BRCA genes

Your body is made up of tiny building blocks called cells. Inside every cell is a set of genes. These genes are the instructions the cell needs to work properly. BRCA1 and BRCA2 are 2 different genes. Everyone has BRCA1 and BRCA2 genes.

BRCA1 and BRCA2 gene variants may cause a:

• higher-than-average risk of ovarian cancer
• slightly higher-than-average risk of pancreatic cancer.

And BRCA2 gene variants may also cause a higher-than-average risk of:

• prostate cancer
• breast cancer in men and people assigned male at birth.

Not everyone with a BRCA1 or BRCA2 variant has a history of cancer in their family. But a gene variant is more likely if there is a pattern of cancer in a family.

For example, in the family there may be:

• several people affected by breast cancer or ovarian cancer
• people diagnosed with breast cancer before the age of 50
• people diagnosed with triple negative breast cancer or high-grade serous ovarian cancer
• diagnosed with breast cancer
• someone who has had breast cancer in both breasts (bilateral breast cancer) or who has had breast and ovarian cancer.

Families from some ethnic groups are also more likely to carry a gene variant that increases the risk of breast and ovarian cancer. For example, this includes families from an Eastern European or Ashkenazi Jewish (Eastern European Jewish) background.

If you are worried about the pattern of cancer in your family, talk to your GP. If needed, they will refer you to a genetics specialist.

The specialist can give you more advice and information. They will explain whether genetic counselling or genetic testing is likely to be useful.

Depending on your cancer risk, your genetics specialist may offer you cancer screening. Screening uses tests to find cancer at an early stage when it can be treated most effectively. Your specialist will explain:

• which screening tests are useful for you
• when these tests should start
• how often you will need these tests.

Women, and people assigned female at birth, with a BRCA1 or BRCA2 variant are usually offered tests to look for early signs of breast cancer. We have more about breast screening in our information about inherited breast and ovarian cancer.

People with a BRCA1 or BRCA2 variant are not usually offered screening for ovarian or other cancers. This is because:

• regular screening tests cannot prevent these cancers
• there is no clear evidence that screening tests for these cancers can find a cancer early when it is more treatable.

Sometimes screening for other cancer types is offered as part of a clinical trial. Taking part in a clinical trial is your decision. Your doctor or nurse can explain whether a clinical trial is available and the possible risks and benefits of taking part.

There is no screening programme for prostate cancer in the UK. But men, and people assigned male at birth, with a BRCA1 or BRCA2 variant sometimes choose to have a blood test called the PSA test. This test can help diagnose early prostate cancer. Before you have the test, your GP or nurse will talk to you about the benefits and disadvantages of having it.

Cancer is more likely to be successfully treated if it is found at an early stage. Knowing what is normal for your body means you are more likely to recognise any changes that could be a sign of cancer. This means that if you develop cancer, it can be treated as early as possible.

We have more information about possible symptoms of:

• breast cancer
• breast cancer for men
• ovarian cancer
• prostate cancer.

We also have general information about the signs and symptoms of cancer that you may find helpful. Symptoms can be caused by things other than cancer. 

Always contact your GP if you have symptoms that are ongoing or unusual for you.

There may also be factors in your lifestyle that affect your cancer risk. There is not always clear evidence about how lifestyle factors affect cancer risk in people with a BRCA1 or BRCA2 variant. But there is strong evidence that a healthy lifestyle can improve your general health and well-being. 

Ask your genetics specialist for advice about your risks. Your healthcare team can give you more information about healthy living.

Not everyone with a BRCA1 or BRCA2 variant develops cancer. But it can be difficult to cope with the uncertainty of a higher cancer risk.

You may have questions about your family history, genetic testing and screening. Or you may be thinking about risk-reducing surgery or drugs. There may not always be clear answers. It is important to talk to your genetics specialist, GP or nurse. They will be happy to answer any questions you have.

There is no right or wrong way to cope. But help is there if you need it. If you are struggling to cope with a higher risk of cancer, talking about your feelings and worries may help. You may want to talk to a partner, family member or friend.

Macmillan is also here to support you. If you would like to talk, you can do the following:

• Call the Macmillan Support Line for free on 0808 808 00 00.
• Chat to our specialists online.
• Visit our BRCA positive forum to talk with people who have, or might have, a BRCA1 or BRCA2 gene variant. You can share your experience and ask an expert your questions.