copy of each of these genes from each parent. When one — or both — of these genes has a mutation, it can prevent these genes from doing their jobs and allow cancer cells to develop.

In people assigned female at birth, having a BRCA1 or BRCA2 mutation gives you a 7 in 10 chance of developing breast cancer before age 80. The risk is higher in people who have multiple family members with the same mutation.

In addition to increasing your chances of developing breast cancer, these mutations also increase your chances of:

  • developing breast cancer at a younger age
  • developing cancer in both breasts
  • developing ovarian cancer or other forms of cancer

People assigned female at birth are not the only ones who face a risk with these genetic mutations, either. People assigned male at birth who carry the gene mutations can also develop breast cancer, and they have an increased risk of developing prostate cancer and some other forms of the disease.

While the BRCA1 and BRCA2 mutations are the most common, they aren’t the only cancer-causing genetic mutations that can be passed through families.

Other gene mutations linked to inherited breast cancers include:

  • ATM
  • TP53
  • CHEK2
  • PTEN
  • CDH1
  • STK11
  • PALB2

Most home testing kits for inherited breast cancers focus on the BRCA1 and BRCA2 mutations. Some test for more than one variant of these mutations, and most use saliva to run the test. In comparison, laboratory tests done in the clinical setting may use saliva or blood samples.

Choosing a test kit

If you’re concerned about your risk of inherited genetic diseases like breast cancer, you should discuss your concerns with a healthcare professional. They may order testing, or you can opt to be tested on your own.

Home testing is also an option if your provider agrees that testing would benefit you but your insurance provider won’t cover traditional laboratory testing.

Below are several options if you’re interested in home testing for BRCA mutations.

23andMe

23andMe tests for three variants of the BRCA1 and BRCA2 mutations. The company also offers packages that check for other inherited genetic mutations.

Cost: Prices of 23andMe packages range from $99 to $199, depending on how many reports you want included in your results.

Insurance eligibility: You may be eligible to use your flexible spending account (FSA) or health savings account (HSA) to purchase 23andMe kits.

Results: The least expensive 23andMe Ancestry package does not include reports on BRCA1 and BRCA2 mutations. To receive these results, be sure to order the Health + Ancestry or the 23andMe + kit.

When you receive the test report, it will indicate whether or not you carry a genetic predisposition for one of the tested conditions. These tests do not diagnose active disease, and not everyone who carries a variant of a genetic mutation will develop the condition associated with that mutation.

These kits will include reports on your predisposition to conditions that include:

The kits will also provide you with reports on how your genetics play a role in things like:

  • overall wellness
  • physical features
  • how you will pass on genes to your children
  • how your body processes certain medications

Where to buy: 23andMe is sold through the company’s website, Amazon, and some retailers like Walmart.

Additional guidance available? 23andMe does not provide medical advice or genetic counseling about your results. The company provides links to help you locate healthcare professionals in your area if you need additional guidance.

Invitae

Invitae offers tests for a number of cancer types, including:

After completing an online pretest consultation, you will be given recommendations on which test or tests are right for you.

Invitae’s breast cancer panel tests for the following genetic variants:

  • BRCA1
  • BRCA2
  • ATM
  • BARD1
  • BRIP1
  • CDH1
  • CHEK2
  • NBN
  • NF1
  • PALB2
  • PTEN
  • RAD50
  • STK11
  • TP53

Additional, less common variants may also be tested.

Cost: Invitae charges $250 for each diagnostic panel or single gene test in any given clinical area. For example, if you wanted to test for breast and thyroid cancers, these would be considered two different clinical areas, and you would pay $250 for each test.

Insurance eligibility: Invitae accepts Medicare and Medicaid, and it’s offered as an in-network testing option with a number of commercial insurance companies. Self-pay rates and assistance programs are available whether or not your insurance covers the cost of the test.

Results: Invitae’s result report will tell you whether your sample was positive or negative for the tested genetic variants. The results may also suggest that there was some evidence of a variant, but that additional testing is needed. Even if the result is positive for a particular variant, this is not a diagnosis of active disease.

Invitae encourages customers to work with a healthcare professional when considering genetic testing and interpreting the results. Suggestions for next steps are offered with each report, and support from a genetic counselor is included in the price of each test.

Where to buy: Invitae offers its tests only through its own website or in partnership with healthcare providers.

Additional guidance available? Invitae includes support from genetic counselors in the price of its report and can provide your healthcare professional with a “next steps” guide based on the results of your specific test.

There are a number of direct-to-consumer genetic testing kits that promise to provide you with comprehensive information about your risks of various diseases.

Some of these tests are based more on ancestry than your genetic data, and others can only be ordered by healthcare professionals on your behalf. Before ordering, be sure to research what is included in your test and a bit about the company selling it.

There are not many direct-to-consumer tests that specifically check for BRCA mutations. 23andMe was the first, authorized by the Food and Drug Administration in 2018.

While these tests can provide valuable information, some concerns of using these tests include:

  • high error rates
  • whether the test has been validated by a medical professional
  • how many variants are included in the testing
  • how secure your personal and genetic information is kept

Can at-home genetic tests predict all forms of breast cancer?

No. BRCA1 and BRCA2 are just two specific types of gene variants that can lead to the development of breast cancer. There are many other types of variants that could cause breast cancer, as well as nongenetic causes.

Does a positive result mean I have cancer?

No. Even if you test positive for a BRCA1 and BRCA2 variant, you are not guaranteed to develop breast cancer. It only means that you carry a gene mutation that increases your lifetime risk of developing certain cancers.

Will my insurance pay for genetic testing?

Sometimes. Some insurance companies cover the cost of laboratory testing for inherited cancers. Some may also cover the cost of home test kits. Check with the company that provides the kit, as well as your insurance company, before ordering a test kit.

Genetics play a role in the development of a number of diseases, including breast cancer. Home testing for genetic diseases have become popular in the last few years, but these tests can still leave room for error.

Genetic testing for cancers and other conditions is best done in partnership with a medical professional who can counsel you on your individual risks and recommended next steps based on your results.