Lower threshold means more Kiwi women will qualify for BRCA test

The NZ Breast Cancer Foundation congratulates Genetic Health Service NZ on its decision to lower the threshold for BRCA testing to people with an estimated 10% chance of having a BRCA gene mutation.

Until now, NZ has tested at the 20% threshold, lagging behind the recent shift to the 10% threshold in the UK and Australia. The BRCA mutation greatly increases a woman’s risk of breast or ovarian cancer, and has also been linked to pancreatic and other cancers. Depending on individual and family factors, women with the mutation have a 40-90% chance of developing breast cancer. Angelina Jolie was reportedly told her BRCA1 mutation gave her a 90% chance.

“The lower threshold will make genetic testing available to families who have previously missed out, despite being at significant risk of having the BRCA mutation,” said Dr Reena Ramsaroop, chair of the NZ Breast Cancer Foundation’s medical advisory committee.

While it will undoubtedly cost more to test at the lower threshold, a study undertaken by the NHS in the UK found that the benefits in terms of preventative treatment and better monitoring of at-risk people made testing cost-efficient at both a 10% and 5% threshold.

“It’s likely that the same cost-efficiencies would apply here in the long term,” said Dr Ramsaroop, “and in the meantime, more women will be accurately informed of their risk, and better able to make decisions on the best course of action for them and their families.” Dr Ramsaroop emphasised that counselling will remain an essential part of the Genetic Health Service offering. In addition, the NZ Breast Cancer Foundation’s free counselling service has been extended to include people who have tested positive for a BRCA mutation (www.nzbcf.org.nz/FreeCounselling).